Clause 32
Mental Health Bill [Lords]
2:30 pm
Ann Winterton (Congleton, Conservative)
The amendments deal with important issues. They seek to protect children and safeguard their treatment, which is an honourable intention, but we do not feel that they will achieve it. It might be helpful if I put the matter in context. We expect very few people to be suitable for supervised community treatment. As hon. Members know, only patients detained for treatment under the Act will be eligible for SCT. Consequently, it will be available only to the small number of children detained.
Even then, most children will not be eligible, because SCT will not be necessary to ensure that they get the treatment they need in the community when they leave hospital. For example, many children will live at home with parents, who can ensure that their daughter or son continues with key treatment in the community if that is necessary to keep the child well. Equally, the home can provide a safe environment for a child to live without endangering themselves or others. For many children, SCT will not be necessary, and if it is not necessary, it is not permitted.
That said, the Government do not think it right to prevent children under 16 from benefiting from SCT altogether, as amendment No. 63 would. SCT is designed to allow patients to be treated in an environment of minimum restriction according to their individual needs and circumstances. It will allow some patients who would previously have been detained to spend less time in hospital and more time at home with their families, an increase in freedom from which children as well as adults must be able to benefit. If we choose an arbitrary cut-off point of 16 to decide who is or is not eligible, we risk discriminating against children under that age when SCT could bring real benefits. That approach would risk contravening European human rights law.
The review of CTOs internationally covered children and young people. It covered CTOs throughout the world, many of which have no lower age limit and included children and young people. Ruling out SCT for children under 16 years old will fundamentally fail to protect them. It would be an unnecessary restriction. If that is what clinicians believe is right for a child and it might mean that a child could return to a home environment, it is important that we accept that it might be best for an individual child. To rule it out completely would be wrong. It would not force anyone to make a CTO on a child if it were not appropriate for that individual.
The hon. Member for East Worthing and Shoreham was right to say that we need to provide very good guidance to practitioners when treating children under the new provisions. We must make sure that we cover the special needs and circumstances of children. My officials have therefore invited experts in such matters, including the children’s commissioner, to work with us on the code of practice.
As I have said, we do not accept amendment No. 65, but that does not mean that we underestimate the vital role that parents can and should play in decisions that are made about what treatment their child should receive. However, the amendment goes too far because it would allow parents to veto treatment on behalf of a child who lacks competence to consent to treatment. It would be inconsistent with the approach taken under the Act. If a clinician’s view is that treatment needs to be provided to a child, for parents to have a veto over that would make it inconsistent with the general working of the Act.