Clause 34
Mental Health Bill [Lords]
10:30 am
Angela Browning (Deputy Chairman (Organising and Campaigning), Conservative Party; Tiverton and Honiton, Conservative)
It is my pleasure to open the debate. This part of the debate will be long—not only new clause 14, but clauses 34 and 35 are particularly lengthy—but I shall crystallise it. We tabled new clause 14 because there is a basic principle that the Government need to address and which relates to the prescription of treatment and the authorisation of medication by the second opinion approved doctor in advance of what might become a deteriorating situation some weeks or months later. We are concerned about that.
Clearly, the situation could be as simple as somebody refusing to take their medication at a later stage or disliking the side effects. Equally, however, there could be a very salient reason why the patient stops taking medication down the track—a physical occurrence such as a heart attack or something of that nature. It seems wrong that the criterion applied to the patient could be such that, although there might have been a change in circumstances since the initial assessment of why he or she needs a particular treatment or medication, the SOAD—the authorising doctor—may have decreed several months in advance that that treatment or medication must be given. No matter what the relevant circumstances, there would be compulsion, and the patient would be only too well aware of that. That seems wrong in principle.
Therefore, the rather lengthy new clause 14 would simplify the situation so that, when there was a significant change of circumstances, the patient would be reassessed based on those circumstances, and the piece of paper that the doctor had in his or her pocket stating what might happen down the track would not simply be dutifully applied. There would be proper consideration of the patient’s change of circumstances. That is the fundamental principle.
We think that that is helpful to the Government because it would not only encourage the application of best medical practice, but be in the patient’s interests. If the SOAD had the power to predetermine treatment two or three months before, but there had been a change in circumstances that he or she was unaware of, surely it would be in everybody’s interests for the patient to be reassessed at that point.
I suspect that the Minister may tell me that the fact that the doctor had that piece of paper in his or her pocket might encourage the patient to maintain treatment and medication, but the balancing argument is surely that the appropriateness of a treatment, whatever it may be, should be reassessed when there is a significant change in the patient’s circumstances.