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Section 54 — Measures that may be authorised

Part of Mental Health (Care and Treatment) (Scotland) Bill: Stage 3 – in the Scottish Parliament at 12:15 pm on 19th March 2003.

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Photo of Adam Ingram Adam Ingram Scottish National Party 12:15 pm, 19th March 2003

It is with pleasure that I speak to amendment 114, given that I lodged a similar amendment at stage 2. My amendment was defeated only by the convener's casting vote.

As Mary Scanlon said, amendment 114 has widespread support in the mental health community. It would allow tribunals to exclude particular treatments from being given to patients who are subject to CTOs, while allowing the tribunal to make a general treatment authority subject to such exclusions or limitations as it might consider to be appropriate.

Such powers would be in line with the Millan committee's proposal that compulsory intervention should be tailored to the individual patient's needs. If the patient had concerns about a particular type of treatment, the tribunal could take those concerns into account before it decided whether to approve the plan of care. The implication of the proposal is that if an individual has a strong wish not to have a particular treatment, such as ECT, the tribunal could take that into account. That would allow the tribunal to exclude such treatments from being given.

Through experience over time, service users become knowledgeable about treatments that work for them and others that are so distressing that they would not wish to accept them under any circumstances regardless of any benefit that professionals might claim they will have. Too often, professionals dismiss those wishes in what is often regarded by recipients as an arrogant and patronising way on the grounds that the recipient lacks insight into their condition. The bill will reinforce that approach.

As Mary Scanlon said, the effect of section 54(1)(b) as drafted would give the tribunal a blunt choice. It would have to decide whether to grant or refuse a general authority for treatment in accordance with part 13. I suspect that few, if any, CTOs will be refused and that many people will thus be forced to endure unnecessary ordeals during treatment. A more humane, sophisticated and flexible regime is called for and I call on members to support amendment 114.

I also refer to the minister's earlier arguments calling for the tribunal to have flexibility. I suggest that this is a clear case for consistency.