Mental Capacity (Amendment) Bill [Lords] — House of Commons, 2018-12-18
Topic: Health
Maria Colette Caulfield (Conservative, Centre-right): Let me start by welcoming the Second Reading of the Bill and by declaring an interest as a registered nurse who has used the current legislation in clinical practice. I therefore welcome the provisions in the Bill, which amend and reform the current legislation The Mental Capacity Act 2005 was a groundbreaking piece of legislation, which, for the first time, provided safeguards not just for those without capacity, to enable decisions to be made about their care, but for healthcare professionals, families and friends who were having to make the most difficult decisions in the most difficult circumstances In terms of the deprivation of liberty aspects of the legislation, there is no doubt that, after 10 years, reform is urgently needed. The DoL system has become too cumbersome and too bureaucratic, and it is not responsive enough to patients’ changing needs. I therefore fully support the Law Commission’s report last year, which recommended that DoL be repealed and replaced. The Bill delivers those reforms There was a huge amount of debate in the House of Lords, and many amendments were tabled. The Government were in listening mode and accepted many of those amendments. Therefore, it is disappointing to see the Opposition amendment before us today, which simply states that we should decline to give the Bill a Second Reading. There will be plenty of opportunities in Committee and on Report for Members to lay down amendments about the concerns they have. This is such a serious issue, and there is such a backlog of cases; we are talking about the most vulnerable people in our society, and to leave them waiting for assessment or languishing with a DoL system in place that is clearly not working—we have a huge body of evidence that shows that—is irresponsible. If Opposition Members have concerns—many of them have raised genuine concerns today—I urge them to table amendments to address them, and not simply to reject Second Reading out of hand At the Lord’s Committee stage, concerns were raised, and the Bill has been amended accordingly. There are four measures, in particular, that I welcome. First, the scope of the Bill was extended to 16 and 17-year-olds. That is a welcome move, which will ensure that they are covered by the new legislation. In addition, I welcome the fact that family and friends will be able to trigger a review if there is an objection. That possibility does not exist in the current legislation. I also welcome the fact that the person we are discussing will be part of the consultation. Although they cannot make an informed choice, because they lack capacity, it is important to continue that dialogue with them, because they are the most important people in the whole process. I welcome the introduction of safeguards in relation to conflicts of interest and care home providers undertaking assessments. That was recognised as a genuine concern and the Bill has been amended as a result I still have a concern about independent hospitals. It would have been helpful if Opposition Members had tabled an amendment to reflect that concern. We want to ensure that the proposed legislation covers patients who move between various sectors—independent hospitals, care homes or NHS hospitals—in all scenarios. There is a feeling that there is a gap that still needs to be bridged and perhaps that could be considered in Committee I want to make a final point, Madam Deputy Speaker, on what I know is not the responsibility of UK Government Ministers. I sit on the Northern Ireland Affairs Committee. Only last week, the Committee heard evidence from mental health professionals about people who lack capacity in Northern Ireland. There is actually no legislation in Northern Ireland, compared to the rest of the UK, on mental capacity. While there is no Northern Ireland Assembly and no Northern Ireland health Minister, that will remain the case. It is a huge concern that while UK Ministers are amending current legislation to make it more adaptable and responsive to patients’ needs, vulnerable patients in Northern Ireland have no legislation to cover them. There are healthcare professionals working in Northern Ireland who do not have safeguards to protect them. I urge Ministers to have discussions with the Northern Ireland Office and Northern Ireland Ministers to see whether something can be done until the Northern Ireland Assembly is up and running As a healthcare professional who has used the existing legislation, I am encouraged by the changes proposed in the Bill. I welcome the reform of the legislation to protect the most vulnerable, to protect healthcare workers in that setting, and to protect family and friends. I welcome further debate in Committee.