Clause 55.—(REGULATIONS FOR PURPOSES OF PART IV.) (Hansard, 5 May 1959)

§ The Minister of Health (Mr. Derek Walker-Smith)
I beg to move, in page 38, line 3, to leave out "and" and to insert: to furnish or make available to those patients, and their relatives, such written statements of their rights and powers under this Act as may be so prescribed We had an interesting discussion in Standing Committee on the important matter of communicating in simple language relevant information about rights, procedures, and so on, to patients and their nearest relatives. I said in the Committee that this was right in principle and that the appropriate method would be to include such information in the sort of pamphlets which hospitals send out for the guidance of patients and their relatives on various matters of procedure and other interests. The Amendment gives effect to the undertaking which I gave on that point. I said then that it was my intention to ensure by administrative means that the hospital authorities and the local health authorities should supply this information, but that, if necessary, a statutory requirement could be imposed in the regulations under Clause 55.
In reply to my hon. Friend the Member for Ilford, North (Mr. Iremonger), I said that if the Clause as drafted was not wide enough to enable those regulations to be made, we could widen the scope. The Amendment is designed to ensure that the Minister will have the power to make such regulations if it proves 227 necessary to impose a statutory requirement, but I would still think it probably right to proceed in the first instance by administrative means.

§ Mr. A. Blenkinsop (Newcastle-upon-Tyne, East)
I merely want to thank the Minister for introducing the proposal which was originally raised by the hon. Member for Ilford, North (Mr. Iremonger) and my hon. Friend the Member for Liverpool, Exchange (Mrs. Braddock). We should like to have the opportunity of considering the form of the explanatory notes. We realise that these proposals will come under the negative Resolution procedure applying to an Order in the House but, as they will come in the form of such an Order which can only be prayed against, I should like to know whether the Minister would take some steps to ensure that there is consideration of the form of the notes before that Order is placed before the House.
That might enable some slight changes to be made if they were thought to be desirable. Otherwise, we shall not he able to amend the form of the notes. We would all be anxious that they should be in the simplest language possible for people to follow.

§ Mr. T. L. Iremonger (Ilford, North)
If the point made by the hon. Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop) were followed up it would be extremely helpful. We were concerned about it in Committee. If there is one thing that Members of Parliament should be authorities upon it is making people understand what they mean. I should like to thank my right hon. and learned Friend for being so helpful on this matter today, as, indeed, he was when I moved an Amendment in Committee. This proposal will be of enormous benefit to the general public and to those concerned with administering the Bill when it becomes an Act.

§ Mrs. E. M. Braddock (Liverpool, Exchange)
I should like to thank the Minister for responding to the debate in Committee. I hope that when these notes are issued to patients there will be nothing in them to differentiate them from those received by ordinary patients in hospital. It would be very difficult if specific and separate documents were 228 issued to patients suffering from mental illness, who were detained for treatment and to their relatives. I hope that these documents will be prepared in such a form that they can be issued to any patient in hospital.

§ Mr. Walker-Smith
I am obliged to my hon. Friend the Member for Ilford, North, the hon. Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop) and the hon. Lady the Member for Liverpool, Exchange (Mrs. Braddock) for what they have said about my action in this matter. We have very much in mind the point made by the hon. Lady, which we also discussed in Committee. It is, of course, of the first importance that what we do should be done in such a way as not to seem to emphasise a distinction which we are all anxious not to make.
We are concerned with two things. First, there are the regulations which are the subject matter of the Amendment; and, secondly, there is the form of words which will go into the pamphlets issued by the hospital authorities. I am quite ready to co-operate on both, but I think that it is really the latter, which is the extra-Parliamentary thing, in which the right hon. Gentleman is most interested, that is, to see that the information and guidance gets over to the patients and relatives in the most simple language that will be most easily understood. On that, I should be very glad of any help that he or any other hon. Member can give me when the time comes.

§ Mr. Blenkinsop
The right hon. and learned Gentleman will understand that, to some extent, the one affects the other. Clearly, if the regulations are very complicated or long, it will almost inevitably make the notes themselves rather more difficult to follow.

§ Mr. Walker-Smith
I understand that, but I believe that the regulations will be neither complicated nor long, because they will be permissive regulations merely to make it clear that the Minister has the power to require this to be done. This is to be done if, contrary to my present expectation, there is any necessity so to require it, but I think that we shall deal with this quite happily and conveniently by the ordinary administrative means.

§ Mr. Walker-Smith
I beg to move in page 38, line 3, at the end to insert: (d) for the constitution of committees to advise local health authorities as to the approval of medical practitioners for the purposes of section twenty-eight of this Act and for prohibiting the grant of such approval except on the advice of such committees. The origin of this Amendment was a discussion held in Committee and reported in the OFFICIAL REPORT, Standing Committee E, in cols. 329 to 333, dealing with provisions under Clause 28 (2). This is the Clause which prescribes the medical recommendations required in respect of compulsory admission. Subsection (2) provides that one such recommendation must be given by a practitioner who is approved by the local health authority as having special experience in the diagnosis and treatment of mental disorders.
I resisted in Committee the suggestion made, at one time, that approval should be taken out of the hands of the local health authorities, but, in so doing, I said that I was attracted by the suggestion of the Royal Medico-Psychological Association that, in approving medical practitioners, local health authorities should act on the advice of joint committees composed of medical representatives of local health authorities, on the one hand, and hospital staffs, on the other.
The constitution of these committees will, of course, have to vary. To take an obvious example, teaching hospital representatives would be on the committees in some areas but not in other areas where there are no teaching hospitals. I therefore proposed that the constitution of the committees should be prescribed by regulation, and I undertook to introduce the power to make such regulations either in Clause 55, which we are dealing with now, or in Clause 28. This Amendment is designed to implement that undertaking.

§ Mr. Kenneth Robinson (St. Pancras, North)
The right hon. and learned Gentleman will recall that in Committee I dissented from the original suggestion that it should be left to the local health authorities to put the seal of their approval on psychiatrists for the purpose of this Clause of the Bill. I am glad that the Minister felt it possible to go so far as the setting up of these joint committees as recommended by the Royal 230 Medico-Psychological Association, and I think that we shall find this to be a satisfactory solution of the problem.
Will the right hon. and learned Gentleman say a little more about the form that the committees will take? I quite understand that they will have to vary from area to area. First, will they be based on local health authority areas or on hospital regional areas; and, secondly, is it intended that all the members of these committees should be medical members and that approximately the local health authority members should balance the regional hospital board members on the committees?

§ Mr. Walker-Smith
My present thinking is that the committees would probably be based on local health authority areas, but if it should prove more convenient to deal with it the other way I would not see any insuperable bar thereto.
It is designed that these should be medical committees. As I have said, the intention is that there should be medical guidance for what is, in effect, a professional matter. As to whether there should be an exact balance, I think that we should leave that flexible because, as I explained in a rather different context, there are so many varying considerations. In some cases, although not in others, we shall have the three elements—the local health authority representatives, the regional hospital board representatives and the teaching hospital board representatives. Therefore, I do not think we can say in any one formula just what will happen. We shall have to leave it a little flexible. If the purpose of the hon. Gentleman is that we should try to get a balance and fair representation between the local side and the hospital side, I very much sympathise with that point of view.

§ Dr. Donald Johnson (Carlisle)
I should like to say a word of appreciation to my right hon. and learned Friend for putting down this Amendment. Although there are changes in the Bill and in the general arrangements, the quality and prestige of the service depend very much on the recommending—I hope that he will not call them certifying—doctors, whose form can really be judged only by those in the hospitals who are at the receiving end of the business. I am sure that it will be of immense help that they are able to express their opinion on this 231 matter, which they have had difficulty in doing hitherto.