New Clause.—(DUTY OF MENTAL WELFARE OFFICER TO MAKE APPLICATION FOR ADMISSION OR GUARDIANSHIP.) (Hansard, 5 May 1959)

§ Mr. Walker-Smith
I beg to move, That the Clause be read a Second time.
This Clause, which I am commending to the House, would make it the duty of mental welfare officers to make applications for the admission of patients to hospital or guardianship under Part IV of the Bill. For this duty to arise under this Clause, they must, first, be satisfied that an application ought to be made, and, secondly, have regard to the wishes of the patient's relatives and other relevant circumstances before coming to the conclusion that it is necessary or proper for them to make the application.
The position under the Bill is this. Clauses 25, 26, 29 and 33 as drafted empower mental welfare officers and the patient's nearest relatives—or under Clause 29, which is the emergency procedure provision, any relative—to make an application, but impose no obligation to do so even when the circumstances in which compulsory admission is permitted are fulfilled. 4.0 p.m.
Under the existing legislation which is repealed by the Bill there is an obligation under the mental deficiency side of the 232 present code; for example, the Mental Deficiency Acts lay on the local health authorities a duty to ascertain the defectives in their area and, if necessary, to take steps for their admission to hospital or guardianship. That obtains under paragraphs (a) and (b) of Section 30 of the Mental Deficiency Act, 1913. Turning to the other code under the Lunacy and Mental Treatment Acts, Sections 14 and 15 of the Lunacy Act of 1890 require the duly authorised officer of the local health authority to apply for an order for the admission to hospital of persons of unsound mind whenever the officer is satisfied that the conditions described in these Sections are fulfilled. So we have a duty to that extent obtaining under the present law.
There has been some criticism of the Bill from the Society of Mental Welfare Officers among others that in the absence of any similar duty on anybody to take action under Part IV of the Bill there is a danger that same patients who need treatment or care might conceivably be overlooked. The effect of this proposed Clause is to repair that omission, while leaving it, as at present under the Lunacy Acts, within the discretion of the individual officer to form his own judgment that the application ought to be made.
In effect, this puts the mental welfare officer in the position of having an obligation to attend to these matters. It is stronger than a simple permissive power would be, but it leaves the decision in each individual case to his own judgment, which must be right. I therefore hope that the proposed Clause, repairing this omission and conferring this degree of duty, will commend itself to the House.

§ Dr. Edith Summerskill (Warrington)
I agree with the Minister. It is rather curious that in a Bill so carefully drafted as this one there should be this omission. It would mean that if, under Clause 29, a mental welfare officer was reluctant or hesitant to do his duty, or the relatives of the patient did not face their obligations, no action would be taken. I endorse the Minister's compliment to the Society of Mental Welfare Officers on their approach to this Bill. The little memorandum they produced was most constructive, very responsible, and showed that this point had been overlooked by us. I am sure that the whole House will welcome this Clause.

§ Mr. R. W. Sorensen (Leyton)
May I ask a question on the penultimate line of subsection (1), which reads …having regard to the wishes of any relatives …"? Has that to be taken as an insistence that relatives must be consulted in this matter? In the course of his remarks the Minister referred to this obliquely, but may I have an assurance that those words can be construed as imposing upon the officer the necessity always to consult the relatives, and that he could not act otherwise?

§ Mr. K. Robinson
Would he Minister also say a word about an undertaking he gave in this connection in Committee, in response to an Amendment I moved intending to place a duty on the mental welfare officer to take action in such cases where the two medical recommendations required by Part IV were forthcoming? In response, the right hon and learned Gentleman quoted at column 324 a paragraph in the Report of the Royal Commission on the Law relating to Mental Illness and Mental Deficiency and then commented that the Amendment was rather wide, but that the recommendations of the Royal Medico-Psychological Association were confined to suicidal and homicidal cases. He then said that he would think about the matter in the light of these considerations. I wonder what conclusion the right hon. and learned Gentleman reached on this point, which would be perhaps an extension of the duty he is now placing for the first time on the mental welfare officer.

§ Mr. Walker-Smith
If I have the leave of the House to reply to the point raised by the hon. Gentleman the Member for St. Pancras, North (Mr. K. Robinson), it is a fact that I put before the Standing Committee the two opposed considerations which I thought would work in the context of his suggestion. I said then: On the one hand, we have the view that the mental welfare officer is or may be unqualified and that therefore his view should not prevail against the united view of the two medical practitioners. On the other hand, we have the fact that he is a responsible officer dealing with these matters and it would obviously he wrong to put him in the position of being a mere rubber stamp."—[OFFICIAL REPORT, Standing Committee E, 3rd March, 1959; c. 323 and 324.] I have thought more about this point, as l said I would. I have come to the conclusion, from which I think the House would not dissent—especially bearing in 234 mind the tribute quite properly paid by the right hon. Lady the Member for Warrington (Dr. Summerskill) to these gentlemen—that it would be wrong to adopt a course which would have inevitably the appearance of making them, in certain circumstances at any rate, a mere rubber stamp. So, for that reason, the Clause takes the form it does, and does not go the length which the hon. Gentleman had in mind at that time.
On the point raised by the hon. Gentleman the Member for Leyton (Mr. Sorensen), the degree of consultation required, and the statutory provision in respect thereof, is set out in Clause 27 of the Bill. This proposed procedure does not change nor abrogate from those provisions. It is in this Clause to draw attention to the statutory position under Clause 27.

§ Mr. Leslie Hale (Oldham, West)
Apparently, this also applies to admissions under Clause 25, although it provides certain limitations under Clause 27, for obvious reasons. Does the mental welfare officer have to say for what purpose he is recommending the admission, and whether it should be under Clause 25 or Clause 26, or is it left at large?

§ Mr. Walker-Smith
The position is precisely the same as spelled out in Part IV. This proposed Clause merely puts an added obligation on the mental welfare officer. It does not change the procedural steps which must precede an application, whether it be for observation under Clause 25 or whether it be for treatment. Those procedural steps, and all the carefully balanced safeguards with which the hon. Gentleman is so familiar, stand in respect of an application by the mental welfare officer, whether it be under this Clause or any other.

§ Mr. Hale
That I appreciate and accept and agree. What I am wondering is whether, as the Government are providing what the mental welfare officer must say on the form on which he recommends admission, he ought not also have to say, "For the moment I am only recommending, under Clause 25, that there shall be two medical practitioners to follow who need not be fully qualified under Clause 26."

§ Mr. Walker-Smith
It will be clear as to which procedure he is proceeding 235 under, whether it is an application for admission for observation or for treatment. It is important that this distinction is always kept in view.