COMMONS AMENDMENTS (Hansard, 7 November 1995)

The Earl of Courtown
My Lords, with the leave of the House I beg to move that the House do agree with the Commons in their Amendments 19 to 38 en bloc.
These amendments provide for communication with and intimation to informal carers and, in certain circumstances, the nearest relative. They provide that those who give informal care to the patient are informed of various stages in connection with a community care order—the making, renewal, or revocation of the order, variation of its conditions, change of special medical officer, or after-care officer, or re-assessment in hospital.
They also enable the responsible medical officer, or the special medical officer, or the after-care officer, as appropriate, to consult at these various stages with the patient's nearest relative where a patient has a history of violence, despite the patient's objections. The right to over-ride the patient's wish would allow those caring for a patient to obtain information from the nearest relative which might be essential to an assessment of the risk which the patient poses to himself or others. That is in the light of an amendment to the English provisions sponsored by the National Schizophrenia Fellowship.
These amendments ensure that the Scottish provisions are in line with the proposals for supervised discharge in England and Wales and I commend them to your Lordships.

Lord Campbell of Croy
My Lords, I should like again to lend my support to these amendments which very much follow what I was advocating at earlier stages of the Bill. I am grateful to the Government for taking this action.

§ Lord Carmichael of Kelvingrove
My Lords, I have no wish to detain the House and I am most grateful to the Minister for accepting some of the ideas put forward in amendments at earlier stages of the Bill. However, I should be failing in my duty if I did not comment on the meaning of the amendments, and my noble friend Lady Jay has already made some comments in this regard.
I have received correspondence from two organisations in Scotland which have been closely involved with this Bill. Have the Law Society of 1648 Scotland and the Scottish Association for Mental Health been consulted on the amendments? I realise that it is too late to do anything now. However, those organisations which have been closely and continuously involved with the legislation find that it is difficult to understand what will be the ultimate effect of the amendments. For example, the word "propensity" is used. What does that mean? When a community care order is being considered, will the relatives be involved?
I should be grateful if the Minister could clarify a few points in regard to the interpretation of the legislation. As I say, I have no intention of delaying the House but I should make these points.
For example, it had been assumed that community care orders were not for such patients who would qualify for continued detention under the Mental Health (Scotland) Act 1984 but for patients who were well, not considered a risk to society and who were made subject to the order in an attempt to keep them that way.
We can well understand the wish of relatives to be kept involved. It is the view of the Law Society of Scotland and the Scottish Association for Mental Health that relatives should be kept involved but it would be preferable if all nearest relatives were involved. That may be clumsy but I hope the Minister may be able to help with an explanation. That would fit in with the framework within the Mental Health (Scotland) Act and would not admit in legislation the possibility of violent or dangerous people being discharged into the community.
I am not an expert in these matters but I understand that with some relatives a patient may always be calm and reasonable, while with other relatives a breaking point may be reached. Therefore, it may be necessary to consider all rather than merely some relatives. Those views are shared by the Scottish Association for Mental Health and the Law Society of Scotland. I do not ask the Minister to give an answer now but perhaps he will reassure me that those points have been taken into consideration. If anything that I have said is really important and there is a misunderstanding, it may be that a minor amendment is needed to put that right.

§ The Earl of Mar and Kellie
My Lords, this group of amendments to the Scottish part of the Bill will allow the RMO, the SMO and the after-care officer to consult the nearest relative in a particular case where the patient has requested that that should not be done. It is wholly reasonable that the nearest relative should be informed when the patient has a history of violence or dangerous behaviour. Not to do so would be an infringement of the nearest relative's civil rights, not to mention being a breach of common sense.

The Earl of Courtown
My Lords, I thank the noble Lord, Lord Carmichael of Kelvingrove, for the matters that he raised. I shall try to answer some of them at this point. The two organisations to which the noble Lord referred—namely, the Law Society of Scotland and the Scottish Association for Mental Health—were initially consulted on the Bill. Both will be consulted on the drafting of the guidance which will be issued to clarify the amendments. In addition, so far as concerns the nearest relative, the Mental Welfare Commission will 1649 advise on the question of people who are informally involved in the care of the patient. All relevant individuals will be consulted.