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Mental Health Bill [HL]

I rise to support this amendment. In particular, I want to speak about the second-opinion appointed doctor role. There was, no doubt, quite a lot of resentment from psychiatrists back in 1983, on hearing that their opinions would be questioned by other psychiatrists imposed upon them at a certain point in a person’s treatment. This led, at first, to the second-opinion doctor being a rubber-stamping exercise. People would come in, without always arriving when you were on the ward or with your patient, and left their opinion after a brief consultation merely by giving a certificate. They did not have to express a view at all. As we have heard, case law has established that this is no longer acceptable. The Mental Health Act Commission have pressed for years—since the 1983 Act—for this to be a proper second opinion. It has become recognised that this is now much more like a realistic second opinion. We owe it to patients to make this a system of realistic second opinion. It is surprising how many times patients have said that they did not know that it was a second-opinion doctor who had come to give an opinion, so I want to add my support to this particular part of the amendment. The other part, about taking account of patients' wishes, seems to me very closely related to an amendment that we will soon reach—Amendment No. 21, I think—on advance directives. That is a lesser but equally important element of taking account of what patients say. All we are asking doctors to do is what they would do anyway if they were practising properly: to listen to patients and write down their express wishes. That, coupled with the second opinion being a proper opinion, written down properly so that it can be discussed with the patient, seems to me absolutely fair and reasonable. I cannot think how that would add to the expense of the services. It would go a small way to give patients a reasonable second opinion service.