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Mental Health Bill [HL]

Amendments Nos. 33 and 33A both address how local services work together to ensure patients’ safe and efficient admission to hospital, including patients requiring urgent admission. Amendment No. 33 concerns the responsibility for conveying to hospital a patient who is admitted under the Mental Health Act. The Bill leaves that responsibility with the person who made the application for the patient’s admission. That will almost always be an approved social worker or, in future, the AMHP. Amendment No. 33 would transfer responsibility for conveying the patient to hospital from the AMHP and place it with the NHS trust or someone authorised by the trust that contains the hospital to which the AMHP has made the application for admission. Currently, a patient for whom an application has been made is the responsibility of a named individual—the ASW—until they are admitted to a hospital. The Bill places accountability with another named individual, the AMHP. However, if we place the responsibility for conveying a patient with an NHS trust, we lose that individual responsibility and I fear that it will become more likely that a patient will not be safely conveyed to hospital, although I recognise the concerns expressed by the noble Earl, Lord Howe, about the responsibility placed on the ASWs. That does not seem desirable when the system that we have now better ensures the patient’s safe passage to hospital. Any problem with the trust’s processes that results in a failure to ensure the patient’s proper conveyance could place the patient or others at risk of harm or neglect. It is therefore essential that we ensure a robust system with clear lines of personal accountability, which is what the Bill provides for in the form of an AMHP. The skills that an AMHP brings will be well suited to the job of conveying a patient in the least distressing manner, rooted as they are in a holistic perspective of patients’ needs. AMHPs will be highly trained in their role. The AMHP attends the patient to assess them before making the application, so they are normally already with the patient and should have already established a relationship with the patient. If the responsibility for conveying the patient lies with the trust-appointed person, there may be delays in identifying that person and waiting for them to arrive.