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Mental Health Bill [Lords]

The amendment does not provide for that. All the safeguards that I have outlined cover the matter. We should not try to limit clinicians’ ability. Amendment No. 100, which would remove clause 30, is disturbing. Clause 30 requires the responsible clinician to consider supervised community treatment whenever longer-term leave is in view for a patient. If leave of absence for longer than seven days is given to a patient, the clinician should consider whether supervised community treatment is the most appropriate way forward. Anxieties have been expressed about the use of leave of absence when people remain under compulsion but are in the community. We want to ensure that clinicians consider whether supervised community treatment is appropriate so that such supervision exists in the community. Opposition Members would obviously prefer patients to go on leave in the community for long periods without the structure and safeguards of supervised community treatment to support them. That is not the best means of managing patients’ care and treatment. It is therefore unacceptable to try to limit the discretion that we are giving clinicians to determine what they do. That is the point: the powers give clinicians discretion; that does not mean that they have to act. Further amendments tabled by Opposition Members and by the hon. Member for Wyre Forest (Dr. Taylor) are designed to impose requirements about consultation. I certainly understand the concern, which was also raised by my hon. Friend the Member for Birmingham, Selly Oak (Lynne Jones). It is important for consultation to take place, but I would draw the attention of hon. Members to the statement of matters that should be considered when we are talking about principles in the code of practice—and that includes the involvement of patients in planning, developing and delivering care and the treatment appropriate to them. We believe that that principle should be at the heart of how the Bill is delivered. I am afraid, however, that there are issues of confidentiality. It is true that there will be occasions in which it is not necessarily right to consult a range of people as the amendments suggest. It has to be the patient’s right to say who they would or would not like to be consulted, and it would be extremely difficult for us to dictate that from here. These are matters for the code of practice, and I am quite prepared to look further into it and see whether it needs to be strengthened by pointing out that we want consultation. I will look again at that, and I will consult both my hon. Friends and other hon. Members in doing so. Other amendments were tabled by my hon. Friend the Member for Hendon (Mr. Dismore) and the hon. Member for Oxford, West and Abingdon (Dr. Harris). For example, amendment No. 79 would provide a power for the tribunal to"““remove or vary any condition””" relating to the patient’s behaviour. Let me explain that we see CTOs operating through clinicians talking with patients about the conditions that would be contained within a supervised community treatment order. If the patient turns around from the word go and says that there is no way that he is going to accept any of it, supervised community treatment will not work. It is all about a partnership between patient and clinician—but with the knowledge that if things go wrong, clinicians have the ability to bring someone back into hospital. They do not have to do so. If the patient says that he is not taking his medication because he believes it to be too strong and regards the side-effects as unacceptable, the clinician can say, ““Well, let’s try something else.”” It does not automatically mean that an individual has to come back into the hospital setting. It is, as I say, about a partnership. I recognise the concerns in all these issues about the conditions of supervised community treatment. That is why we are bringing forward some substantial amendments, which place the focus firmly on the purpose of conditions and remove altogether from the Bill the examples of conditions that could be set for a patient. These put beyond doubt the fact that the conditions must be about either ensuring that the patient receives treatment, or preventing harm to the patient or others. That means that we have responded to the concerns brought forward in Committee and in the other place and made it absolutely clear what the conditions are about. Given that we have tabled these amendments to the conditions—[Interruption.]