Speeches by Evans.

“Clause 11 will introduce new section 56A into the Mental Health Act 1983. The clause represents an important reform to the framework for how treatment decisions are made to detain patients under part IV of the Act. The clause effectively establishes a statutory clinical checklist. It imposes a duty on the approved clin…”

“The hon. Lady points to the fact that the police are named, as they should be. Imagine if we took out the police completely—whowould then have the power to restrain, restrict and detain people under the Mental Health Act? That is the whole point of having the provision. What we are trying to do is refine and constrict …”

“The hon. Lady makes an excellent point. This is especially relevant when capacity fluctuates in some patients, which we expect to see more often with the kind of dementia that will potentially come forward —for example, some of the new illicit drugs that are available can cause significant problems. Does she agree that…”

“I cannot resist the opportunity to probe the Minister on something so important. He said that NHS England will predominantly look at this, but changes are happening there. Will he ensure that Gillick competence and the assessment of capacity will be at the heart of this? It is unclear now, given that it will take two y…”

“Clause 20 addresses a central principle in healthcare, ethics and law: the right of individuals to make informed decisions about their treatment, and the conditions under which that right can be overridden. Let me begin by recognising the objective of clause 20 as both important and welcome. It replaces the outdated an…”

“I welcome the Government’s recognition that modern technology can play a valuable role in improving care in the mental health system. The move to allow remote interviews and examinations for second opinion appointed doctors, through live audio or video links, reflects the realities of healthcare today and the potential…”

“The clause will amend section 61 of the Mental Health Act 1983 on the review and treatment of detained patients. The 1983 Act requires approved clinicians to provide reports on the treatment and condition of detained patients, particularly where patients do not consent to treatment. Those reports are integral to the sc…”

“I rise to speak to clauses 15, 17 and 18 and Liberal Democrat amendment 13. Clause 15 will amend section 58A of the Mental Health Act 1983 in regard to ECT. It is worth understanding the law as it stands. At present, if a patient lacks capacity to consent to ECT, treatment may be administered only if a second opinion a…”

“I am frantically trying to find the exact point in the explanatory notes—I think it is in either paragraph 114 or paragraph 115—about where the second opinion comes together. There is a reference to having a combined certificate. That seems to be a practical solution, but I worry about the crossover relating to who may…”

“I would be grateful if the Minister could comment on the certificates being combined. There is a concern, if we go from two certificates to one, that the reason why two certificates were chosen in the first place could be lost, especially if the certificates are competing. There could be an incumbent preponderance towa…”

“I am grateful for the opportunity to scrutinise clauses 13 and 14. Clause 13 will make significant amendments to how medical treatment is administered under the Mental Health Act 1983 in circumstances in which a patient refuses, or is deemed to have refused, that treatment. The clause points us to significant questions…”

“You have actually caught me at a perfect point, Mr Vickers. The concept of therapeutic benefit is central to the second opinion doctor’s assessment. However, in clinical practice, interpretations of therapeutic benefit can vary considerably. How do the Government propose to ensure consistency and fairness in such asses…”

“Forgive me, Mr Vickers; I will get to the point a little more briefly, but the whole point is that the person has to be appointed through the CQC. The CQC will make that decision, because by definition it is the body that makes such decisions. If it is not resourced properly or if it has problems, regulatory or otherwi…”

“My hon. Friend makes an incredibly important point. We heard on day one how these services interact, and that is completely correct. We need to look through the lens of public safety, because while we are quite rightly enshrining the autonomous nature of the patient as an individual, there is also the question of what …”

“The Minister makes an excellent point, and that is part of the reason why the Opposition did not want to spring this question on the Government in an amendment or a vote, but rather to have the conversation first, because this is an important clause to get right. The two sides can be worked on in parallel when consider…”

“I appreciate the hon. Lady’s insight, both as a politician and as a patient. I guess the Opposition are concerned that there is no explicit duty here, which is why legislating for that is so important. There was a huge number of inquiries about the case from 2011. There have been sufficient changes, but in 2023, as we …”

“I am grateful for the opportunity to speak to clause 10, which addresses the nomination of the responsible clinician under the Mental Health Act. As we have heard, the responsible clinician is a pivotal figure in the operation of the Act, holding substantial legal powers in relation to detention, treatment and discharg…”

“I appreciate the answer that the Minister gave, but we would like to probe the opinion of the Committee, given the principles that are enshrined in the Bill and childhood trauma is an example of something with a causal factor. Amendment proposed: 44, in clause 8, page 15, line 17, at end insert— “(iii) seeks to minimis…”

“I think I see where the Minister is coming from, but to take the example that he chose last time we spoke about this, there could be someone with a severe eating disorder. At the moment, there are in-patients with an eating disorder whose care is seen as palliative. Part of the problem lies in how we decide what is a r…”

“There are a few questions to be answered. Given the nature of acquired brain injury—for example, the capacity of someone who has had a stroke can fluctuate—it is very hard from a clinical position to know where the benefit of treatment starts or finishes. We must future-proof the Bill. We have an ageing population, so …”