Mental Health Bill [HL]

moved Amendment No. 20: 20: Clause 14 , page 9, line 44, at end insert— ““““care plan”” means a structured plan which sets out timescales, responsibilities and services required to meet a patient’s assessed mental health needs;””.”” The noble Lord said: My Lords, I shall also speak to Amendments Nos. 43 and 53. These are revised versions of my amendments in Committee. As I have removed that part of the original draft which I sense was the real sticking point for Ministers—although it was a dog that did not bark in our debates in this House—I hope that we can now reach an agreement to provide the 1983 Act with a lever that helps implement the Government’s admirable policy on care planning and risk assessment for detained patients. The amendments have been shorn of the provisions presented in Committee whereby the mental health review tribunal could choose to discharge a patient on the grounds that its care plan was not being implemented. It may be that those clauses could have been interpreted as a new criterion for discharge. I believe that the existing criteria are sufficient. Tribunals are empowered to discharge patients where the need for continued compulsion cannot be demonstrated, and that probably encompasses all the situations I had in mind anyway. That leaves us with a proposed duty on services to provide a comprehensive care plan to all patients detained in hospital or leaving hospital under a community treatment order. There would be a statutory duty to consult nearest relatives, carers and patients themselves in drawing up this plan where it was appropriate to do so. I will not bore the House by reiterating the current failings—and there are many—in the implementation of the care programme approach, or by stressing the consensus in Committee that care planning under such a scheme, if implemented properly, would be the cornerstone of good, humane and safe mental health services. I will simply address the Minister’s objection in our previous debate that, "““giving the CPA statutory force would require legislation to be so widely drafted as to be meaningless””.—[Official Report, 15/01/07; col. 536.]" I do not accept that the amendment before us today is meaningless or that it could not have any effect on services. Indeed, I do not accept that the current Act’s provisions on planning for aftercare under Section 117 are meaningless, although they impose broadly drafted duties on health and social care authorities. Neither would I accept that Section 132 was meaningless, although it requires hospitals to provide information to patients and relatives in broadly drafted terms. Anyone working with the current Act during its time on the statute book would accept that such examples of broadly drafted duties have had some effect in changing professional behaviour and improving the service to patients and carers. Where services provided to patients and carers fall short of those requirements, their basis in law is an important lever to improve such services. It is a lever used by patients, carers and monitoring bodies. Of course, I speak as the chairman of the Mental Health Act Commission and must declare that as an interest. I entirely agree with the Government's position that detailed guidance on care planning should be established in the code of practice, but nothing in the amendment would change that. I also agree that it would be counterproductive to establish statutory duties that required care plans in addition to those required by the care programme approach, thus creating a bureaucratic burden on services, but nothing in the amendment would do that either. The amendment would simply place on services the statutory duty to do something that a great number of them fail to do at present: to provide patients with a decent care plan. It is government policy that they should do so and I cannot see why that should not be a legal requirement. I beg to move.