Mental Health Bill [HL]

My Lords, that is a helpful intervention. My noble friend is right: nothing in the Bill requires a professional to act beyond their professional competence. A professional will not be able to make decisions about medication unless they are qualified to do so. I shall carry on in order to refer to two other aspects of the amendment. The noble Earl, Lord Howe, referred to concerns that, in effect, clinicians will be forced to err on the side of caution and make a patient subject to a CTO on discharge from hospital simply to cover their backs. With respect, if a responsible clinician is considering supervised community treatment, they must make the decision with reference to the criteria in the Bill and the guidance that we will provide on the application of those criteria. We have debated before the issue of trust in professionals when exercising their judgment to do so fairly, so surely it is right to expect responsible clinicians to exercise their judgment on the application of the criteria. We need to be very careful before we accept this caricature of how a supervised community treatment order might work in practice. I understand the points made by the noble Earl about aftercare—ACUS, as it is known—and his argument that this ought to be retained as a way in which supervised aftercare could be provided. However, the problems are twofold. First, it is clear that it has not been used because neither professionals nor patients have much confidence in it. We have evidence that it has not worked well. A study commissioned by my department in 2001 found that take-up was low, largely because it was seen as bureaucratic and lacking in the necessary powers. For instance, there are no powers to recall a patient to hospital for treatment. I also say to the noble Earl—and here I go back to our previous debate where clarity has been called for, particularly for the professionals who are going to have to operate the legislation—that to have two different systems for the management of mental disorder in the community would make it more difficult and confusing to clinicians in deciding which system is more appropriate for their patients. I fully accept that supervised community treatment is a compulsory regime and should not be taken lightly. I believe that the stringent criteria set out in the Bill and the safeguards built into supervised community treatment, along with the judgment of professionals, albeit guided by the code of practice, will ensure that the clear advantages offered by supervised community treatment will bring very worthwhile benefits to many patients now being detained in our hospitals. I therefore urge the noble Earl to reconsider his view.