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Department of Health consultation on the draft revised Mental Heath Act 1983 Code of Practice

25 January 2008

Response of the British Medical Association

Introduction
The British Medical Association (BMA) would like to take this opportunity to respond to the consultation on the draft revised Mental Health Act 1983 Code of Practice and to outline the views of the members whom this will effect. The BMA is an independent trade union and voluntary professional association which represents doctors from all branches of medicine in the UK.

Our response includes input from all the relevant BMA committees including its Psychiatric Subcommittee, the General Practitioners Committee, the Committee on Community Care and the Ethics Committee.

The BMA welcomes the introduction of a revised Code of Practice that is readable and accessible to those who work with patients with mental health problems in addition to those people with mental health problems and their families. The innovative use of flow charts in the draft Code is a helpful addition and the case examples quoted in Chapter 4, ‘Assessment and Examination prior to applications for admissions to hospital’ are useful. We would like to endorse Chapter 8 on the role of the nearest relatives and very much welcome the fact that Chapter 26 confirms the retention of Second Opinion Appointed Doctors (SOADs). We would suggest that an index be included in the Code in order to assist navigation and it may also be useful to include an earlier explanation of Supervised Community Treatment (SCT) as the glossary does not begin until page 228. Given the length of the document, we suggest that an alternative easy-read version is produced to make the document as accessible as possible.

Although the BMA supports many aspects of the draft Code, the Association has serious concerns regarding Chapter 6, ‘Appropriate Medical Treatment Test’. In our view this chapter, in its current form, has the potential to prohibit professional ethics around ‘appropriate treatment’ providing some medical benefit and the lack of clarity may render the ethical principle underlying the appropriate medical treatment clause (Section 145(4)) as meaningless. Our concerns about the paragraphs in Chapter 6 are discussed in detail in the appropriate section below and we strongly recommend that this section of the draft Code be redrafted.

We would also like to highlight our concerns with Chapter 13, ‘Allocating a Responsible Clinician’. These concerns are based on the principle that we are opposed to the possibility that under the new Act renewal of detention might be undertaken on the authority of an RC who is not a registered medical practitioner. This issue is discussed in greater detail below.

To read the response in full, please download it in PDF format using the link on the right.