UK Parliament / Open data

Mental Capacity (Amendment) Bill [Lords]

That may well be the case, but the difficulty here is that we have a complex system when we should have a simple system that clarifies that an independent advocate, an IMCA, should not be appointed if a cared-for person objects to it, but that everyone who wants or needs an advocate can get one. There should be an absolute right to request that an advocate be appointed both for the cared-for person and for any appropriate person who is representing them.

Our amendment would ensure that support is provided where an appropriate person is not able, on their own, to give the cared-for person the support that they need. That is particularly important, and there are many examples. I am sure that the vast majority of responsible bodies would not exploit loopholes, but we feel that there are loopholes in the current situation.

Budget pressures are another concern. There are concerns that advocates may not be allocated because of Government cuts to local council budgets. We feel that it is important that the wording from the existing Mental Capacity Act is retained. Let me give an example. The concern was put succinctly in evidence submitted to the Public Bill Committee by the Doughty Street Chambers Court of Protection team, who said:

“The requirement to ‘take all reasonable steps’ is a weakening of the current requirement that the supervisory body must appoint an IMCA...It is therefore possible that a ‘cared for person’ may qualify for an IMCA but that due to resource issues the reasonable steps taken do not result in such an appointment, and this safeguard may not be available.”

From everything the Minister has said, I know that she agrees about the importance of advocacy, and we have heard a lot of case studies, one of which I will briefly mention. My hon. Friend the Member for Slough (Mr Dhesi) described a case that has stuck with me since. An advocate was visiting a man in a care home who was clear that he wanted to leave and move back to his own home. When the advocate looked into the matter further, they discovered that the man’s home had been put up for sale by the local council to fund his care. He had no idea that that was happening and was extremely upset. With the help of an advocate, he was able to challenge the local council’s decision and prevent his home from being sold. I recall that example from Committee, and it is a powerful one that demonstrates just how important an advocate can be. Without one, this man’s home would have been sold without his knowledge, and he would then have been forced to remain in a care home that he wanted to leave. There are countless examples of how important an advocate can be.

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It is a fundamental safeguard that all people under LPS should be able to access an advocate. We cannot leave any loopholes in the provision of adequacy—it must be the default—and everyone who wants and needs an advocate should be guaranteed access to one.

Let me touch briefly on Government amendments 13 and 14, which address what happens when a person is held in an independent hospital. We called on the Government to change these provisions in Committee, and Government amendments 13 and 14 address our concerns. The amendments are needed because, under the current provisions of the Bill, it would have been up to the manager of an independent hospital to authorise the arrangements for deprivation of liberty. That was wrong. From everything we hear reported and from investigations, we know that many families are excluded from decisions in independent hospitals, and these amendments will change that. However, I come back to the question of why the Government have been prepared to remove the conflict of interest for independent hospitals and not for private care homes. We have talked about resourcing with regard to local councils, and this change will actually have an impact on the funding and resources of local councils.

There are still some issues around Government amendment 24, but I do not really have time to discuss them because other Members wish to speak. The amendment has been tabled only because the Government removed in Committee the strong right to information that existed in the Bill when it was sent to us from the House of Lords. Following the undoing of that House of Lords provision, there are ways in which amendment 24 is not satisfactory. The wording is far too broad, and there are concerns that information rights have loopholes that could be used by those who should be giving information to the cared-for person and the people representing them. We should not be having to worry about that at this late stage of the Bill.

I support amendments 1 to 4, tabled my hon. Friend the Member for Rhondda (Chris Bryant), as they raise an important issue and would ensure that the impact of treatment for an acquired brain injury was considered throughout the LPS system. Those are vital safeguards

for the large number of people that my hon. Friend talked about, and I hope that the Government will give them the consideration they deserve.

I thank my hon. Friend the Member for Stockton North (Alex Cunningham) for tabling amendment 48. Resolving the issues that he has raised is not simple, and I hope that he gets the time to discuss his amendment. I hope that the Minister will confirm today that nobody will be forced to pay the costs of an assessment because they need a liberty protection safeguard, and that she will accept that amendment.

Let me touch briefly on the definition of deprivation of liberty in the Bill. I want to register the complaint that I have already made to the Minister, which is that case studies have been circulated to Members of the House of Lords but not to the Committee while the Bill was going through the House. That is not acceptable. I have not even had answers to the concerns about the case studies that I raised in Committee. The rush to get the Bill through, which we are seeing all the way along, has caused that problem.

I have also raised additional concerns expressed by the Care Quality Commission, which wrote to me detailing a number of concerns about its role in monitoring the liberty protection safeguards. I have raised those concerns with the Minister, but I want finally to return to one aspect of them. The Minister said that

“the Liberty Protection Safeguards provide a range of safeguards including review and oversight by the responsible body, access to independent representation and support and, where required, the statutory safeguarding system.”

The Bill moves us into a situation where the LPS can be used when a cared-for person is in a private home. That is a problem, because the CQC does not regulate domiciliary caring agencies in the same way that it regulates care homes. The Minister needs to confirm that some people will be subject to the LPS without the CQC monitoring the application of the LPS to them. Oversight should not be partial in that way. If the Bill extends the system to people being cared for at home, then that has to be done properly. The Minister has assured us that the Government and the CQC are working together to address these issues, but I remain concerned that we have so many questions to which we have not been given answers.

There is still much to do to improve this deeply flawed Bill. I hope that the Minister and other hon. Members will take this opportunity today to improve the Bill by passing our amendments so that we can improve the safeguards for vulnerable people.

Type
Proceeding contribution
Reference
654 cc813-5 
Session
2017-19
Chamber / Committee
House of Commons chamber
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