Latest news with #RoyalCollegeOfPsychiatrists
The Independent
26-05-2025
- Health
- The Independent
Handing NHS staff police powers to detain mental health patients would have dangerous consequences, health bodies warn
Lawmakers have been issued a stark warning over plans to extend police powers to NHS staff allowing them to detain mental health patients, with a group of major health organisations expressing 'grave concerns' over the proposed changes. The Royal College of Psychiatrists, the Association of Ambulance Chief Executives, the Royal College of Nursing and Association of Directors of Adult Social Services are among those saying proposed changes to the Mental Health Bill will cause 'significant harm with dangerous consequences.' In March, the government suffered several defeats in the Lords as peers debated ways to modernise mental health legislation. Conservative shadow health minister Lord Kamall proposed a change to the Mental Health Bill so that nurses, doctors and other staff could carry out detentions of patients without the need for police officers to attend incidents. Health minister Baroness Merron told the Lords the government did not support 'extending police powers in this way' but peers backed the Conservative proposal, resulting in changes to the draft new law. The changes - which come after concerns were repeatedly raised about the pressures mental health issues are placing on policing - mean powers previously reserved only for police could be transferred to health or other professionals to detain and restrain people in crisis, in public spaces or at home. Launching a joint statement, major health organisations have expressed 'grave concerns' and argue the 'police play a crucial role in carrying out many tasks that medical practitioners cannot perform, such as assessing whether a home is safe to enter'. They said 'reducing police involvement in mental health emergencies could lead to serious risks for both patients and clinicians.' The joint statement said wording accompanying the amendment 'states that 'the proposed amendments would remove the need for the presence of police at mental health incidents in the absence of any risk.' 'This is misleading as instances of detentions under the Mental Health Act where there is no risk are almost non-existent. 'It also negates the fact that the mere presence of uniformed officers can ensure that an otherwise risky situation remains contained and safe.' They also warned that transferring police powers to health professionals risks damaging their 'therapeutic relationships' with patients, meaning it has the 'double-effect' of hindering the ability to provide care, while also deterring people from seeking help from services where they might be forcibly detained. The organisations said the changes 'have not been tested' with health professionals or discussed with patients. 'We are keen to work with police and government to find ways to improve responses to mental health crises to ensure the safety of all professionals involved, patients and the community', the statement adds. It comes after the NHS unveiled plans to open more mental health crisis centres across England in a bid to keep those patients out of crowded A&Es. The new service, staffed by specialist doctors and nurses, will be open to patients who present symptoms of a mental health crisis, such as suicidal thoughts or psychosis. Ten NHS trusts have already launched separate units for mental health emergencies, some on the sites of existing A&Es, which are open to walk-in patients are well as those referred to the service by GPs and police. Dr Lade Smith, president of the Royal College of Psychiatrists, said delegating police powers to health professionals 'would not be within the spirit' of the proposed reforms to the Mental Health Act. She warned: 'It is well known that at times, people experiencing a mental health crisis cannot be safely reached and cared for without the assistance of the police. 'Delegating police powers without proper consultation or planning is likely to disproportionately affect those from minoritised backgrounds and would increase risk to patients and compromise the safety of others. It sets a dangerous precedent. 'Like mental health services, the police are facing significant workload pressures. 'It is simply logical and now vital that we work together to develop more effective ways of responding to mental health crises.' A Department of Health and Social Care spokesperson said: 'Extending police powers to other professionals would represent a major shift in the roles, responsibilities and practice for health and care staff and would place additional resource on an already stretched NHS at a time where we are trying to rebuild a health service fit for the future. 'It also raises questions around whether it is right for the health and social care professionals to have powers to use reasonable force which could have implications for patient, public and staff safety, as well as potentially damaging the relationships clinicians have with patients. 'We are grateful to health and social care stakeholders for their in-depth engagement on this complex issue.'
The Independent
16-05-2025
- Health
- The Independent
There is still time for amendments to be made to the assisted dying bill – but it deserves to pass
When the Terminally Ill Adults (End of Life) Bill passed its first stage in the House of Commons in November, The Independent agreed with the majority of MPs. They voted at second reading to approve the draft law in principle, while many of them had reservations about the terms of the bill and expected it to be improved when it was subjected to detailed scrutiny. In particular, we agreed with those who said that the safeguards against coercion needed to be strengthened, and that the requirement for a High Court judge to sign off on a decision to die was unworkable. To her credit, Kim Leadbeater, the Labour backbencher who is the sponsor of this private member's bill, has taken those concerns seriously and sought to allay them. Since November, the bill has been improved, as was confirmed in the Commons on Friday. The safeguards have been strengthened and the role of the High Court judge has been replaced by a panel including a lawyer, a social worker and a psychiatrist. This is a better and more workable arrangement, drawing on a range of relevant expertise, rather than a narrowly legal authority. No doubt the bill could still be improved further. We are worried, for example, that the Royal College of Psychiatrists said earlier this week that it could not support the draft law in its current form because, among other things, 'there are not enough consultant psychiatrists to do what the bill asks'. But this raises questions that are beyond the scope of the bill itself, and it would be wrong to block the bill on the grounds that it may not be possible for everyone who wants to use its provisions to do so. If assisted dying is right in principle, it is better that it is available to some rather than none. Among the amendments Ms Leadbeater accepted on Friday was one to exclude anorexia explicitly from the definition of a terminal illness. This is another welcome change. MPs also agreed amendments to ensure that there is no obligation on anyone, such as medical staff, to take part in a patient's decision to seek an assisted death; to prevent doctors from discussing the option of an assisted death with under 18s, unless the patient has raised it first: and to require the government to publish an assessment of the availability and quality of palliative and end-of-life care. These are all further improvements to the bill. That is not to say that it has now achieved a state of legislative perfection. We remain concerned, in particular, about whether the protections for people with mental illness are sufficient. The Royal College of Psychiatrists says that 'mental health services simply do not have the resource required to meet a new range of demands'. Ms Leadbeater should continue to try to meet the concerns expressed in good faith by the bill's critics. There is still time for further amendments to be made before MPs are asked to give their yes or no verdict on the bill next month – and it can then be amended further in the House of Lords. However, one of the striking contributions to the debate on Friday was made by Marie Tidball, the Labour MP for Penistone and Stocksbridge. As an MP with a disability – she was born with shortened limbs and a single digit on each hand – she said she had voted for the bill in November on the understanding that it would be strengthened and improved, and that she was now satisfied that it had been. Of course, the bill is not perfect, and never could be, because the subject is so difficult and the circumstances in each case will be different. Ms Leadbeater must continue to make it the best it can be, but those MPs who gave the bill a conditional vote of confidence in November can now safely send it on to its next stage in the upper house.
Telegraph
16-05-2025
- Health
- Telegraph
Medics criticise assisted dying Bill ahead of MP debate
Another leading medical body has raised concerns about the risks of the assisted dying Bill 'failing to protect vulnerable patients' as the landmark legislation returns to Parliament today. The Royal College of Physicians said it believed there were 'concerning deficiencies' with the proposed Bill as it stands. Its statement followed one earlier this week from the Royal College of Psychiatrists which said it had 'serious concerns' and could not support the Bill in its current form. The Terminally Ill Adults (End of Life) Bill, which relates to England and Wales, returns to the House of Commons today for the first time since MPs supported the legislation in principle back in November. The legislation was backed by 330 votes to 275 at second reading and MPs are now going to debate and vote on amendments during its report stage which is expected to run into a second day next month ahead of a crunch final vote. The Government is neutral on the Bill, which was tabled by Labour MP Kim Leadbeater, and any votes MPs make are according to their own conscience rather than along party lines. It is far from certain that the Bill will make it onto the statute book, with all eyes currently on how many MPs could change their minds on the issue.
The Independent
15-05-2025
- Health
- The Independent
MP behind assisted dying Bill defends it as medical body adds voice of concern
The MP behind the assisted dying Bill has defended it as another leading medical body raised concerns about the risks of it 'failing to protect vulnerable patients'. The Royal College of Physicians (RCP) said it believes there are 'concerning deficiencies' with the proposed legislation as it stands. Its statement follows one earlier this week from the Royal College of Psychiatrists (RCPsych), which said it has 'serious concerns' and cannot support the Bill in its current form. That statement was branded by one opponent of the Bill as a 'blow to its foundations'. Kim Leadbeater, the Labour MP behind the Bill, said it was coming back 'even stronger' when it returns to the House of Commons on Friday for the first time since a historic yes vote in November. She said the Terminally Ill Adults (End of Life) Bill, which relates to England and Wales, goes 'further than any other around the world in its safeguards, oversight and regulation' and that the Government's impact assessment has confirmed this. 'The law as it stands is not working for dying people or their loved ones; that much is clear,' Ms Leadbeater wrote in The Mirror. 'A majority of MPs recognised this when they backed my Bill in November. 'When they come to debate it once again today, they can be confident that it returns even stronger.' Prime Minister Sir Keir Starmer, who voted for the Bill last year, has indicated he remains supportive of the proposed legislation and that it has 'sufficient time' in Parliament amid claims from some it is being rushed through. In a boost for the Bill, new Reform MP Sarah Pochin has confirmed she will support it. Mike Amesbury, who she replaced in the Runcorn and Helsby constituency earlier this month, had voted no last year. Reports speculating on the numbers of MPs who had supported the Bill last year but are now considering voting against it have been dismissed by the Bill's backers who reject the idea the proposed legislation is at risk of collapse. But the RCPsych statement prompted MPs, some with medical and clinical backgrounds, who back the Bill, to urge their colleagues in Parliament to support it. A statement, signed by supportive MPs including doctors Neil Shastri-Hurst, Simon Opher and Peter Prinsley, insisted 'most healthcare professionals understand that the current law is not working', that it 'criminalises compassion', places clinicians 'in an impossible position' and cannot be tolerated or defended. In their position statement on Thursday, the RCP said despite changes to the Bill in recent months which supporters argue have strengthened it, the college believes 'there currently remain deficiencies that would need addressing to achieve adequate protection of patients and professionals'. It said there are 'key factors' which must be in place should assisted dying be legalised. These include decisions around a patient's prognosis to be informed by 'expert clinical professionals including those who know the patient', decisions on capacity, and safeguards around coercion to be informed by face-to-face assessments of 'relevant and appropriately skilled health and care professionals', regulations of medicines and a guarantee resources will not be diverted from other end-of-life care. Their concerns follow those from RCPsych which said it has 'unanswered questions' about the safeguarding of people with mental illness, and warned of a shortage of consultant psychiatrists to meet the demands of the Bill. Both colleges said they remain neutral on the principle of assisted dying. The RCP's clinical vice president, Dr John Dean, said: 'The ultimate decision on assisted dying rests with society through Parliament, but professional and clinical issues are integral to legislation, regulation, guidance and safe and effective implementation. 'Our members and fellows who we represent have a wide range of views on assisted dying. While the RCP neither supports or opposes a change in the law on this matter, the Bill in its current form has concerning deficiencies. 'Notably, the proposed mechanisms of decision making are not in line with good clinical and professional practice. Further statutory guidance is also required to ensure effective regulation of drugs, providers, and the involvement of clinicians. 'Parliament must address these critical issues in the legislation or risk failing to protect vulnerable patients and uphold the integrity of clinical practice.' The chairwoman of the Royal College of GPs, Professor Kamila Hawthorne, also told the BBC this week that doctors have 'real concerns about the practical and legal implications of a change in the law on assisted dying', which she said 'must be acknowledged and addressed, so that any legislation is watertight'. Speaking during a visit to Albania, Sir Keir was asked if his views on assisted dying had changed during the passage of the Bill. He told broadcasters: 'My views have been consistent throughout.' In a later interview he reiterated the Government's neutrality on the Bill and said it was facing 'a lot of scrutiny, both inside Parliament and outside Parliament', adding that he was 'satisfied' it had 'sufficient time' in Parliament. Some opponents have claimed proposals are being rushed through as a private member's bill and that it has not had the same level of scrutiny had it been a Government Bill. Dozens of amendments have been tabled and many could be debated and voted on during a five-hour sitting in the Commons on Friday. It is not yet clear whether time will allow for a third reading vote, with the possibility that the report stage could instead run into a second day next month because of the large number of further amendments proposed. As it stands, the Bill would allow only terminally ill adults in England and Wales, with fewer than six months to live, to apply for an assisted death – subject to approval by two doctors and the three-member expert panel featuring a psychiatrist, social worker and senior legal figure. Ms Leadbeater has defended the scrapping of the High Court judge safeguard which has been replaced by the expert panel. She told LBC Radio this was a 'more holistic approach, a more patient-centred approach' and is 'much, much stronger' as a result.
The Independent
14-05-2025
- Health
- The Independent
Is the tide really turning against assisted dying?
As the Scottish parliament backed the general principles for assisted dying in a vote, reports suggested some MPs might be turning against the equivalent bill at Westminster, which will be debated in the Commons on Friday. No 10 announced that Keir Starmer will be in Albania for the European Political Community summit on Friday, and so will miss the debate. The prime minister personally supports the bill, along with two-thirds of cabinet ministers, but the government is formally neutral on the subject. On Wednesday the Royal College of Psychiatrists withdrew its support for the bill, issuing a statement: 'The RCP has reached the conclusion that we are not confident in the Terminally Ill Adults Bill in its current form, and we therefore cannot support the bill as it stands.' A BBC survey of GPs also found a majority were opposed, although it was not a representative sample. BBC News sent more than 5,000 GPs a questionnaire; 'more than 1,000 GPs replied, with about 500 telling us they were against an assisted dying law and about 400 saying they were in favour'. At the same time, it was reported that at least five MPs who previously abstained on the bill have decided to vote against it – although another two abstainers have decided to support it. What will happen on Friday? Friday is the bill's report stage, which is when the committee formed to consider it in detail 'reports' back to the whole House of Commons. There are likely to be votes on a few amendments to the bill, if the speaker judges that they have significant support among MPs. Most attention is focused on an amendment that would require the government to make 'an assessment of the availability, quality and distribution of appropriate health services to persons with palliative and end of life care needs'. Other amendments that are gathering support include a prohibition on doctors from raising the prospect of an assisted death with patients, and an exclusion for eating disorders such as anorexia being defined as a terminal illness. But there is unlikely to be a vote on the principle of the bill itself. For that reason, the prime minister's absence is not significant and is unlikely to mean that he is having second thoughts. The critical vote is expected on 13 June, or possibly later if there are a lot of amendments to consider. That will be the vote on third reading, which is the final stage in the Commons, before the bill goes to the House of Lords. So, will the bill become law eventually? The bill is likely to pass when it does get to third reading. It secured a larger-than-expected majority of 55 in its first vote in November. If a handful of the 46 MPs who abstained then vote against it, it will still pass. None of the MPs who voted for or against in November has publicly changed their mind. Supporters were bolstered by the passing of a similar bill by the Scottish parliament by a 14-vote margin on Tuesday. How has the bill changed since November? The big change came in February, when Kim Leadbeater, the Labour backbencher who sponsors the bill, announced that she would remove the role of a High Court judge as the backstop and replace it with a panel of experts. As one of those experts would be a psychiatrist, the Royal College's opposition is significant, but does not appear to be decisive. The bill would allow a doctor to assist a patient to die in England and Wales – if the patient has a terminal illness with less than six months to live, and if the decision is approved by two doctors and a panel including a specialist lawyer, social worker and psychiatrist. What is happening in Scotland? MSPs at Holyrood voted by 70 votes to 56 in favour of the Assisted Dying for Terminally Ill Adults (Scotland) Bill introduced by Liberal Democrat Liam McArthur, with one abstention. Afterwards, Mr McArthur said: "This is a landmark moment for Scotland." A number of high profile MSPs, including first minister John Swinney, deputy first minister Kate Forbes, and former first ministers Nicola Sturgeon and Humza Yousaf had all voted against the bill, along with Scottish Labour leader Anas Sarwar. Holyrood had previously rejected two attempts to legalise assisted dying at the first vote, with MSPs voting down similar proposals in both 2010 and 2015. However, with the parliament having backed the general principles of the bill, it will now go forward for further scrutiny and amendments. It will become law only if MSPs approve it in a final vote, which should take place later this year. As it currently stands, the bill would only allow people who have lived in Scotland for at least 12 months, and who are registered with a GP in Scotland, to request an assisted death. Two doctors would both have to certify someone is both terminally ill and has the mental capacity to make such a request for this to proceed. There would also be a period of at least two weeks between a request being made and the necessary medication being provided – with the patient having to be able to take this themself. As with the equivalent in Westminster, the bill in Scotland was introduced by a member, not the government.
