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Complex medical roles in mental health review tribunals

Published online by Cambridge University Press:  02 January 2018

H. A. Prins*
Affiliation:
Mental Health Review Tribunal, I Home Close Road, Houghton on the Hill, Leicester LE7 9GT
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Abstract

Type
Columns
Copyright
Copyright © 2000 The Royal College of Psychiatrists 

Gibson (Reference Gibson2000) makes a thoughtful rejoinder to the suggestion by Richardson & Machin (Reference Richardson and Machin2000) that the dual nature of the roles exercised by the mental health review tribunal (MHRT) medical member precludes open-mindedness. That this need not be the case was demonstrated some years ago by Langley (Reference Langley1990, Reference Langley1993) and Brockman (Reference Brockman1993). Gibson suggests that the role of the MHRT doctor was introduced in the 1959 Act to facilitate examination of the “hospital notes without ruffling medical feathers”. In reality, the issue of the medical member's role was more complex than this. During the parliamentary debates on the 1959 Act there were very conflicting views expressed as to who was best fitted to make judgements concerning the need for detention, bearing in mind the then current legislation which involved a purely judicial decision. A compromise appears to have been reached by the introduction of the present three-member MHRT panel.

Gibson's remedy, which would involve tribunal members reading the medical notes for half an hour prior to the hearing, has two serious weaknesses. First, in many cases the notes are too voluminous and complicated to make this possible in the time-scale suggested. Second, medical notes sometimes require a certain degree of medical interpretation for the benefit of the two non-medical members of the panel. However, these issues may turn out to be academic in the light of the current Government's proposals for reform of the 1983 Act (Department of Health, 1999) involving a considerably more complicated (and, most likely, more costly) system than we have at present; a system which also comes very close to infringing the European Convention on Human Rights' mandates. It is also very clear that the Government's proposals have not found favour with some members of the Scoping Study Review Team (Reference PeayPeay, 2000). There is an old adage ‘marry in haste, repent at leisure’. Maybe in this case it would be appropriate to substitute for this phrase, ‘legislate in haste’ (on the basis of a pre-determined and heavily constrained remit and time-scale by Government) and we will be most certain to ‘repent at leisure’.

References

Brockman, B. (1993) Preparing for Mental Health Review Tribunals: reports and dilemmas. Psychiatric Bulletin, 17, 544547.Google Scholar
Department of Health (1999) Reform of the Mental Health Act, 1983: Proposals for Consultation. London: Stationery Office.Google Scholar
Gibson, A. C. (2000) Medical roles in mental health review tribunals (letter). British Journal of Psychiatry, 176, 496497.Google Scholar
Langley, G. E. (1990) The Responsible Medical Officer and Mental Health Review Tribunals. Psychiatric Bulletin, 14, 336337.Google Scholar
Langley, G. E. (1993) Mental Health Review Tribunals in practice. Psychiatric Bulletin, 17, 331336.Google Scholar
Peay, J. (2000) Reform of the Mental Health Act, 1983: Squandering an Opportunity. Journal of Mental Health Law, 3, 515.Google Scholar
Richardson, G. & Machin, D. (2000) Doctors on tribunals. A confusion of roles. British Journal of Psychiatry, 176, 110115.Google Scholar
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