Don's diary: a communique on care

March 14, 2003

July 2002
The request comes as a surprise - would I consider becoming adviser to the Scottish Parliament health and community care committee for the new mental health bill? Poor remuneration, impossible deadlines and a lot of extra work - you bet!

The bill is complex. Its main precepts are to narrow the criteria for detaining patients; to allow patients more involvement in their treatment; to create mental health tribunals with the power to detain as well as lift detention; and to introduce the concept of community-based compulsory treatment orders. At this stage, the main task is to advise on who should be invited to give evidence. We try to be inclusive and even-handed.

The bill is published on the 16th. At 168 pages, it is the largest bill to come before the Scottish Parliament. Read all night as I am to brief the committee on the 18th.

Main function now is to suggest questions for MSPs to ask witnesses. I discover that as a formal record it is important to get responses to the principles underpinning the bill as well as more controversial aspects (such as the use of electroconvulsive therapy for non-competent, and thus non-consenting, patients). I sit between convener and deputy-convener and learn new skill of sitting silently for several hours while desperate to intervene. I'm impressed by the users and carers who give evidence and by the MSPs' efforts to put people at ease.

Join MSPs on visit to the new purpose-built medium-secure unit in Edinburgh, fitted with en suite shower rooms (baths are too big a suicide risk) and modern solid furniture (too heavy to be thrown).

Participate in an evidence-taking session in Dundee. Over an informal lunch there is general agreement that the bill is a move forwards, providing more safeguards and options for patients, and (unspoken) satisfaction that Scotland seems to have got it broadly right compared with England, which has got it broadly wrong (being English I can say this).

Everyone feels better when the Law Society for Scotland says it is such a complex bill that even it is having difficulty understanding it.

Sit through part of a debate on genetically modified crops before our session on the law and am impressed by MSPs, ability to move quickly from one complex issue to another.

Last part of the job is drafting the central part of the stage one report - a difficult task, but I am ably assisted by the clerks to the committee. The first meeting does not go as planned: my polite goodbyes meet with what begins to feel like a hostile reception. It turns out that the MSPs assumed I would be staying with them for stage two - not normal practice. Hugely flattered, I agree. The live television coverage of the presentation of the report to parliament just happens to include fulsome thanks to me, which I keep on video to prove that someone, somewhere, thinks I am useful.

January-February 2003
Read 1,357 amendments and wonder about the very particular type of mind necessary to draft legislation. I plan to attend the committee (despite not now having a formal place in the proceedings) but the sudden death of my father means I put this on hold. Thank God for email - I continue to send comments. Stage two concludes and it is now up to parliament.

Jacqueline Atkinson is senior lecturer, public health and health policy, faculty of medicine, University of Glasgow.

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