Sojan Joseph
MP for Ashford · Labour · United Kingdom
“I agree with the hon. Member that people with power, especially those with political platforms, have used it to spread misinformation about vaccination. Some medical professionals working in our hospitals and the NHS—doctors and nurses—are also against vaccines. Can the hon. Member explain how we can tackle that issue?”
House of Commons16 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“This morning, I visited the Churchill school in Hawkinge and had a good interaction with the young children. Most of their questions were about protecting nature, and they repeatedly asked how we can support them to plant more trees.”
House of Commons13 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“As the chair of the APPG on adult social care, I pay tribute to unpaid carers for the enormous contribution they make to their families, their communities and wider society. I often have meetings with them, and as part of my job before I became an MP—I worked in the NHS—I had a lot of contact with carers.”
House of Commons9 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I would appreciate it if the Minister would respond to that point, and if the Government would consider something to support carers, while not putting any more administrative burden on the NHS, where we are focusing on providing more support on the frontline.”
House of Commons9 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“It is good to see you in the Chair, Ms Lewell. I strongly believe that public health is very important to our health system because it focuses on prevention, so that people do not end up in A&E or in hospital beds. Unfortunately, over the last 10 or 15 years we have seen the opposite.”
House of Commons9 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I worked as a nurse on the frontline in mental health services, and what we saw was money being diverted to create more senior leadership, more groups, more meetings and more management, while we were missing the people who actually did the work on the frontline.”
House of Commons9 July 2026Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
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“As Place2Be has said, children and young people from low-income families are four times more likely to experience mental health problems than children from higher income families, while one in four children and young people with a diagnosed mental health condition live in a household that has experienced a reduction in household income. This is why I want reform of the way that we deal with mental health. From Westminster, I would like greater cross-Government working to address the social detriments of our mental health. At a local level, I believe that greater co-operation between schools, colleges and universities, along with local health providers and others in the local community, can help create education settings that are effective at protecting young people’s mental health and general wellbeing.”
House of Commons13 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Ensuring enough mental health support for children and young people in educational settings will help to free up NHS time and resources, while making sure that we have a healthy and productive population in the future. We should also make sure that support exists in the community. Can the Minister provide an update on the Government’s plans for Young Futures hubs? Does he agree that open access drop-in hubs could be an important step in providing community-based mental health support for children and young people? There is clear evidence that the places and circumstances in which people are born grow, study, live and work have a powerful influence on their mental health.”
House of Commons13 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“These examples underline how children who receive support quickly are less likely to develop long-term conditions that negatively affect their education, social development and health later in life. I welcome the fact that my right hon. Friend the Secretary of State for Education has been clear that children’s wellbeing will be a priority for this Government. Research from the British Association for Counselling and Psychotherapy indicates that children whose mental health difficulties are initially too complex for lower intensity interventions, but not complex enough to be referred to higher intensity interventions such as CAMHS, can easily miss out on the mental health support that they need.”
House of Commons13 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I recall two examples from my experience of working in mental health system that demonstrate the difference that early intervention and support can make. They are of two young people of similar age: one is a teenage boy, who unfortunately has not been able to access the support he needs and, as a result, is struggling to cope. That is not only impacting on his mental health but is having a detrimental impact on his family, especially his parents. By contrast, in the second case, the parents of a teenage girl who had been diagnosed with a mental health condition knew that I worked in mental health at the time and came to see me. I was able to ensure that she was referred to CAMHS at an early stage. As a result, both she and her parents are doing well. She is due to sit her A-levels in the summer.”
House of Commons13 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I agree, and I have many similar cases. I want to refer some real-life examples. There is an excellent exhibition in the Upper Waiting Hall this week about the Mental Health Act, which has been put together by Mind. It features artwork and written pieces by people who have been detained under the current Act. I had the pleasure of meeting some of them on Monday, including a young lady called Afeefa. Afeefa is 19 but was first detained under the Act when she was 14. She spoke powerfully and movingly about the treatment that she endured while she was under section. When I asked her if there was one thing that could have helped her, she said without hesitation that if she had received mental health support at an earlier stage, her experience would have been very different.”
House of Commons13 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Q7. May I commend this Labour Government’s landmark reforms to get Britain building through our plan for change? I look forward to working with Ministers to ensure that developers deliver what they promise to local residents, so that those in new homes have access to roads, GP surgeries and dentists, and do not create an extra burden for hospitals such as the William Harvey hospital in my Ashford constituency. What is the Prime Minister’s message to the blockers who are standing in the way of our building the homes and vital infrastructure that our country needs?”
House of Commons12 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“As we have discussed before, people may be homeless or may not have any family members, and it will all have an impact on why they decide to seek the assisted dying route. People may feel that they are a burden to society and the system. If there is any documentation from six months or a year ago, it will be relevant for the doctor. Removing access to medical records for doctors will have an impact on people with mental disorders, intellectual disabilities and neurodevelopmental conditions, so I oppose amendment 201, although I support the other amendments.”
House of Commons11 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“What is relevant, however, are records for people who have a mental health disorder or are vulnerable. For example, people with serious mental illnesses such as chronic treatment-resistant schizophrenia may be on treatments such as clozapine that, if stopped, will have an impact on their mental health. The treatment that they may undergo during terminal illness may have an interaction, and medication that they have been using for many years to treat their mental health condition may have to be stopped. Doctors need to know why the person wanted to choose that route, and whether it will have an impact on their mental health. Restricting access to important medical records by the doctor who makes the decision will have an impact on very vulnerable people.”
House of Commons11 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I support amendments 422, 468 and 423, which I think would strengthen and safeguard the Bill. However, as someone who worked in mental health for many years, I have grave concerns about amendment 201, which would restrict access to medical records. Health professionals work in environments with great confidentiality of records; I have no concern about health professionals or doctors having access to health records. Some Committee members have talked about doctors not needing to know whether a person had tonsillitis, but most medical records or GP summaries will note whether someone has had tonsillitis, along with details about vaccinations and infections. I do not think that those records will necessarily be relevant or that a doctor would look in detail at what medication they have had in that respect.”
House of Commons11 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Currently, when we start a patient on any medication, we usually give out information on indications and contraindications. If patients ask for one, we will give them a leaflet with information about the medication. Can the hon. Member clarify whether the amendment would help in that situation? Does he agree that a leaflet should be given to the patient?”
House of Commons11 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I will not talk for long, because most of my points have already been raised. I welcome the provisions in new schedule 2 on membership of the panel. I was concerned about all patients having access to a psychiatrist and a social worker, so the measures proposed are welcome and reassuring. My reservation, which other hon. Members have raised, is that it would be even better for people to have earlier access to the panel. I am also concerned about whether the panel would have the power to overturn the decisions taken by the two doctors and whether it might be influenced by them. In addition, will the Health Minister clarify his response to amendment 1? He said that specifying one category of doctor, a registered psychiatrist, would create capacity issues. I hope that that will not be an issue when we have a psychiatrist on the panel.”
House of Commons11 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Could the Minister clarify whether the requirement for one year of residency in the UK means that a foreign citizen studying at a university here would be able to consider assisted dying?”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“In its written evidence, it highlighted, “We recognise that the ultimate decision on assisted dying rests with society through Parliament, however any changes to the law will significantly affect clinical practice beyond palliative care…Should the law change, the RCP strongly argues that assisted dying must not divert resources from end of life and palliative care provision, which are not currently adequate.” With amendment 296, my hon. Friend the Member for York Central is trying to get the Committee to acknowledge that some NHS departments work with vacancies of 50 medical professionals. A patient who has been waiting for six months should not have their appointment cancelled because the provision here is prioritised. I think that is what my hon. Friend meant with her amendment, and I commend her thought about wider NHS provision.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I rise to speak briefly to amendment 296. We all know how the NHS operates, how the appointment system works in the NHS and how long people have to wait to see a doctor. I do not think that my hon. Friend the Member for York Central tabled the amendment with any ill thought, but just to highlight the issue. I do not think that the amendment will make the Bill any safer or stronger, or safeguard anything, but the Committee needs to acknowledge it. I will quote the Royal College of Physicians, which represents 40,000 doctors who primarily work in hospitals, including on palliative care. The Royal College of Physicians took a neutral position on the Bill.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I agree. It highlights the point that the impact assessment will be very important here, to see from where the resources are being pulled to provide this. The Committee should acknowledge amendment 296.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“We have discussed this issue many times. Within the Bill there is a provision for clinicians to refer to a psychiatrist if in any doubt. Does the hon. Member think that having that conversation at an earlier stage would be beneficial, rather than at a later stage?”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I beg to move amendment 56, in clause 8, page 4, line 34, at end insert— “(ba) would not, in the opinion of the independent doctor, be liable for detention under the Mental Health Act 1983.” This amendment would require the independent doctor to assess whether, in their opinion, a person would be liable for detention under the Mental Health Act 1983.”
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“All my amendment asks is for one of the two doctors to be a psychiatrist, which in fact makes the process safer and more secure—some of the concerns that we have talked about.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“In my experience of working in mental health for many years, I have seen many terminally ill people being admitted to mental health wards because of their increasing suicidal thoughts. Many people who have a mental illness for many years, especially chronically mentally ill people, lead a normal life with the support of medication, but when they are diagnosed with a terminal illness, such as cancer, and start chemotherapy or taking medication for that, it can interact with the medication that they were already taking. That can have an impact on their mental health or decision making, so it is important that those patients have access to a psychiatrist. I am not asking to make the process more complex or for us to draw any more resources from the NHS by adding a psychiatrist into the assessment.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“It is to be strongly welcomed that both co-ordinating doctors and independent doctors have to make an assessment that the person wanting to ending their life has the necessary capacity to make such an important decision. The question came up during the debate about whether, if somebody has mild depression or another mental health disorder, but they still think that they have capacity, they should be allowed to choose this route. We have seen that, in some other countries where this route is already practised, mental health was originally excluded from the criteria but was later added. Are we saying that even if someone has mental ill health, mild depression or some sort of mental illness, if they have capacity, we can allow them to choose assisted dying? Who will make that decision?”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“There is already a provision in the Bill to refer a patient to a psychiatrist if one of the doctors thinks that there is an issue with their mental health or capacity. We discussed a similar concept when we debated the patient having access to a palliative care consultant. Some of the comments were that needing another person makes it complex, and it should be simplified. Do Members think that if any of the doctors thinks that there is an issue with the patient’s mental health or capacity assessment, making a referral creates that same kind of complexity? Getting access to a psychiatrist could be simplified by having that second doctor be a specialist in mental health.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“The second doctor does exactly the same and assesses whether the person is terminally ill, has capacity to make the decision to end their own life, is aged 18 years or over and so on. Before coming to the first assessing doctor, the patient has already been treated by a consultant and been diagnosed as terminally ill, so the three doctors are basically doing the same job. That is important and relevant to my amendment 1, which asks that one of the two assessing doctors should be a qualified psychiatrist or a specialist in psychiatry. As I said earlier, the issues that have been most discussed by Committee members in the last few sittings were capacity, mental health and suicide. In my view, there is a gap that needs to be addressed. We talked earlier about unconscious bias.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“The importance of capacity as a safeguard is again demonstrated when we turn to clauses 7 and 8, which in turn set out what both the co-ordinating doctor and the independent doctor must assess in order for a terminally ill adult to be allowed to end their own life. In clause 7, the first assessing doctor with responsibility is the co-ordinating doctor. In clause 8, the second doctor is the independent doctor. The doctors are expected to assess mostly the same things. For example, the first doctor will assess whether the person is terminally ill, has capacity to make the decision to end their own life, is aged 18 or over, is ordinarily resident in England, and is registered as a patient with a general medical practice in England.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I should like to speak to amendment 1 —I am pleased that I was able to table my amendment first. We have already discussed safeguarding many times and how capacity is central to these measures. As we know, clause 1 lists the qualifying criteria that a terminally ill person must meet, which includes having the capacity to make such a decision. Indeed, the qualifying criteria might not be written in any order of importance, but the fact that that appears first underlines its significance. In many days of sittings the most spoken words have been mental health, capacity, coercion and suicidal thoughts, rather than pain, cancer and suffering.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“38, Q17.] We have spoken about this many times, but in written evidence the Royal College of Psychiatrists said: “A person’s capacity can change, and it is decision specific. While we are of the view that a person’s capacity to decide treatment can be reliably assessed, an assessment of a person’s mental capacity to decide to end their own life is an entirely different and more complex determination requiring a higher level of understanding.” In a previous sitting, we discussed having a panel that is able to do a psychosocial assessment. I know that the new clauses are yet to be discussed, but the relevant new clause does not specify who the members of the panel will be and whether it should include a psychiatrist or a social worker. That is yet to be made clear, so I am not convinced about that.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“When the chief medical officer, Sir Chris Whitty, was before the Committee, I asked him about mental capacity assessments. He said: “I would hope that most doctors are capable of identifying that someone has some degree…of mental health distress, or mental health illness”. However, he went on to say: “What not all doctors will feel comfortable doing is actually deciding whether that is sufficient to interfere with someone’s ability to make a decision with full capacity. That is where help from colleagues from psychiatry, and mental health more widely, is going to be useful.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 28 January 2025; c.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I thank my hon. Friend for her timely intervention. I was going to say that having tabled amendment 1 asking for a psychiatrist to be involved, and having now been through many Committee sittings, I wonder whether I influenced an unconscious bias among Members to table more amendments relating to mental health, capacity and suicide. I say to my hon. Friend that although there can be a psychiatry referral, if we are talking about unconscious bias, as soon as the first and second doctor make the decision that the person has capacity, is terminally ill and is eligible for this process, the subsequent assessments can be influenced by the first assessment. That happens quite often in NHS healthcare, and especially mental health.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“If the Bill enters the statute book, we should ensure that at least one of the doctors assessing a terminally ill adult who wants to use the legal mechanism to end their life is properly qualified to carry out mental capacity assessments. I know from my own experience that psychiatrists deal with complex mental capacity assessments and other cases every day. For example, psychiatrists who work in accident and emergency departments regularly see people who are intent on ending their life—that is the bread and butter of their work.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“After all, in its written evidence, the Royal College of Psychiatrists said: “Mental disorders, such as depression, are more common in people nearing the end of their life. Delirium is more common… Hopelessness is a common symptom of depression”, and people’s capacity and consent can be affected when they are going through that condition. I can categorically confirm that I have seen that in my own practice. A person could be absolutely normal, but when they are diagnosed with a terminal illness, that can have an impact on their mental health. We have heard about post-traumatic stress disorder and many other events that can have an impact on people’s mental health and, in turn, on their decision making and capacity.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I thank my hon. Friend for confirming that. That is reassuring but, as I said earlier, I would like to know when the patient will have access to the panel. It is important that they access it early in the process, rather than later, because that is where unconscious bias comes in. The purpose of my amendment is to save resources, because I know about the pressure on the NHS. Rather than having an additional psychiatrist on top of the two or three doctors, my amendment would simplify the process and save resources. Although I acknowledge that the evidence I cited referred to the application of the Mental Capacity Act 2005 to the Bill—an issue on which the Committee has already decided—I would argue that it can equally be taken into consideration in this context.”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“We are talking about a very important issue in relation to training. Most training provided in the NHS, whether on the capacity assessment or domestic violence, is mandatory training that people are expected to retake yearly. Unfortunately, reports—especially the CQC reports—show that NHS trusts across the country are not fully compliant with this training, especially doctors, who are conducting this kind of training very poorly. Does my hon. Friend agree that just introducing training is not enough, and that we have to monitor compliance as well?”
House of Commons5 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“When the patient, who has gone through so much difficulty, goes to their doctor or to a GP who knows them well and says, “I would like to choose the assisted dying pathway,” would that doctor then say, “I do not want to discuss this. Somebody else will.”?”
House of Commons4 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I rise in support of the amendments, especially amendments 342 and 425. We have discussed various aspects of the Bill, especially capacity, coercion and medical practices, under many previous amendments. As somebody who worked as a mental health nurse for many years, and who worked as part of a multidisciplinary team, I think that amendments 342 and 425 are some of the most important. Amendment 342 talks about the preliminary conversation with the medical practitioner with whom the patient makes contact. Do we not think that the doctor who knows most about that patient is the best person to have that preliminary discussion? They will have the most information about them.”
House of Commons4 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I know it also talks about giving power to the Secretary of State to formalise who should be part of the multidisciplinary team, which would be a discussion for later. I thank the Committee for giving me the opportunity to speak in support of the amendment.”
House of Commons4 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“We are talking about setting up a multidisciplinary team with a mental health nurse, doctor and social worker who can look in detail at evidence of the patient’s capacity, whether they are choosing it because they feel they are a burden, and whether there is any coercion. I think that is a safeguard for most of the concerns we have discussed in previous sessions. I would love to see a psychiatrist involved, because psychiatrists deal with some of the most challenging patients, including those with suicidal thoughts, on a day-to-day basis. They are the most experienced people to carry out a capacity assessment and, if they are a part of the multidisciplinary team, it will safeguard the Bill. I strongly support amendment 425 and I urge Members to consider it. It will reassure many people who are concerned about some of the discussions.”
House of Commons4 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Written evidence was sent to us on 29 January by the Royal College of General Practitioners, which recommended that a separate pathway that “covered every stage of the process would ensure healthcare professionals of multiple disciplines…who wanted to do so could still opt in to provide assisted dying, but this would be arranged through a different pathway.” The hon. Member for Sunderland Central spoke earlier about how patients may be going through many multidisciplinary teams already, but it could be that none of those multidisciplinary teams have talked with them about assisted dying. They could have been pharmacists or nurses talking about the patient’s care—not assisted dying.”
House of Commons4 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I am not saying that they should say yes or no, but they should be talking about the care provisions and options available to the patient. Amendment 342 is one of the most important amendments we will debate. I will move on to amendment 425. When I tabled amendment 1, my thinking was that a psychiatrist should be involved in these discussions, but I think amendment 425 will safeguard most of the concerns we have discussed in previous sittings. Amendment 425 talks about a “multidisciplinary team” and having a psychiatrist involved as well.”
House of Commons4 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“There are other people who support this concept, and they are the people who will be having the conversation—we have both sides of the argument. I believe that the best person to have that preliminary discussion would be the doctor who knows about that patient the most—about their circumstances, prognosis, family situation and pain. We talk about compassionate care, but where is the compassion in here? I am not saying that another doctor would deny that—but I am talking about compassion. Someone going through the most difficult time in their life would have the confidence to talk to the person who knows the most about them, which is why I fully support that the initial discussion should happen with them.”
House of Commons4 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I fully support the amendments, but they say that the practitioner conducting the preliminary discussion should use an interpreter. Should the interpreter not also be available for all the interactions that follow on from the preliminary discussion?”
House of Commons4 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I rise to speak in support of the amendment. The documentation in our healthcare system is a very important matter. It helps us to share good practice and to learn from mistakes. Whether in secondary care, primary care or nursing homes, the quality and the safety of our patient care is monitored by the Care Quality Commission, which uses clinical documentation to carry out its process of monitoring that quality and safety. It is important that any conversation had with patients by the doctor, or by any medical professional or multidisciplinary team, is documented clearly. That will help to safeguard our patients.”
House of Commons4 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“As the hon. Member for Richmond Park says, we have repeatedly debated people’s mental health and how, once somebody has had a diagnosis of a terminal illness, it can have an impact on their decision making. Amendment 425, which we discussed earlier, is about having access to a multidisciplinary team. That team could have on it a social worker or a psychiatrist who would make a comprehensive assessment, which would cover amendment 271. The amendment is an opportunity for the Committee to look into this issue, to make the Bill stronger, and to bring in safeguards for vulnerable people who may feel suicidal, and may feel a burden to society or to the healthcare system, and may choose this way. Those people who are vulnerable would have a psychosocial and mental health assessment, which would make the Bill stronger and safer.”
House of Commons4 March 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“Friend the Member for Bradford West has talked about unconscious bias. The initial capacity assessment when a person comes to a hospital is very important. If a doctor has assessed at the beginning that the person has capacity, the following assessment can be influenced by that initial assessment. I totally agree with my hon. Friend’s argument about unconscious bias in capacity assessments. As Members have mentioned, the Bill proposes many occasions in the process when capacity will be assessed, but I am still not confident that each capacity assessment will not be influenced by the initial assessment. The amendments would strengthen that area of concern.”
House of Commons26 February 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I will talk about my experience with those margins of error. A person’s capacity can be influenced by various factors, including their life circumstances, the medication they are taking or severe pain. Suicidal thoughts due to their mental state or depression can also influence their capacity. I have worked in acute mental health units. Every day, we carried out capacity assessments, including before we let someone out of the ward, whether they were admitted under the Mental Health Act or were receiving treatment as a voluntary patient. If somebody wanted to leave the ward, before the member of staff opened the door, they had to assess that person’s capacity. Sometimes a person might have said, “I am going to kill myself,” and the nurse would have had to decide whether or not they had capacity before opening the door. My hon.”
House of Commons26 February 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I rise to speak in support of the amendments. Having worked as a mental health nurse for 22 years, I completed mental capacity training many times in my career, and I carried out capacity assessments as part of my day-to-day job. I think that the capacity assessment proposed in the Bill is not safe enough. That was one of the main reasons I voted against the Bill on Second Reading. I have spoken to many people who oppose the Bill, and one of their concerns is about the capacity assessment. We have talked about capacity assessments every day in this Committee. It is one of the key issues that we will need to resolve to strengthen the Bill if it goes through. One of the Royal College of Psychiatrists’ concerns is that capacity decisions are “opinions with a margin of error and are time specific. A person’s capacity can change”.”
House of Commons26 February 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I agree that when an independent doctor comes to assess a patient’s capacity and sees them for the very first time, they are more likely to be influenced by the assessment made at the beginning by the doctor who has known them for many days, weeks or months. I agree with my hon. Friend’s argument.”
House of Commons26 February 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“It is not guaranteed. I am grateful for that intervention. We have talked about training for all registered professionals who will be involved in the capacity assessments. As someone who has carried out that training many times, I draw the attention of the Committee to Dr Rachel—”
House of Commons26 February 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“71, Q85.] That is my experience as well. We also talked about the second doctors. In the NHS, especially in the mental health sector, my experience is that many of the doctors are not in substantive roles—many locum doctors work in many areas. With my experience, I am not confident that trainings are being taken up by many of the people working in the NHS. I do not think that any of the trusts would be able to evidence that they have an 100% completion rate for their mandatory training. Especially for locum doctors, there is no monitoring system by the trusts. I am therefore not confident that this training would be robust enough to support some of the claims.”
House of Commons26 February 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I was talking about the training, which we have talked about many times in this Committee, for the people who may carry out capacity assessments, and about my experience of completing those trainings as part of my profession and carrying out capacity assessments for the past 22 years. We heard oral evidence from Dr Rachel Clarke, who has extensive experience in training doctors and nurses in capacity assessments. She said: “I would suggest that anybody who pretends that those assessments are easy and routinely done well in the NHS has not got enough experience of observing that happening. I teach capacity assessments to doctors and medical students, and it is often the case that they are very poorly conducted.” — [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 28 January 2025; c.”
House of Commons26 February 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I agree. As part of the code of practice, professionals are expected to complete the training that has been outlined already, but I am not confident that that is actually happening. Saying that there will be training does not reassure me that it will be robust enough.”
House of Commons26 February 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗
“I want to make it clear that the capacity assessment is the key. I would love to support this amendment. As I said earlier, this issue was one reason I voted against the Bill on Second Reading, but passing this amendment might change my position and I would love to support it.”
House of Commons26 February 2025Contains Parliamentary information licensed under the Open Parliament Licence v3.0Source ↗