Chamber and committees

The consultation also invited comments on the operation of the act which were outwith the remit of the consultation paper but which consultees felt should be drawn to the government''s attention. In addition ministers and officials are happy to take comments on how the act is operating at any time.

Responses to the consultation, including comments on the matter referred to in this question, are currently being considered. Amendments to the act in the light of the consultation will require primary legislation however there will be some changes which can be made through practice guidance or amendments to secondary legislation, in advance of primary legislation.

There are limited exceptions to this. Firstly, a certificate by a medical practitioner authorising emergency detention in a hospital for up to 72 hours is permitted, although it should be noted that in this period no compulsory treatment may be given. Secondly, a short term detention certificate for up to 28 days sanctioned by a medical practitioner with specialist experience in the diagnosis and treatment of mental disorder permits treatment. In both of these cases there must be a significant risk to the health and safety of the patient or the safety of others. Thirdly, the Scottish Ministers can, by means of a direction under the act, transfer a prisoner to hospital for treatment on the basis of reports from two medical practitioners who confirm that the prisoner has a mental disorder, and again that there is significant risk to the health, safety or welfare of the prisoner or to the safety of any other person if medical treatment is not provided.

In the cases of short term detention and any transfer to hospital for treatment of a prisoner, both the patient and their named person can apply to the Mental Health Tribunal for revocation of the power to detain and treat.

Diagnosis is the expression of a clinical judgement and does not in itself have legal consequences in respect of the liberty of the individual. Where the powers of the Mental Health (Care and Treatment) (Scotland) Act 2003 are invoked the law does provide for appropriate appeal rights.

Where an individual feels that they may have been misdiagnosed as suffering from a mental disorder of any sort they may ask for a second opinion or they may contact the Mental Welfare Commission for Scotland to look into their complaint.

Section 328(1) of the act defines mental disorder as mental illness, personality disorder or learning disability, however caused or manifested.

Diagnosis of mental disorder can only be made by an approved medical practitioner (AMP): this is a medical practitioner who has been approved under section 22 of the act by a health Board or by the State Hospitals Board for Scotland as having special experience in the diagnosis and treatment of mental disorder. An approved medical practitioner will often be a consultant psychiatrist. All AMPs must undergo a two day training package in the provisions of the act before being approved to carry out AMP duties under the act.

The act makes provision for the Mental Health Tribunal for Scotland which exercises powers in relation to detention and which ensures that the clinical judgements of AMPs and mental health officers (MHOs) are subject to appropriate scrutiny.

This was achieved by re-directing paediatric ECMO patients to centres commissioned to participate in the UK''s paediatric ECMO network; by reducing cardiac elective capacity; by maximising the rotas of existing trained staff and by ensuring all post-ECMO patients were transferred out to referring units as soon as possible. Additional accredited surge capacity has also been commissioned temporarily at the Royal Brompton and Papworth Hospitals. There are now 12 beds in the UK for adult respiratory ECMO, which represents more than a doubling in capacity.

As the UK''s designated centre for adult respiratory ECMO, Leicester is and remains the gateway and first option for access to this treatment. The UK CCG, which reconvened to assess the current provision of ECMO at this stage of the pandemic, recommended on 11 November that Glenfield will maintain its capacity at the current level of eight active ECMO beds in order that this central role can be maintained.