Published: 27/03/2003, Volume II3, No. 5848 Page 10 11

Scotland is preparing for the most radical shake-up of mental health legislation for 40 years after the Scottish Parliament resoundingly backed a change in the law.

MSPs unanimously voted for the Mental Health (Care and Treatment) Act following a twoday debate last week.

The main changes heralded by the bill include a new mental health tribunal combining professional, legal and practical experience, replacing the sheriff courts in deciding what is suitable for patients.

Access to advocacy will be enshrined in law and the Mental Welfare Commission, the independent body which has a duty to protect the rights of patients with mental disorders, will be strengthened.

More controversially, the bill provides for a new compulsory treatment order for those in the community as well as hospital.

But this section - which drew most criticism from campaigners - has been tempered by a number of safeguards. These include provision to keep the number of community treatment orders under review to make sure they are not used excessively.

Until the final days of debate, there were some doubts that the bill would be passed before Parliament stops work at the end of this month ahead of the 1 May elections.

In the third stage, there were still more than 750 amendments to be considered and there were over 1,400 at stage two - although around 40 of these were required to change the name from the Mental Health Bill to the Mental Health (Care and Treatment) Bill.

But the Scottish bill did not provoke anything like the hostility produced by the English proposals, which have still not been timetabled at Westminster.

Scottish Association for Mental Health director Shona Barcus said: 'I think the key difference was that the English plans were unpopular because they focused on public order and safety.

'In Scotland, the bill takes more account of service-user rights.

Public safety is in the Scottish bill, but It is not the central tenet.'

But she said that although the bill was 'a big improvement on what We have got at the moment', it was still 'something of a missed opportunity'.

'There is a lot in there that we like, such as advocacy, tribunals and safeguards around compulsion. But It is a big disappointment that There is no reciprocity. We wanted a clause which put a duty [on the health service] to provide safe and appropriate services, but they wouldn't put that in.'

The bill is expected to cost an extra£23.1m per year with one-off start-up costs of a further£9.25m by the end of 200708. The Scottish Executive is committing£17.1m a year to implement the bill and the NHS will be expected to spend an extra£6m a year.

British Medical Association Scottish secretary Dr Bill O'Neill said: 'The Scottish Parliament is to be congratulated on the passing of this legislation. It is a further demonstration of the success of devolution.

'We are conscious of the failure south of the border to bring forward mental health legislation that provides sufficient protection for patients, and initial proposals for public order regulations were resisted by doctors and patients alike.'