The current system for keeping vulnerable people safe has become unworkable - Minister for Care
Passing the Mental Capacity (Amendment) Bill reforms is essential to ensure the most vulnerable in our society continue to receive access to essential legal protections, says Minister for Care, Caroline Dinenage MP.
The next stage of the Mental Capacity (Amendment) Bill has begun in the House of Commons. The passage of these reforms is essential if we are to ensure some of the most vulnerable in our society continue to receive access to essential legal protections.
To say we are at a critical moment is no understatement. The current system for keeping vulnerable people safe has become unworkable.
Take the example of a person with dementia. They may lack the capacity to make important decisions about their own care so if there need to be restrictions placed on them to keep them safe, for example locks on external doors, they must be carefully assessed to ensure it is in their best interests.
Under the current system, known as the Deprivation of Liberty Safeguards (DoLS), there is an alarming backlog of more than 125,000 applications awaiting assessment, with the number continuing to rise.
This is in part due to a surge in applications after a 2014 Supreme Court ruling which widened the scope of the safeguards and the number of people whose arrangements need to be assessed.
Our proposed reforms, known as the Liberty Protection Safeguards, are based on the Law Commission’s three-plus years of engagement with service users, local government and providers and will ensure people are kept safe by aligning the authorisation process with existing care assessments and planning.
Our model differs from the Law Commission’s in some parts because they looked at wider changes to the Mental Capacity Act, whereas our Bill focusses on urgent reforms to the DoLS system itself. We have also gone further than their proposals in some aspects, for example, making it an explicit duty on the face of the Bill to consult with the person involved.
The safeguards in the new model have also been strengthened by its passage through the Lords, where we listened to the views of colleagues and made amendments to reflect these.
In practice, our impact assessment shows the cost of funding the current system to clear the backlog would cost over £2 billion. Rather than propping up a broken system we believe taxpayer’s money is better spent on delivering care with a streamlined, easier to access system.
There has been concern that care home managers have too much power in the proposed model. But care home managers will never be responsible for authorising arrangements or conducting reviews.
This will rightly be the sole duty of responsible bodies such as local authorities or hospitals. Care home managers will continue to play a role in identifying a need for safeguards as part of someone’s care and treatment as they do in the current system.
We also expect care home managers to play a role in flagging whether someone has objections to their arrangements. Our Bill is clear that those interested in the person’s welfare, such as family members or other healthcare staff, are also able to flag objections to the responsible body.
For people with long term progressive conditions, starting the process from scratch every year can be cumbersome and unnecessary. We will therefore triple the maximum authorisation length from one year to three years, as recommended by the Law Commission.
However, a three-year authorisation will only be possible on a second renewal. They will only be granted to people who have already received two prior assessments and authorisations and whose circumstances are unlikely to change.
By streamlining the system we will ensure quicker access to safeguards while also saving local authorities and hospitals money, which they can reinvest in frontline care.
More than 48,000 people have been waiting over a year for an assessment. This is unacceptable.
I know members of all sides of the House want to do something about this, and we are determined to continue working collaboratively with members throughout the Commons stages of the Bill, as we did in the Lords.
We may not have another opportunity within this Parliament to deliver these reforms - we must not let down the 125,000 people waiting without protections.
Caroline Dinenage is Minister for Care and Conservative MP for Gosport.