Policy and Politics: Mental Capacity Bill nears approval

Indira Das-Gupta

Royal assent represents a victory for the Making Decisions Alliance.

Royal assent for the Mental Capacity Bill, expected this week, will be the culmination of a carefully orchestrated campaign by a broad alliance of charities to persuade the Government to protect the right of the vulnerable to make their own decisions.

At one point the Daily Mail almost scuppered the Bill with stories that it would bring "euthanasia through the back door". This was echoed by the Society for the Protection of Unborn Children, which fiercely lobbied MPs.

That the Bill still managed to win the support of both the Lords and the Commons is thanks largely to the Making Decisions Alliance - a group of 39 charities including Turning Point, the Alzheimer's Society, Help the Aged, Scope, Leonard Cheshire and Sense.

Richard Kramer, co-chair of the alliance and policy director at Turning Point, said working together made the campaign much more effective. "The Government would rather talk to one representative body than lots of different organisations," he said. "We were very committed, and met every fortnight for two years. There was a huge degree of consensus because we made the time to hammer things out."

The alliance was set up because of growing frustration that the Government had committed itself to legislation in 1999 but was making no progress.

To increase awareness among the public and MPs, the alliance commissioned an NOP poll, which found that 92 per cent of those questioned mistakenly thought doctors are legally obliged to consult partners of patients who are unable to make their own decisions.

"The poll opened up the debate and showed how a Bill would be relevant to a lot of people," said Kramer.

Detailed campaign packs were sent to the alliance's members, who sent 8,000 postcards to the Government calling for a change in the law. This led to a pre-legislative scrutiny committee, which took evidence from the alliance and adopted many of its recommendations.

The claims by the Mail and the SPUC forced it to step up its campaign, and make clear that it was against euthanasia. Kramer said: "Although we never expected members of the SPUC to change their minds, we felt it was important to maintain dialogue with the opposition."

The alliance continued to push for concessions, tabling amendments through MPs and peers, including an anti-discrimination clause and an extra £6.5m for advocacy. Kramer said: "We have kept an open relationship with the Government, and thus maintained momentum."


- It introduces the presumption that people can make decisions for themselves unless it's proved that they are not able to do so

- It gives a central role to advocacy, so those who have trouble making or communicating decisions have an independent person who can argue for them

- It places a duty on doctors, lawyers and others to consult with the individual, relatives and carers

- It includes a non-discrimination clause preventing doctors from making decisions based purely on someone's disability or limited capacity.

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