Why have a National Mental Capacity Forum?

Featured article - 27 October 2016
By Baroness Ilora Finlay, NMCF chair

Some people ask “why bother to have a National Mental Capacity Forum?” The answer lies in what has happened to date. The Mental Capacity Act of 2005 (MCA) was hailed as a great piece of legislation to empower people with impaired capacity to make the decisions they can make and to ensure that when others made a decision on their behalf, the decision was truly in the best interests of the person and not the interests of others. In an ideal world we should not need such legislation – we should be respecting the intrinsic worth of everyone and supporting them. But the real world is not like that and ‘life’ throws all kinds of difficult and sometimes terrible events at people.

Only today I was listing to ‘Thought for the Day’ on radio 4, about a person in a minimally conscious state after an accident, whose close friends visited; the hope of a ray of recognition was a cherished moment they hung on to. But then later in the day I watched a powerful play reading 'Don't Leave Me Now' about dementia. It is up on YouTube accurately depicting the frazzled nature of carer fatigue and the grief amongst those who love the person with dementia. And it illustrates some of the issues in decision making. There are many good films up on YouTube, emphasising the five principles of the MCA, and stressing that it applies to a specific decision at a specific time. Yet even that latter point seems poorly understood in practice.

The National Mental Capacity Forum members are working to disseminate clear understanding of the MCA to make sure those who need support can get it and that they are empowered to make their own decisions wherever possible. Of course I hear stories of when things are not done properly, when decisions are restrictive, but there is goodwill to improve understanding. I have recently met with the Academy of Medical Royal Colleges, with the Care Quality Commission and other health leaders – and time and again there is a commitment to improve the care for those with impaired capacity and improve implementation of the MCA.

An excellent little book “Grandpa on a skateboard” by Tim Farmer is eminently readable and explains the practicalities of assessing mental capacity and unwise decisions – it makes a good bedtime read for anyone involved in dealing with people. There seems to be so much to do to just get the core principles of the MCA understood widely. The Shropshire collaborative developed the brilliant handprint to portray them and it seems to have captured the imagination of many – so let’s all use it.

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