Right of patients to reject treatment is under threat, say Unison members

The rights of alcohol and substance misuse patients and obese people to reject treatment are under threat because of a government-commissioned review, Unison members have said. 

The government has asked Dame Carol Black, an expert on work and health, to review what impact alcohol and drug addiction and obesity have on people’s job opportunities.

This includes considering whether welfare benefits could be linked to patients consenting to appropriate treatment or support. 

At Unison’s health conference in Brighton this week, members said this could lead to patients having their benefits withdrawn if they refuse treatment. 

They voted in favour of a motion which said the principle of consent for treatment is under threat, that consent must be free from undue influence and that any move to coerce treatment could diminish trust between patients and healthcare professionals.

Nurse Emma Corlett told the conference: ‘I cannot see someone with diabetes being sanctioned if they don’t take their insulin properly.’

Sam Sharp, from Cambridgeshire, works to engage patients with mental health services and said some people will struggle because they are too ill to have insight into their mental health problems.   

She said: ‘They may be so poorly that they struggle to face the day and get out of bed.’

She added that she did not want to participate in ‘coerced treatment’ and she wanted to treat patients with dignity and respect.

When Professor Black’s review was launched last summer, prime minister David Cameron said it was important to consider what to do when people refuse treatment but ‘expect taxpayers to carry on funding their benefits’.

The government has said not enough is being done to provide treatment for people with long term conditions even though the conditions may be the main reason for people being out of work. 

The conference motion also called for guidance from the Nursing and Midwifery Council (NMC) on what this might mean in relation to the code of conduct. 

The code of conduct says nurses and midwives should get ‘properly informed consent’ from patients.

A Department for Work and Pensions (DWP) spokesperson said it is awaiting the outcome of Professor Black’s review and the government will consider what the review says. 

A consultation for the review ended last September and the DWP spokesperson said the review report is expected in the next few months.

A NMC spokesperson said: ‘We understand nurses and midwives concerns around coerced treatment for mental health patients and the Code addresses this issue.

‘It is clear that nurses and midwives must keep to all relevant laws about mental capacity that apply in the country in which they are practising, and make sure that the rights and best interests of those who lack capacity are still at the centre of the decision-making process.

‘The Code is also clear that nurses and midwives must make sure they get properly informed consent and document it before carrying out any action.'