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The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 within England and Wales as a framework for making decisions about incapacitated persons' care and treatment generally not amounting to a deprivation of their liberty (although such could be authorised under its powers by the new Court of Protection). From a planned date of April 2009, the MCA is to be enlarged by the provisions of the Mental Health Act 2007 (MHA 2007) to encompass deprivation of liberty, with the addition of a new framework of Deprivation of Liberty Safeguards (DOLS). The MHA 2007 also revised significant aspects of the Mental Health Act 1983 (MHA), which were implemented in November 2008. The interface between the MCA, as amended to include DOLS, and the revised MHA is complex and potentially ambiguous. This paper describes in detail some issues that may arise at the interface of the two acts, and seeks to inform professionals involved in the use of these legal frameworks of the resulting complexity.

The purpose of this paper is to review policy or guidance on the implementation of Section 5(4) written by NHS mental health trusts in England and health boards in Wales.

A Freedom of Information request was submitted to all trusts in England (n=57) and health boards in Wales (n=7) asking them to provide a copy of any policy or guidance on the implementation of Section 5(4). Documents were analysed using content analysis. Specific attention was given to any deviations from the national Mental Health Act Codes of Practice.

In total, 41 (67.2 per cent) organisations had a policy on the implementation of Section 5(4). There was a high level of consistency between local guidance and the Mental Health Act Codes of Practice. There were however; different interpretations of the guidance and errors that could lead to misuse of the section. Some policies contained useful guidance that could be adopted by future versions of the national Codes of Practice.

The research has demonstrated the value of examining the relationship between national and local guidance. Further research should be undertaken on the frequency and reasons for any reuse of the section.

Greater attention should be given to considering the necessity of local policy, given the existence of national Codes of Practice.

This is the only research examining the policy framework for the implementation of Section 5(4).

There will be few who complain of the importance of place which the subject of food hygiene has been given in recent years in the public health field, or of the striking advances which have been made. In the field of legislation, present food regulations are clearly an advance on any that have gone before ; hygienic practices and hygiene of person are covered in a way and with a completeness never previously attempted and it is difficult to see any further progress being possible in this direction, at least for some years to come. The results from the long campaign in health education have probably not reached expectations, not from want of effort on the part of those responsible but because the medium to be educated, in parts at any rate, is not an essentially receptive one. The larger and progressive concerns engaged in the preparation and packing of foods have been responsible for much that is good, particularly in instituting strict control in the places where harm can most easily be done. Not a few employ the “ no touch ” technique by workers throughout preparation if possible, and at every stage where it can be reasonably applied.