It is our assessment that any legislative change which sought to introduce a statutory test in under the MHA, could have unintended consequences for how competence is assessed in other settings, in particular mental health settings more broadly, including informal inpatients, and other linked areas of decision making. Introducing a statutory test for under- 16s solely under the MHA risks creating additional confusion within wider mental health settings and other settings. This could lead to the creation of two different tests depending on whether or not an under-16 was detained under the MHA. It also risks undermining the principles of Gillick competence, which apply broadly across health and social care contexts— including reproductive health and children’s services—and could impact the wider legislative framework relating to children. Fundamentally, we are concerned that in seeking to provide clarity, the creation of two different competence tests is likely to cause further confusion and uncertainty on the ground for decision makers and children, and, have negative unintended consequences on the ability of children to exercise choice and autonomy over their care and treatment. The MHA Code of Practice already offers guidance on assessing competence in under-16s. We will consult on updating this guidance in the revised Code to improve the practical application of Gillick and assessment of competency. Race Discrimination Committee View One of the most significant factors that prompted the process of reform that has resulted in this Mental Health Bill was the disproportionate use of compulsory detention and treatment under the MHA on people from minority ethnic backgrounds, particularly black people. Unequal treatment on the basis of race, especially in respect of the coercive powers of the state, is, of course, a significant human rights issue. We recognise that some of the changes proposed in the Bill could help to reduce racial inequity in the application of the MHA. We also recognise that the causes of differences of treatment and particularly outcomes between people of different races can be varied and complex, and that addressing them may require wider systemic and societal change beyond the scope of this or any legislation. Nevertheless, we were surprised that the Mental Health Bill contains no measures directly addressing racial and ethnic inequalities in the application of the MHA and we agree with many witnesses that the Bill could go further. We share the view of witnesses including the Care Quality Commission that the inclusion of an additional guiding principle of equity in the Bill would be beneficial. While by no means a complete answer, this would emphasise the key need for equitable treatment under the MHA. We propose an amendment to the Bill to add this additional guiding principle.