The title 'severe mental impairment' itself is a difficult one to come to terms with - it is a blunt label that has a tinge of language used in a previous age - the word 'mental' has connotations that once had a great stigma attached, and which people may still associate with the large hospitals that we housed our mentally impaired people in past decades. But it is a catch all phrase that enables anyone, not just with dementia, but who may have another condition permanently affecting cognitive functioning, in legal terms to be exempt from liability for council tax.
Incidentally, the term Severe Mental Impairment for the purposes of council tax is not related to the severe mental impairment used in the Mental Health Act 1983 - its use stems from the Local Government Finance Act 1992 detailing the changes brought in with the abolishment of poll tax. The two are not to be confused.
The thinking behind the exemption is that those with permanent conditions affecting cognition and social functioning are not able to understand local issues that council tax is spent on, and therefore cannot be considered to have a stake or accountability in said issues.
After establishment of permanent condition such as Alzheimer's, eligibility for attendance allowance or other qualifying benefit, the doctor must then certify the person as having a Severe Mental Impairment.
Because dementias are progressive, and often gradual in their course, I often receive questions about whether someone can claim the severe mental impairment exemption - and the answer often is, I can't be sure. The judgement made by the doctor is just that, a judgement based on their knowledge of the person, to decide whether they have the ability to comprehend local issues and therefore whether their impairment is 'severe' enough to warrant exemption. There is no clear boundary or point at which this occurs - as is the case in many dementia related issues. If the doctor is unsure, after consulting with fellow medical practitioners, they are advised to exercise caution and not certify. This is possibly where some carers and people with dementia end up having long waits to hear about their application - whichever disease is causing the dementia, will get worse over time, so it is possible that someone ineligible at the time of application may consequently be eligible several months later.
So to the question of voting - it is important to note that the electoral register is created separately to the council tax, and the two are subject to different legislation. Although it is not the only Act of parliament that impacts on deciding whether someone has the right to vote, the Mental Capacity Act 2005 is most relevant in this circumstance. Just because someone is exempt from paying council tax on grounds of severe mental impairment, does not mean they are unable to understand the process of voting, make a decision (wisely or not!) as to who they wish to vote for, and express that decision.
These considerations - whether someone can understand the information related to the decision, retain long enough to decide, make a decision and communicate that decision - are used by the Mental Capacity Act 2005 to establish whether someone lacks the mental capacity to decide, and only when there is reason to question that we don't have capacity. In many circustances - for example, deciding whether to employ a carer, or have medical treatment, or wear a warm coat on a hot day, the person's best interests must be the basis for making each decision on their behalf. However, when voting is concerned, the law states that a voting decision is one that cannot be made on behalf of a person - therefore if someone does not have mental capacity to cast a vote, they are excluded from being able to vote.
It is important to be clear that presence of a condition such as Alzheimer's or any other dementia, does not in itself remove the right or mental capacity to vote. All steps should be taken to enable someone to make and communicate an informed decision. If someone with dementia lives alone, has nobody to support them in registering to vote, to get to the polling station at the right time on the right day, or arrange a postal or proxy vote, they are likely to lose out on their right to vote, despite still possibly being able to do all these things and cast a vote with appropriate support.
Links to useful websites:
http://www.direct.gov.uk/en/HomeAndCommunity/YourlocalcouncilandCouncilTax/CouncilTax/DG_10037422
http://www.trafford.gov.uk/adviceandbenefits/counciltax/
http://www.legislation.gov.uk/ukpga/2005/9/contents
http://www.aboutmyvote.co.uk/
http://www.electoralcommission.org.uk/
redditch.whub.org.uk/cms/docs/smi%20notes.doc
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