Dr Kalyani Katz is a fee-paid Medical Member of the First-Tier Tribunal, Health, Education and Social Care Chamber (Mental Health). She has been working for the tribunal since 1996, and was a consultant psychiatrist at the Central and North West London NHS Trust until she retired in 2011. The main purpose of the First-Tier Tribunal (Mental Health) is to review patients detained under the Mental Health Act and to direct discharge of patients where the statutory criteria for detention are not satisfied. I started working part-time in the NHS when my son was born. After he started full- time at school I had two free days at my disposal. A colleague suggested I apply for a tribunal role. This was a perfect role for me, as it was flexible, interesting and highly relevant to my clinical practice. I have now retired from clinical practice but I continue to work for the tribunal, on average two days a week and mainly in the London area. I also help to mentor colleagues applying for tribunal roles, and I hope to assist in training medical members. As a medical member of the tribunal I have been able to see the importance of balancing the freedom of patients against their right to appropriate treatment. This work helped me to see how patients viewed their detention and their treatment, and it made me explain in detail to patients under my care the rationale for their detention and treament. This, I believe, made me more compassionate as a clinician. I also learnt the importance of working in collaboration with patients and their families. The tribunal panel consists of a judge, (the legally qualified member), a medical member (a psychiatrist) and a lay member with relevant experience. As a medical member I have three important functions. I have to assess the patient a day or two before the hearing in order to elicit relevant information that might assist the panel in making a decision. During the hearing, in addition to sharing my earlier findings with the panel, I draw attention to the important issues in each case and I question witnesses - above all the patient and their responsible clinician. I take part in the panel’s discussions that lead to their decision, and I help record the reasons for this decision The medical member is expected to inform the other panel members about the details of the mental illness, the symptomatology, the treatment options and the relevant risk assessments. Working in this context with professionals from other backgrounds has greatly broadened my perspective and my understanding of patients and their individual circumstances. The method of selection of Medical Members differs from processes that psychiatrists may have experienced in other applications. Candidates need to prepare well, and it is a good idea to approach a practising Medical Member for advice before applying.
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