Baroness Barker (LD)

My Lords, I do not want to bore people who were not present 20 years ago when we were discussing the introduction of this measure, but the main focus of our discussion was that CTOs would be a means of enabling people with serious and enduring conditions, such as schizophrenia, to be compelled to take medication in the community. That was as a matter of public safety and protection for those people. Twenty years on, we are talking about people with eating disorders: it is completely different. The noble Baroness, Lady Browning, is right: the evidence base behind the discussion is woefully lacking. What we do not know—we do not have the evidence for it—is what change has come about on the part of clinicians. It was sold to us that we were going to stop people being held inappropriately in acute services where they did not need to be and where there was not going to be any therapeutic benefit for them. We have never, to the best of my knowledge, seen that there has been change, nor, indeed, that there has been a flow of resources that has enabled those patients who have been on CTOs to leave acute hospitals and not go back. Unless and until we get that evidence base, frankly, we can all come up with our theories about what are the causal factors, but they are nothing more than our own prejudices and theories. That said, my amendment on CTOs comes from real-life, front-line experience. As the noble Lord, Lord Kamall, read out from the briefing, there are people whose experience of being on CTOs has been so bad that they want to see an end to them; they do not want to see other people being subjected to them, and I have a degree of sympathy with that. Having said that, I accept that there are some people for whom they work.