Unfitness to Plead Consultation Responses - Law Commission ...

introduction, more than ten times the expected number of orders have been made. Their use has
proven highly popular among clinicians, many of whom would point anecdotally to a role in
protecting the public as well as patients themselves. Patients, understandably, are found to have
mixed feelings, but appreciate CTOs in particular where they provide an alternative to
hospitalisation. In my view, it would be feasible for a Court to have this power. In my view it follows
a clear line of logic for a Court to impose a CTO instead of a supervision order where an ‘unfit’
defendant has committed an act or omission in the context of not having adhered to treatment for
the illness that has rendered them under disability (in whatever way).
Of all the points above, I think that the replacement of supervision orders with CTOs, or at least an
alteration to the way in which supervision orders operate, is perhaps one of the most important
issues. I am mindful that if they are not improved at this juncture, there may not be another
opportunity to do so for some considerable time.
The Commission may also observe (or fear) that a change in the test for unfitness would be likely to
catch increasing numbers of non mentally disordered offenders, or indeed those feigning mental
disorder. I think that malingered unfitness is another potentially huge problem that might follow
revisions to the procedure. As a medicolegal expert I already see this frequently. I think it is
necessary for the problems of malingering to be given some thought, whatever the final shape of
the new proposals become.
Can I pass the Commission my best wishes in its future work on fitness to plead. Given my special
interest in the topic area I would very much like to continue to be involved, if required, and I would
be more than happy to attend further events arranged to help take these changes forward.
With kind regards,
Dr Tim Rogers MB BS MRCPsych MSc
Consultant Forensic Psychiatrist
North London Forensic Service
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