Dr. Imelda Whyte:

The risk is that approved units for our most severely unwell will be unable to safely manage that very small number of acutely, seriously unwell people. This goes back to Dr. Martin's opening statement about Penrose's law. If approved centres are unable to safely manage these people, where do they go for care? The reality is that when a certain small number of people are unwell, they are a risk to themselves, to others and to other patients in their environment. That has to be kept in mind. It is incumbent on all units to reduce all restrictive practices. When we talk about restrictive practices, we often think about seclusion and restraint. Admission is a restriction. A patient with an eating disorder who is on a meal plan is under a restriction. There are levels of restrictions. We are talking about the serious ones, which are restraint and seclusion. To echo my colleagues, the expectation that serious restrictions would be reduced to zero is probably unrealistic. If that provision was no longer there, one would wonder what would happen to that small number of patients.