The title of this paper should not be taken to imply that the Mental Health Act tribunal system is not currently effective. There has been little serious criticism of the work of the tribunals, and they appear to have become accepted as a permanent aspect of the detention of patients. Some doctors appear to regard them as an irritation that distracts from the care of patients, and civil liberties pressure groups tend to question their real effectiveness. Careful, detailed studies have also tended to be critical, pointing out many defects that require attention. Peay (1989) has done some impressive research into the work of tribunals which must form the basis of any future reform. Cavidino (1989) has done a much wider study, but underpinned by a ‘theory’ which detracts from its value for tribunal members, and its treatment of tribunals is peripheral, and therefore superficial.