It’s hard to believe that I have now been President of the
College for nearly six months. Most of the time it has felt like I
have joined the cast of my favourite programme, “The West Wing”,
except that I am the only member of the cast who hasn’t got a
script. But it is steadily getting better.
The good news - psychiatry and mental health continues to be
high in the news and political agenda. The importance of “parity of
esteem” between physical and mental health has been recognised not
only by government, but all the political parties in the run-up to
the general election in 2015. The bad news – there is no more
money. So we will have to keep the pressure up to ensure at
least some of the broad sunlit uplands that we are promised will
actually come to pass. It is not all bad though – we have already
achieved things in developing more liaison services, and more CAMHS
Tier 4 beds.
As is customary, when you start, there is a brief media circus,
in which journalists interview you at length in the hope you will
say something interesting. And try as one will, it is very
difficult to remain completely bland and boring for an hour, so
usually something slips out, and inevitably that is the story.
So I got a lot of column inches and even a Times Leader on my
first day, courtesy of my views on the dangers of
over-medicalisation and professionalisation of distress. The
Guardian’s Health Editor Sarah Boseley then interviewed me for an
exclusive in which I highlighted the need for government to deliver
"parity of esteem" for mental and physical health services. A long
interview with HSJ went very well – by which I mean everything was
so sensible that the journalist started to lose the will to live,
perking up only with a side swipe at Monitor – but who doesn’t do
that. The Times had another go – this time focusing on my use of
“parity of misery” as a more accurate description of the current
And so it goes on – the usual dance in which one party seeks to
be statesmanlike, sensible, balanced and so on, whilst the other
looks thoroughly bored until you finally say something
Closer to home, Council have supported my priorities for the
next three years. These include recruitment and retention
(workforce and training), College standards for individual practice
and services, and communications and engagement. Or as Peter Aitken
put it - making us visible, credible and useful.
Most of you probably don’t care, but because of major changes in
our governance procedures, we now have a Board of Trustees that
deals with all the important but occasionally dull stuff, and also
is the arena in which our new (and spectacularly impressive lay
trustees) hold us up to independent scrutiny. This means that
Council can now spend longer looking at major policy issues in
depth – such as assisted dying, community treatment orders and so
My major concerns remain with recruitment and retention. If we
crack that, then all else follows. The expansion of the Foundation
Year so that 50% of all junior doctors will do a psychiatry post,
is a challenge, but if we get it right, the impact will be
profound. We know that we need more, not fewer, psychiatrists in
the future – and the 20 year forward look by the Centre for
Workforce Intelligence confirmed that; but it is for us to ensure
that we attract more medical students into psychiatry to fulfil
I am also very keen that we get working on new student
initiatives such as a Student Psychotherapy Scheme in every medical
school, and I am pleased to report that the Medical Psychotherapy
Faculty is running with this, probably just to take their minds off
the irresistible rise of IAPTS.
And just as in the West Wing, there are moments of fun. I did
'Any Questions' in August. Once we got started it was actually
enjoyable. Less enjoyable was the two days of irritable bowel
syndrome between receiving the call and doing the programme. Any
doubts as to whether IBS is a psychosomatic disorder are hereby
ended. That never happened to President Barlett.
Talking to an audience of 1,000 people in
a debate with Will Self, not a great admirer of our profession,
was also daunting. But it’s great that so many people were prepared
to come out on a rainy night to take part in a debate on mental
health. Even better – we won.
There’s more debating to come in January 2015
when, in keeping with the tradition past President Sue Bailey
began, College HQ will be hosting the first of RCPsych’s Evening
Lectures series. The first, ‘Time to put psychedelics back into
psychiatry?, will be given by Professor David Nutt at 6.30pm on
Tuesday 20 January. The prospect of a cult psychiatrist talking
about cult drugs should be irresistible.
So that’s life in the West Wing to date.
Certainly not boring. Not ever.
21 November 2014
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