The Society enters 2005 in very good shape. I reflect that when I joined the Society in 1974, Help the Aged provided us with a small amount of accommodation in Bernard Sunley House and we had a part-time secretary. We now own a substantial property in a trendy part of London and have five very dedicated and professional staff.

Thinking strategically
We cannot rest on our laurels as the biggest specialty in the Royal College of Physicians (London). We need to have an organisation that makes our influence felt in the wider medical and political worlds. Front page news in this month's newsletter is the strategic plan, which was first presented at the Council Study Day in July and will be the major item of debate at the UK Management Meeting in January. In creating the plan Alex Mair and myself worked very closely together. We initially produced a very large document as a end product of brain storming and consulting a wide variety of opinion. We then slimmed down the results to encapsulate the main areas in which the Society needs to develop.

The purpose of the strategic plan is to develop a business plan, so that the activity of the Society can be focussed and our success or failure in achieving our aims might be measured. It is very easy to grow committees and have talking shops, but at the end of the day each part of the Society must have a purpose, function and product. I aim to increase the professionalism of the organisation so that we can be effective and not waste resources and time. Any organisation needs to start with a vision. My vision for the Society would be to provide the best possible care for frail older patients. A vision generates a mission, which is embodied in our strategic plan and translates into a business plan of activity and investment.

Every organisation needs to evolve and adapt to meet the contemporary challenges. Geriatric medicine certainly has many of these to face. Some of the basic questions we are trying to answer in the strategic plan are:-

• How can we effectively make the geriatrician's voice heard in public debate?
• How do we play a full role in the international community of geriatricians and gerontologists?
• How do we provide young geriatricians with opportunities to build successful careers?
• How do we revive the flagging academic sector?
• How do we maintain the energy and drive for the change, which has been so characteristic of geriatric medicine?
• How can we produce alliances of organisations that have a shared concern about older people in society, so that we can be more politically effective?
• How do we promote interdisciplinary working?
• How do we generate the resources to maintain and expand our activities?
• How do we register and meet the needs of our members?

The strategic plan is open for debate and I hope all our members will give it serious consideration and make their views known at regional meetings or to me direct. We will have a discussion forum on the BGS website which is being overhauled, beginning with a newly developed CPD section, and I would welcome comments posted onto the forum. There may be areas that we have neglected, or areas where we need more emphasis, and it is ultimately up to the members, to decide how the organisation progresses.

The first couple of months as President have involved me in a lot of activity, only a few of which I can highlight here.

United in Care
On December, 1st I was very proud to introduce our first stand alone Interdisciplinary meeting, United in Care, held at the Royal College of Physicians (London). The Society owes a tremendous debt to Doug MacMahon who took on the organisation of this meeting when it was flagging, and you will see from the report included in the newsletter that he managed to assemble an excellent cast of speakers and we had a truly inter-disciplinary audience of 150 people from nursing, paramedical and medical backgrounds. We are very grateful to MEP for organising the meeting. It was rather nostalgic to have a meeting back at the Royal College of Physicians (London), which remains an excellent venue. We hope to develop these meetings and the inter-disciplinary committee of the Society will be reformed. We will have a post-mortem of the strengths and weaknesses of the meeting. I personally hope this will be an annual event, which will do much to strengthen our alliances with other disciplines.

Through our associate membership and our special interest groups, we are opening the door to non-medically qualified members and I hope this trend will increase as the practice of geriatric medicine is clearly inter-disciplinary, and if we are, as a Society, to maintain our authoritative position, we must work as we do in our hospitals, in close collaboration with our nursing and para-medical colleagues. To this end I was very grateful to speak to the network of nurse consultants in elderly medicine at the Department of Health, by invitation of Debra Sturdy. I found the group of around sixty consultant nurses a very stimulating group of people with whom we should work closely.

Influencing policy
Our aim to influence policy has shown a number of recent successes. Firstly, our regular meetings with Ian Philp in his capacity as Geriatrics Tsar had been extremely helpful. Ian of course, is a very active member of our Society and his recent document Better Health in Old Age demonstrates the progress that geriatrics is making. Ian has been extremely open to our ideas and has kept us well informed about current debates. He has recently become President of AGILE, a society for physiotherapists specialising in ageing, and he and I are anxious to try and produce a forum, hopefully with the British Geriatrics Society playing a full part, where the specialist societies for managing older patients can engage together in issues of improving care.

Agreeing to disagree
It is perhaps an indication of the Society's influence that we have twice been asked to give evidence to the House of Lords Committees. Firstly, Peter Crome ably put our view on the scientific aspects of ageing. Then on the 14th December, Gill Turner and I spoke to the written submission that the Society's Policy Committee, submitted to the House of Lords Sub-Committee on the Assisted Dying for the terminally ill Bill. This Bill is a private member's Bill, sponsored by Lord Joffe. Our written statement has been published and is available on the website. The submission illustrates, I think, the strength of our Society in developing a consensus in a complex and divisive matter. While I strongly believe that our statement encapsulated the broad view of practicing geriatricians, we did have to contend with strong views from both sides of the spectrum of the argument.

I had a heated email conversation with ex-President Peter Millard, who objected to some of the caveats at the end of our statement, and who has expressed his views in a letter to the Editor. The matter was resolved amicably with a promise by Peter to stand me dinner at the RSM, to which I will hold him. Ray Tallis, on the other hand, is a very strong advocate of the Bill. It is interesting that the Royal College of Physicians in London adopted a neutral stance to the Bill in spite of Ray's very persuasive arguments within their Ethics Committee and to the Council of the College. I was very fortunate to have Gill Turner by my side at the Select Committee, and I believe we acquitted ourselves well and will have some impact on future legislation. Interestingly, we submitted our evidence together with Jonathan Ellis and Tom Owen of the Policy Team of Help the Aged, and although we had produced our documents completely independently, the organisations were strongly in agreement with each other. I think it is a very healthy situation when a professional organisation has the same view as the body representing its patients.

Lessons from Scotland
On the 15th December, I had an informal meeting with Carol Black, President of the Royal College of Physicians in London, which I hope will be the first of a series of informal contacts. She was shocked when I expressed the belief that the Colleges in Scotland integrated geriatric medicine to a greater extent and supported the specialty in a more effective way. I am a firm believer that the strength of geriatrics in Scotland is aided by their major involvement in their Colleges. The London College has become a confederation of specialist interests and while geriatric medicine is probably the largest of these, I am worried that our visibility in the London College is small. We do, however, have hopeful signs with Ian Starke being Director of CPD and Jonathan Potter (Canterbury) having been heavily involved in the CEEU. I am grateful for the support of the three UK colleges in resolving to have a special question group in geriatric medicine for Part I of the MRCP, and under Carol Black's energetic and open leadership of the London College, I think we shall make further progress with the agenda of our specialty.

In the afternoon of 15th December I had a meeting instigated by Jackie Morris and attended by David Black, with Nigel Edwards, Director of Policy at the NHS Confederation. Nigel Edwards' organisation is an important player in determining policy in the Health Service, as it represents trusts and other organisations related to the NHS. We expressed our concern that the innovation and drive of geriatricians was not reflected in policy formation, and particularly that the debate on managed care has adopted a far too American tone. We have, in principle, an agreement that the National Confederation will organise a meeting with the British Geriatrics Society and debate the future of managed care of the frail older patient. I think this is a positive step in increasing our influence in policy making.

I am looking forward in the next few months, to speaking at both the Scottish and Welsh National Meetings and I have been delighted to accept an invitation to give the Willy Bermingham Memorial Lecture to the Irish Gerontological Society, our sister organisation in Ireland. The cordial relationship between our two societies has been a source of strength and a stepping stone for a wider international involvement of the Society.

Finally, thanks to the leadership of Peter Crome, we are making headway with the Clinical Excellence Awards. I would like to thank everybody for their help and hard work. It sometimes seems that the support for our members with regard to CEA takes a disproportionate amount of time and effort, but our increasing success on behalf of our members is very pleasing.

I hope 2005 will be a time of significant progress for the Society. I am certainly enjoying the ambassadorial element of being President and I am hopeful that my efforts, and those of all the senior officers of the Society, will be effective in making the voice of our specialty a prominent one in the contemporary debate.

Jerry Playfer