As you read this after the excesses of the festive season, may I take this opportunity to wish you a happy and prosperous 2006.

We have much to look forward to with the conference in Newcastle-Gateshead and the newly established SIG for nurse consultants and specialists, not to mention reduced subscription fees now that the mortgage on Marjory Warren House has been paid off. I know that Stuart Parker will be particularly pleased about this last fact after his impassioned plea at the AGM a couple of years ago. Nonetheless there are a few storm clouds gathering with many Trusts apparently carrying significant financial overspends, stories of rehabilitation wards being closed and the rumoured break up of at least one Stroke team. Working in a Foundation trust we have found that the financial position is closely scrutinised by the regulator monitor and firm action has been taken to control expenditure.With Payment by results, the balance between income and expenditure is being looked at down into departmental level, emphasising the need to make sure the activity undertaken in geriatric medicine units is accurately coded and measured to avoid further threats to our services. Have other units experienced the same pressures?

Demoralised again
Many thanks to Jenny Yeo, a flexible trainee in the Northern Region who wrote to me following the piece in the last issue about demoralisation of trainees as a result of changes in GIM training, particularly Hospital at Night, which seems to have made night shifts very onerous in some places. Jenny writes, “I am also concerned about the increasing role consultants are likely to have….[in the acute take]. The suggestion has been that younger consultants should shoulder the…..burden of GIM and then move out of this later in their careers, but this ignores the needs of…. consultants, male and female, with young families.” Jenny suggests there is a need for a national level debate on this issue, perhaps in the arena of Modernising Medical Careers. I have opened a forum on this issue on the BGS discussion board. Any views?

The View from Primary care
I was recently asked to take part in an Educational event for GP’s where the brief was to provide a view of the future of General practice from a hospital perspective. This was counterbalanced by a GP talking about their perceptions of hospital life. In looking for stereotype images, we both produced the same picture of James Robertson Justice playing Sir Lancelot Spratt in “Doctor in the House” - perhaps I am giving off the wrong signals. What was really interesting was that both of our presentations highlighted the vital role of Primary care in the management of long term conditions and also the lack of significant numbers of GP with special interest posts in all specialities across Tyneside. Have colleagues in other regions or nations, if applicable, found the same lack of take up? The concerning feature, which we should probably note, was the anxiety that new entrant private companies will not only become involved in providing competing Primary care services from purpose built premises with diagnostic facilities, but also in commissioning negotiations with provider trusts. The world is changing very fast and as geriatricians we need to be aware and understand where we fit in this environment.

BGS conferences
Several interesting debates have taken place since the Harrogate conference alluding to firstly, a reduced attendance and secondly, the recognition in terms of CPD points of sponsored symposia. I am not certain whether the reduced attendance represents loss of novelty value with a repeat venue or whether there is an underlying trend towards restriction of study leave and reluctance of trusts to release consultants since the new contract was introduced. Although the relationship with the pharmaceutical industry is a very important one, there has been a suggestion that in some symposia the thin line between education and product promotion is in danger of becoming blurred. Ian Taylor tells us that in future CPD points available are likely to be restricted to 6 points per day and I wonder whether this will affect the attractiveness of symposia slots, given that the BGS sessions are going to enjoy priority over commercial symposia in the daily 6 point allocation. Would anyone like to offer feedback on these issues to editor@bgsnet.org.uk, or via the BGS Discussion Forum on the website?

Springtime on Tyneside
Talking of BGS conferences rings a reminder that the Spring conference will soon be upon us and it will be a great pleasure to welcome delegates to sunny (in the loosest term of the word, of course) Gateshead [and Newcastle]. Janice O‘Connell whetted our appetite with her presentation in Harrogate and her article in the last newsletter, but I would like to take the opportunity to recommend a visit to this part of the world and indeed encourage delegates to stay over for the weekend, to see what the region has to offer. Those of you who have garnered their knowledge of the North East from “Get Carter” and “The Likely Lads”, or more recently, “Spender” or “55 degrees North”, may be surprised by the classical lines and natural beauty of the city. The Northumbrian coast with its remote and forbidding castles, unspoiled beaches, and mystique of Holy Island will assure an enjoyable stay. There are certain ground rules of course:

• No coats, only white T shirts especially if the temperature drops
• No red and white striped shirts in Newcastle
• “Pet” is a term of affection, not an instruction
• Please be tolerant of drunks, there are a lot of them
• Please avail yourself of a “Larn yersel’ Geordie” phrase book
• Nail down all personal possessions, especially the conference marquee, Michael. There is a great tradition of sharing on Tyneside.

Final word – The X factor
Impressed by the singing of one of our ward patients who used to perform around the pubs and clubs on Tyneside, we recently suggested we nominate him with his mates to appear on Simon Cowell’s television talent show, “The X-Factor”. We are going to call them “Vestlife.”

Dave Beaumont