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One of the nicest traditions of the Society is that each President, during his term of office, hosts a lunch for past Presidents.

This took place on the 16 May at the Royal Society of Medicine. Only two of our surviving Presidents were unable to attend, George Adams, who is now in his nineties, still sends us a message of support but unfortunately is unable to travel to mainland UK these days and John Brocklehurst was unable to attend at the last minute because of illness of his wife. It is very reassuring for me to see such good health and longevity in past Presidents.

Following the meal we had a lively discussion about the state of geriatrics past and present, which more than demonstrated the benefit of collective memory. Jimmy Williamson, President 1986-1988 had the honour of being the most senior past president. As a former mentor of mine, it was great to see him in such sharp form and so up to date with modern developments. The next most senior was Marion Hildick-Smith 1988-1990. Marion was a terrific influence on my career. She was one of the first geriatricians to have a serious interest in Parkinson’s disease and develop the rehabilitation model of managing the condition. She was influential in the Parkinson’s Disease Society and was also instrumental in developing excellent services in Canterbury. It is not surprising that Canterbury is such a leading centre in geriatrics to this day, following the foundations that Marion put in place. I was particularly delighted that Brian Williams was able to attend. He has just been elected President of the Glasgow Royal College of Physicians and Surgeons. It is a huge honour in its own right and it is great that a geriatrician should fill this post for a second time - another ex-president of the Society, Sir William Ferguson-Anderson having also held this position. It was particularly pleasing for Peter Crome and myself that all Presidents of the last twenty years were able to attend. I am keeping my fingers crossed that Peter will continue this tradition so that I will able to attend as an ex-President in two years time!

CME Journal
Two days later we had the UKMC meeting and because of missing the March meeting, this was a particularly long and arduous, not helped by Jackie Morris inadvertently turning up the central heating! One of the most difficult discussions we had was regarding the provision a CME Journal for the Society. Duncan Forsyth who is both a Council Member but also the Editor of a CME Journal run by RILA, put forward a proposition to the Society whereby RILA would provide the Journal to the members of the Society. Duncan made a strong case as had our CME Director Ian Taylor.

As you know we have been asking for the views of the membership in regional groups regarding this matter and the feedback from this was still unclear. After a rigorous debate, a vote was taken, and by the narrowest majority, it was decided not to accept the proposal at this time. Possibly the most serious reason for the ambivalence of the committee is the fact that the editorship of the Age and Ageing journal is changing and it was felt that the views of the new Editor on this matter were important before a final decision was taken. I do hope however, that we do soon have a paper form of CME to complement our other excellent educational activities.

Age and Ageing
The Society has renewed its contract with OUP for the publication of Age and Ageing. Our relationship with OUP has been an excellent one (I am pleased about this as the original contract was negotiated during my time as deputy Treasurer). Age and Ageing was originally produced at some expense to the Society, but now contributes a substantial amount to the BGS income. We have been lucky having outstanding editors of Age and Ageing who have raised the profile and respect in which the journal is held. I would like to pay particular tribute to Professor Gordon Wilcock who is standing down as Editor. It is great that one of the foremost academic geriatricians of his generation should have devoted so much time and effort to the journal. As with Graham Mulley before him, he stamped his own style on the journal, particularly notable has been the growth of research letters and the commissioning of very thoughtful and excellent editorials. Research papers have been attracted from a wide international base, again, establishing our Society in the forefront of academic geriatrics.

Hoarders and their hoardings
On the 23 May I had a pleasant trip to Brighton where I engaged in a debate with Prof David Brookes on the Geriatric v Neurological Approach to the Management of Parkinson’s Disease. I was particularly pleased to find amongst the audience two old friends, Tony Martin and Ganesh Mankikar. I was sad to hear from Ganesh that Tony Clarke had died in recent months. He was a great clinical observer and described Diogenes Syndrome and Salad arrhythmias. He was one of the first, with Dr Mankikar, to develop a Falls Service and research into falls. They developed an excellent service in Brighton and it is no surprise that this is now a thriving unit with Professor Raj Kumar at its head and taking a leading role in the development of the Medical School of Brighton. Philosophically, I always felt that Tony Clarke was guilty of a misnomer in describing Diogenes Syndrome. Diogenes was known for his lack of personal possessions, living in a barrel and reputedly, when asked by Alexander the Great what favour he would like bestowed upon him, he asked the great man to take two steps to the left so that his shadow would no longer block out the sun; whereas sufferers of Diogenes syndrome often hoard a clutter of possessions, particularly old newspapers and demonstrate and an inability to get rid of needless possessions over the many years.

Gary Andrews
To continue the note of mourning I was very sad to hear of the death of Prof Gary Andrews. He was one of the greatest internationally renowned academics in geriatric medicine and gerontology from Melbourne in Australia. He exemplified how one could use gerontological concepts to develop clinical models and was in the forefront of preventative medicine in geriatrics. He gave a number of notable presentations at international meetings and at the BGS. It is a sad irony that as someone who had done so much to promote increased health in older age, he should not survive himself, dying prematurely in his early sixties.

Science and Technology Committee
After a short visit to Sweden to learn about developments in the pharma world and chairing the national launch of an anti-parkinsonian drug in Manchester (pharma names have been omitted in the interests of eschewing product placement tactics!), it was back to geriatric matters on the 7th June when an extremely useful meeting took place at the headquarters of Help the Aged, facilitated by Dr Lorna Leyward of Help the Aged and Dr Sinead O’Mahony of the BGS, to look at Ageism in Clinical Trials. This initiative started some eighteen months ago and Sinead has taken the lead from our Society and indeed has done significant research in this area. The meeting on the 7th June will be seminal as we are proposing to have a joint seminar in this area and also to develop further research so as to draw attention to both gender and age inequity in therapeutics. It appeared to be a particularly appropriate time to do this as on the 5th June there had been a Lords Debate on Ageing, based on the report of the Science and Technology Committee on Ageing, to which Peter Crome contributed for our Society. James Goodwin of Help the Aged attended the debate and kindly provided me with a transcript of some of the proceedings. It makes extremely interesting reading. A great friend of our Society, Lord Sutherland of Hamwood, was particularly effective in pointing out the incoherence of much government policy towards ageing and the necessity of a serious co-ordinated approach with research efforts and academic activity directed to the problems of old age. This was followed by a chorus of support from among others, Lord Turnburg, previous President of the Royal College, Baroness Murphy, psychogeriatrician of repute, and Lord May. Sir Prof John Grimley-Evans found himself quoted with a line ‘live longer, die faster’ and much of the debate was concerned on how science and medical research could be more effectively used to cause compression of morbidity. I hope, following this debate, we will see increased support and the regeneration of academic geriatrics, and that funding will be made available in these areas.

Medicine for an ageing population
One of the highlights of my time as President of the Society occurred on the 8 June, when the Society had a joint meeting with the Royal College of Physicians London on Medicine for an Ageing Population. During my first meeting with Dame Carol Black when I became President of the Society, I drew attention to the fact that the Scottish colleges and the Dublin College were far more generous in the time they gave to topics of old age medicine than the London college, where it had been five years since they had previously had a meeting. Characteristically, Dame Carol Black responded and our bid against other specialist societies was successful. I think the meeting will be regarded as a landmark event. My aim was to encompass the whole spectrum of geriatrics from epidemiology and biology of ageing, through clinical science and practice, finishing with matters of organisation of medical service. The meeting could not have got off to a better start than a marvellous lecture by Professor Shah Ibrahim on What an Ageing Population Means for Health. Shah gave a scintillating talk on the implications of demographic change, showing us at the end, his top tips for a prolonged active life – don’t smoke, regular exercise, healthy diet, go to school, get married, get a ‘big pension’, live in the South!

Programmed for survival
When setting up the programme for this meeting I was determined to try not to have any overlap from the previous meeting five years ago, but I made an exception in the case of Tom Kirkwood as he has always aligned gerontology with longer term medical needs and he is such a superb communicator. In 1978 Tom first described the disposable soma-theory in Nature. Although this claim was controversial at the time its strength has continually grown. I feel that the work of the Institute of Ageing and Health, University of Newcastle is at the forefront internationally in this field. Tom has done much to overturn traditional fixed views of ageing. His lecture concluded that we are genetically programmed for survival, not death, and ageing is a process we can influence. Many age related diseases share common underlying mechanisms and this forms the bedrock of the science on which the specialty of geriatrics is based. It was a great pleasure to hear Howard Bergman, President of the Canadian Geriatrics Society, talking about frailty and making the case that this concept should be the basis of our specialty. His lecture was riveting and raised many intellectually challenging points. The FE Williams Lecture, one of the most important in the College’s calendar was given by Professor Graham Mulley. Graham honoured the memory of FE Williams magnificently with a superb original lecture on the Myths of Ageing, using art, poetry and popular media to demonstrate the myths and subsequently knock down many of the taught assumptions that culture gives us about old age. The lecture will be published in the College Journal and I strongly recommend that people to read it.

The meat of the meeting was the engagement with clinical problems and Dr Sinead O’Mahony on Therapeutics, Dr Shaun O’Keeffe on Delirium, Professor John Young on Rehabilitation and Dr John
Hindle on Parkinson’s Disease, all rose to the challenge and giving tour de forces. The time constraints of this meeting were severe. Each speaker getting around twenty minutes with ten minutes for discussion. I marvel at how all of them managed to encompass vast topics satisfactorily in such a short space of time. These presentations conveyed the excitement and vitality of our speciality in a perfect setting.

The final session was devoted to the logistics of care and once again two superb presentations, Professor David Black on the Challenge of Ageing Population in Education and Training, made use of his outstanding career as a geriatrician and now as Directorate Post-graduate Dean to spell out his vision of the future of our specialty. He focussed not on the specifics, but the general direction of travel. He examined what the new professionalism in the NHS meant for geriatricians and as always David managed to make sense of an extremely complicated brief and I am sure his map of the future of geriatrics is very accurate. In the final lecture, Professor Ian Philp gave a captivating and honest talk about New Ambitions for Old Age. He captured the political realities of changing policy for the benefit of older people. When the history of this period of geriatric medicine is written, Ian’s influence will be immense and we are extremely lucky that the National Director for Older People is not only a geriatrician to his fingertips, but also has a broader societal view combined with pragmatism of what is possible in the political arena.

I would like to thank the College for facilitating this meeting and putting so much effort into the organisation, particularly Jo Summers and Anne McSweeney. It is interesting that we had about 150 delegates. Not quite a sell out, but in stark contrast to the week before, when a meeting on acute medicine, (normally sold out) had to be cancelled due to lack of support. As there is increasing pressure on study leave and time off, I hope that meetings such as this will not be jeopardised in the future. Everybody attending will have come away with a very positive feeling about the future of geriatrics and about the confirmation that its status within the medical community is higher than it has ever been before.

Finally a big thank you to Oliver Corrado who steps down as Chairman of the Education and Training Committee. All our committees are functioning extremely well at the moment and the Chairman and members of committees put in many hours of often-unsung work. Oliver has kept me closely informed about all evelopments and has orchestrated the talent on his committee to superb effect.

Harrogate
The programme is now in place for the meeting in Harrogate in October and it is perhaps timely reminder to people to apply for study leave. I hope very much that we will have a big attendance at Harrogate. In the meantime I hope everyone has time to enjoy the glorious summer weather and by the time this gets to you England have won the World Cup!

Jerry Playfer