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This month I’ve decided to depart from the pattern of previous editorials by commenting on recent events in the field of geriatric medicine and the involvement of the BGS in responding to media interest.

Some months ago the President initiated discussion at the UKMC about how the Society might raise its profile and become recognised as an authoritative and accessible commentator on health care issues affecting older people. Our Chief Executive, Alex Mair, has being working with officers and trustees to develop plans to achieve this objective and early results are appearing with broadsheet articles, letters and profiles of respected figures in the Society.

Responding to Events
These discussions were recently highlighted following publication in the British Medical Journal of the discussion paper on the subject of cardiopulmonary resuscitation in Nursing homes and community settings by Simon Conroy, John Gladman and colleagues, which we picked up as a Stop press item in the last issue and reflect upon elsewhere in this issue. The Society was asked for comment on the day of publication and David Oliver did a fine job in speaking to the media and directing questions to members with particular expertise in the subject. Nonetheless the issue remains, how do we draw the attention of the media to our members as a source of expertise; how do we secure advance warning that issues are about to break, and how do we respond rapidly with meaningful comment that resonates with a significant majority of members, particularly when the subject, as in the Conroy case was provoked by other members of the Society? I know from my association with the Policy Committee over the years, that we have the means and expertise to develop responses, but what seems to be required here is an altogether faster and more proactive vehicle for PR purposes.

Living well in Later Life and Wanless Review of Social Care
As if to highlight the need for rapid response, the publication of a variety of documents including the Turner review of pensions, Living well in later life and the Wanless Social care review illustrate significant progress in the care of older people but major concerns over partnership working, mental health services and, in particular, an appalling lack of dignity and respect for older people in hospital. These reports have been ably summarised by David Oliver. We have produced statements, available on the BGS website, supporting and commenting on these issues but always with a feeling we are off the pace. Even worse, it has been suggested apparently, by other groups representing the interests of older people, that geriatricians are part of the problem because we have failed to challenge the way hospital and community care has developed and the apathy of parts of society in general to the needs of older, frail people.

So, what are we - responders or campaigners?
Now, here’s the rub. Talking to friends and colleagues, it seems to me there is a lack of identity within the Society. Who do we represent – doctors or wider professionals involved in the care of older people? The establishment of the Nurse Consultants SIG surely answers that one. Do we represent patients’ interests? Not according to some because we have viewed ourselves as a non-campaigning organisation. In my view, that approach may not be sustainable because what comes across from specialist registrars, younger consultants, nurse specialists, physio - and occupational therapists is not just an interest in health care, but a passion for older people’s health, and also a sense of injustice and outrage at the issues raised by these reports. As well as looking at the area of external relations, we need as a Society, to understand the views of the members internally to make sure our actions are relevant and important to them. So, to add to David’s appeal, should we campaign? If so, about what? You need to come forward with your concerns, ideas and issues in order for the officers to take the right path. We also need advance warning of papers, articles or lectures by members of the Society, which could generate media interest, in order to get our response in first.

Final Word – are you the Vicar?
I am not aware of any research in this area but from my observations over the years, it seems to me that geriatricians are more likely than any other group of specialists to be mistaken by patients for men [or women] of the cloth. Now I reckon my good friend Richard Prescott could do a passable impression of a Bishop any day, but I wonder if others have noticed the same thing? I once stood in the middle of a nightingale ward at Bensham hospital with an open set of notes in my hand, flicking earnestly through some filed results, when I looked up to see a frail lady beckoning me over from her chair. As I knelt beside her she said quietly, “Reverend, please can you sing Jesus wants me for a sunbeam?”

David Beaumont