September and October are high season for meetings - the BGS autumn meeting taking pride of place.

A personal highlight for me was to be asked to give the Willie Bermingham Lecture at the Irish Gerontology Society in Dublin on the 23rd September. Willie Bermingham was a Dublin fireman who within a short period of time was involved in incidents in which eight elderly people died in very poor circumstances. Willie founded a charity ALONE and with enormous drive and energy sought to improve conditions for older people, creating new and better housing and support systems. The charity ALONE is still vigorous today. Sadly Willie Bermingham died at the age of 47 and it was a great privilege to honour his memory.

The Irish Gerontology Society was founded over fifty years ago, not far short of the BGS. The meeting was held at Reilly Hall, University College in Dublin. I was overwhelmed by the vitality and high standard of presentations and posters at the meeting. The President of the Irish Gerontology Society’s Cillian Twomey worked with me in Liverpool in the seventies and was only the fifth geriatrician to be appointed in Ireland. He has made an enormous contribution to establishing the speciality in Ireland and Europe. Jobs are still very competitive in Ireland and this adds an edge to the academic performance of the trainees. I recommend our trainees should try to place posters or presentations at the next IGS meeting in Galway. If successful they will find it an invigorating academic climate.

In the Willie Bermingham lecture, I used as my starting point, a paper by John Leonard in the BMJ in 1976 titled “Can Geriatrics Survive?” The irony of this paper was that John Leonard suggested that geriatrics should be incorporated in general medicine whereas it is general medicine which has disappeared while geriatric medicine is now the largest and fastest growing specialty. Whilst celebrating some of the successes of geriatrics, indeed going as far as to say the present era is the golden age of the specialty, I tried also to outline some of the challenges that lay ahead, which the younger generation of geriatricians on both sides of the Irish Sea will face.

I was particularly pleased to learn in Ireland that Bernard Walsh was successful against strong open competition from all specialties becoming one of the first clinical professors of medicine at Trinity. It again shows the enlightened nature of Irish medicine that they are creating substantive academic posts for people with outstanding abilities in clinical medicine and teaching. Bernard’s work is well known to all who attend BGS meetings as he, Davis Coakley and their team always contribute outstanding posters, many of which have scooped our prizes. JB as he is universally known, is admired by all who work with him. I have remained good friends with him since he worked with me in Liverpool where his talent was immediately evident.

Goodbye....
UKMC meeting on the 22nd September was poignant as we lost three stalwarts from the committee, firstly Kevin Kelleher, who as Honorary Secretary and editor of this newsletter has made an enormous contribution. Interestingly, Kevin knew Willie Bermingham well and was until recently, one of the Trustees of the charity ALONE. I have benefited greatly from Kevin’s original and perceptive take on the current medical scene. He is now heavily involved in postgraduate education for which he is well qualified and we wish him well in that regard.

Sally Briggs ends her terms as Chair of the Trainees. I have been very impressed by the energy and enthusiasm of our Trainees Group. This has stemmed in no small measure from the leadership of Sally and others, who have driven it to new heights. Sally’s profile in the Liz Gill article in the Times was, I think, the best piece of publicity the society could have had. Sally is a role model in seriously pursuing a medical career, using part-time training so she can also devote time to her growing family. Geriatrics is amongst the most feminised of specialties and I personally welcome this. Our specialty is taking a leading role in initiatives in flexible working and training which will allow talents such as Sally’s to flourish.

It will be sad to lose Ed Wilkins from the UKMC. He has had a wonderful attendance record. He has always contributed in a cogent and important way. Ed has made the devolution of the Society work effectively keeping the Welsh branch connected with the main body of the British Geriatrics Society.

...and hello
We welcome in as Honorary Secretary David Beaumont who has already been a major contributor as Chairman of the Policy committee. David is unflappable and his analytical and effective contributions are exactly what the Society needs, and I am sure he will be another outstanding secretary and editor of this newsletter. David Oliver replaces Dave Beaumont as as Deputy Honorary Secretary. We trust he is sharpening his pencil in readiness to take on the editorship of this newsletter in two years! Moving into Margot’s seat as Deputy Hon Treasurer is Tom Smith and Jed Rowe as Deputy Meetings Secretary. Welcome on board!

Sally’s replacement is Phyo Myint who worked with me for a short time in Liverpool and is now well established in East Anglia as a research fellow in Cambridge. Phyo represents the modern up and coming generation and it is particularly valuable that he has an academic strand which I hope will be helpful in our efforts to encourage the further development of academic geriatrics. Phyo has been singlehandedly responsible for co-ordinating the now regular “Why I went into research” columns in which research active specialist registrars encourage other young geriatricians to follow in their footsteps.

Ed is replaced by Martin Edwards who has given stalwart service, having been twice Chairman of the Welsh BGS.

The UKMC meeting in September was lively and open and we made progress in our agenda on public relations and the restructuring of our relationship with the Royal College of Physicians in London.
On the 14th September Jackie Morris (who we welcome back to the UKMC as Chairman of Policy) led a team of geriatricians including Graham Mulley, Duncan Forsyth, John Gladman, Elizabeth Kendrick with myself as Co-Chair of the meeting, arranged jointly between the Society and the National Health Service Confederation. As it happens the meeting was slightly different than we had envisaged, shoehorned into a series of five. Everybody gave excellent presentations and I think it was a good advert for geriatric medicine to the policy makers and so called architects of health care. I am however, worried that the NHS Confederation did not feel fit to give us a stand alone meeting or indeed have the attendance of a major figure from their organisation. I am afraid that specialties are going to have to fight to have their voice heard as the current trend is to ignore medical professional expertise. The mandarins and the high level planners of the Health Service seem to feel that doctors have had their way too often, they wish to introduce competition into the system and if possible reduce the contribution made by professional experts in policy formation. The history in our field would show strongly that innovation and improvements in health care for elderly people have almost always been driven by clinicians who have taken on neglected problems and transformed situations a la Marjory Warren. Without this leadership and direction the care of older people will suffer.

Harrogate
Harrogate was yet again a delight and great credit to Juanita Pascual for her excellent organisation of the programme and meeting. Wednesday afternoon’s session on primary care was well attended and was highly stimulating. The highlight for me was Robert Kane who spoke with passion and intelligence and was without doubt a geriatrician to his fingertips. Gordon Lishman from Age Concern has twice been a guest at BGS symposia. Each time he has chosen in some way to admonish rather than recognise the enormous contribution of all the professionals who work delivering care. I therefore award my prize for the best question during the whole of Harrogate to Eileen Burns, who asked him what he could do to promote the good news and the efforts of all those dedicated people who provide care for older people in this country. The answer, I thought, was somewhat evasive! The number of delegates at Harrogate was down on the nearly record levels of last year, reaching just shy of 500. We were short of delegates from the South and Scotland and I encourage them to sample northern civilisation next year! The meeting did have a vibrant feel and I am sure that everybody enjoyed the occasion and got very good value for their CPD.

At the dinner it was my great pleasure to present awards to two of our most notable members who have contributed in different ways to the speciality. Prof Bim Bhowmick joins a line of distinguished geriatricians to be awarded the Founders Medal. He has made an enormous contribution to the development of geriatrics, particularly in Wales, but also on the wider front with his involvement with the College of Physicians. His life story would make an epic film as he has overcome disadvantages by hard work, intelligence and talent.

I presented the President’s Medal to Mahendra Gonsalkorale. Mahendra exemplifies all that is good about geriatric medicine. He has always pursued the specialty with a passion and a drive and for the best possible motives. Many others have flourished because of Mahendra’s help and encouragement. He is an exceptionally good lecturer and teacher. He has made notable contributions in improving the care, particularly in the fields of PD and community care.

A rather unusual presentation was to Brian Jackson Dooley. I know that there are a variety of opinions on the links between our Society and the Pharmaceutical Industry. I hope the Society exhibits professionalism and responsibility in our relationships with the industry. We recently made a positive decision not to have advertising on our web site and we are evolving policies for issues such as donated prizes from the pharmaceutical industry so that they don’t detract from the scientific nature of our meetings. Nevertheless, all of us are aware that postgraduate education would collapse without the support of the pharmaceutical industry, be this right or wrong. Without the profits we have made from the exhibitions at our annual meetings we would not own Marjory Warren House or fulfil our charitable duties. Brian Jackson Dooley has had two careers; he was in the Fleet Air Arm of the Navy and was part of the Nuclear Deterrent Strike Force. On retiring from the Navy he entered the pharmaceutical industry with Britannia Pharmaceuticals and I first met him around 1983 when we held the BGS scientific meeting in Liverpool. My task was to arrange the pharmaceutical industry exhibition and Brian was at that stage invaluable in helping me contact the industry, telling me what to charge and how to organise the exhibition. Britannia has not missed a single BGS meeting since. As he is retiring I felt it appropriate to give a small presentation as a mark of appreciation for his support of our Society, signalling to the pharmaceutical industry that we value their contribution. Many other specialist societies are having difficulty getting sponsorship for their meetings and I think our continuing success is due to our pragmatic approach and keeping the relationship on a sound professional basis.

We also invited Clive Bowman, one of the medical directors of BUPA, but still one of us. Clive kindly hosted a wonderful meal on Wednesday night, following the primary care meeting. With changing times, the geriatrician may well be in a much closer alliance with BUPA and other private providers than we hitherto thought possible, and as long as they are as enlightened and knowledgeable of geriatrics as Clive is, we have little to fear!

Around the Regions
On the 15th September I had the pleasure of being invited to the North West BGS in Manchester, and it was great to see so many familiar faces. I was very honoured by the attendance of Prof John Brocklehurst along with Jim Leaning and Arup Banerjee.

Although it was nice to meet many old friends of my generation, I was disappointed that the trainees and younger consultants seemed to abandon the regional BGS as a forum in which to develop their careers. I know that the training in Manchester with Paul Baker’s MSc course is excellent and many of the trainees and younger consultants are doing great work. I just hope that within their activities they can see the necessity of contributing and reforming the ideas of the BGS both at regional and national level.

The pleasure of being president is that in my travels I am getting to meet many members of the BGS and listening to the real opinions of members of the Society. I believe there are some real anxieties about the changes that we face and a feeling that the geriatrics is being sidelined. We face problems of maintaining rehabilitation or input in the community. More than anything, I think that there is a feeling that we are losing the control that we had in this field. People have high expectations of what the British Geriatrics Society can achieve in this regard. It is important to realise that the Society is simply the combined efforts of its members, and I hope you will find in the coming months that we will be making head way in putting across a strong geriatric point of view both through the colleges, through political contacts and our developing PR programme.
We will also need to adapt to the changing circumstances and delivery of health care, and only if we adapt successfully will the society continue to thrive. The onus is on the younger generation and I would like to see them taking a more prominent role in developing our future strategies and contributing to the Society.

Jeremy Playfer