I was thinking I could say, I was singing “The wild rover”, as I arrived, an itinerant BGS delegate, in Birmingham for the 2005 Spring Meeting, covered extensively in this edition.

However it may be considered insensitive as the car manufacturer of the same name failed to survive the brutal realities of economics and modernisation in a global market.

The Chinese, mark you, had failed to deliver the ultimate take-away. Our friends in the East clearly take a long term view, a fact to which I can testify as I have just received my second in-year reminder that they hope to host the International Association of Gerontology Conference in Korea in 2013! Planning is all….the BGS strategy only covers 2004-2006.

Perhaps we should attempt 10 years, but then again, it may be wasted effort as was brought home to me by a clear theme running through the meeting at Birmingham 2005, i.e the challenges of defining the core of such a diverse discipline as ours at a time of such change in our Health Service. This has been a theme for a long time of course, but some current circumstances seem to bring it back to centre stage just now, namely:

 

Brief Reflection on Accuracy Fish always accurately know where to move and when, and likewise birds have an accurate built-in time sense and orientation. Humanity, however, lacking such instincts resorts to scientific research. Its nature is illustrated by the following occurrence. A certain soldier had to fire a cannon at six o’clock sharp every evening. Being a soldier he did so. When his accuracy was investigated he explained: I go by the absolute accurate chronometer in the window of the clockmaker down in the city. Every day at seventeen forty-five I set my watch by it and climb the hill where my cannon stands ready. At seventeen fifty-nine precisely I step up to the cannon and at eighteen hours sharp I fire. And it was clear that this method of firing was absolutely accurate. All that was left was to check that chronometer. So the clockmaker down in the city was questioned about his instrument’s accuracy. Oh, said the clockmaker, this is one of the most accurate instruments ever, just imagine, for many years now a cannon has been fired at six o’clock sharp. And every day I look at this chronometer it shows exactly six. So much for accuracy. And fish move in the water, and from the skies comes a rushing of wings while Chronometers tick and cannon boom. By Miroslav Holub

An increasing emphasis on costing every item of service e.g. Health Resource Groups (HRGs) and “Payment by Results (PBR)

The agenda of Chronic Disease Management moving to primary care and the new methods of payment in the GP contract

The nature of intermediate care costings, “A national evaluation of costs and outcomes of intermediate care”, by Stirling Bryan Professor of Health Economics at the BGS Spring meeting 2005.

Specialisms being rebadged

Collections of evidence for re-validation when it finally gets going.

So what fun it is, when we thought that our work was all about being a vocationally motivated physician, in the broadest sense, for ageing folk.

Should we continue to invest a lot f mental energy in what looks like a series of never ending social experiments? What, after all, do all these agendae and costings and evaluation have to do with the physician’s day to day life? Well, consider the following:

• Having your outpatients’ attendances reviewed and gearing up for direct booking?
• Watching how many “Modern Matrons” your workforce Development Confederation is commissioning?
• As Intermediate care investment increases how is the investment for your hospital service featuring in your Local Development Plan?
• What will the emergency physicians of the (near) future learn from the geriatric evidence base that aids them in treating the older person’s illness for the 24-48 hours they might spend in the “acute” sector, (unless in high dependency units/intenstive therapy units or Stroke units which maybe not remain based in Trusts - see http://www.jchmt.org.uk/ stroke/index.asp)
• What will define the core evidence for maintaining competence as a geriatrician for revalidation?

And so, many of us take time off (considerable time), from our true vocation, to draft position papers (several of which appears in this issue), and policy documents and yet more policy guidelines.

The post dinner speaker clearly gave us a steer that The Lunar Society (www.lunarsociety.org.uk) may decide to discuss such matters as clearly our hosts in Brum have the intellectual rigour for it.

A big thanks to the organising committee and the usual conference support structures for a most enjoyable event. I am sure the evaluations on the meeting were good.

Europe
On a lighter note, the EUGMS has seen fit to vest its secretariat with the BGS office (see Simon Conroy’s article).

Kevin Kelleher