THE BRITISH JOURNAL OF PSYCHIATRY (THE JOURNAL OF MENTAL SCIENCE)

[Published by Authority of the Royal Medico-Psychological Association]

SUPPLEMENT, OCTOBER 1968

THE ROYAL MEDICO-PSYCHOLOGICAL ASSOCIATION

ONE HUNDRED AND TWENTY-EIGHTH ANNUAL MEETING

THE ONE HUNDRED AND TWENTY-EIGHTH ANNUAL of members of Council were the guests of Mrs. MEETING was held at Moorhaven Hospital, Ivy- Pilkington at hotels in Newton Ferrers. bridge and in Plymouth on 9-12 July, 1968. Dr. Members and their wives were the guests of H. V. Dicks presiding over the earlier proceedings the Joint Management Committee at an informal and Dr. Francis Pilkington from the time of his reception at the Plymouth Nuffield Clinic. induction on 10 July.

WEDNESDAY, 10 JULY, 1968 TUESDAY, 9 JULY, 1968 Morning Session Committees and Council met during the morning Dr. H. V. Dicks in the Chair and afternoon at the Nursing Studies Centre at The President reminded those present that this Moorhaven Hospital, and the following Seminars was a private meeting of the Association and was were also held at the hospital. not open to the Press. "IN-PATIENT PSYCHOTHERAPY", Dr. J. M. Gilroy. The closure of the One Hundred and Twenty- "A STUDY OF PATIENTS RE-ADMITTED 3 MONTHS Seventh Annual Meeting was moved and agreed to. AFTER DISCHARGE", Dr. C. Methven. "AN OUT-PATIENT FORENSIC CLINIC" Dr. J. Wood. Minutes "AN EXAMPLE OF RESEARCH IN GENERAL PRACTICE AN INVESTIGATION INTO PUERPERAL III HEALTH" The Minutes of the One Hundred and Twenty- Dr. R. A. Blair. Seventh Annual Meeting held in July, 1967 and of the "PSYCHIATRY IN GENERAL PRACTICE" Dr. G. Adjourned Annual Meetings in February and May, Smerdon. 1968, having been published in the Supplement to "THE ROLE OF THE PSYCHIATRIC NURSE" Mr. J. the Journal, were approved and signed by the Green, S.R.N., S.R.M.N. President. "THE ROLE OF THE PSYCHIATRIC SOCIAL WORKER" Obituary Mr. P. Hunter, A.A.P.S.W., R.M.N. The President announced with regret the death of The Films Sub-Committee arranged a show at the following members: which the following films were shown: FISH, FRANK JAMES, Professor of Psychiatry, Univer- "SOME DISORDERS OF THE CEREBELLUM AND sity of Liverpool. An Ordinary Member since 1953. EXTRAPYRAMIDAL SYSTEM" HARTIGAN, GEOFFREY PHILIP, Deputy Medical "NEUROLOGICAL SIDE EFFECTS OF THE PHENO- Superintendent and Consultant Psychiatrist, St. THIAZINE GROUP OF DRUGS" Augustine's Hospital, near Canterbury. An Or- "MODIFIED LEUCOTOMY IN A CASE OF OBSESSIONAL dinary Member since 1955. NEUROSIS" JONES, DAVID ELLIS, Orchard Close, Greenhill Road, The President-Elect, Dr. Francis Pilkington, Sandford, near Bristol. An Ordinary Member entertained members of Council to Dinner, and wives since 1945. PATRY, FREDERICK LORIMER, Consulting Psychiatrist, Sections : J. H. Kahn, Anne Bolton (Child Psychiatry) ; Manatee Memorial Hospital and Vétérans Admini- A. Shapiro, W. A. Heaton-Ward (Mental De- stration Hospital, St. Petersburg, U.S.A. An ficiency); T. F. Main, I. S. Kreeger (Psycho- Ordinary Member since 1964. therapy and Social Psychiatry) ; P. Sainsbury, PEARSON, FRANCIS CRAWFORD SCOTT, Surgeon A. J. Coppen (Research and Clinical). Commander, Royal Victoria Hospital, Netley. An Ordinary Member since 1963. Committees The Président moved that the Standing Commit- Presidency, 1969-70 tees be re-appointed, with the additions and deletions The President reported that in view of the un- in the printed Agenda. certain date of the inception of the proposed College This was approved. the Ad Hoc Committee had postponed the nomination for the Presidency for 1969-70. The Committee would Annual Reports of Council, Officers, hold itself in readiness to be recalled and its nomina- Standing Committees and Sections tion would be reported to an Adjourned Annual Meeting if the present Bye-laws still applied. Annual Report of Council During 1967, 196 new members joined the Asso- Officers and Council, 1968-1969 ciation. The following tables give the figures for The President moved that the Officers of the 1 January during the past five years: Association for 1968-69 be elected as follows: 1964 1965 1966 1967 1968 Treasurer...... Wilfred Warren Ordinary General Secretary . . A. B. Monro Members 2,382 2,615 2,926 3,158 3,341 Registrar William Sargant Honorary Librarian Alexander Walk Members 27 29 29 30 32 Editor-in-Chief .. Eliot Slater Corresponding The Président moved that the Nominated Mem- Members 47 50 52 54 56 bers of Council for 1968-69 be: Associate C. P. B. Brook, Sir Denis Hill, Denis Leigh, Members 27 33 40 50 59 J. N. P. Moore, Martin Roth, Ian Skottowe. The motions were carried unanimously. 2,483 2,727 3,047 3,292 3,488 The Président announced that, in accordance with the Bye-laws, the following were also officers of the During the year the Petition Committee have had Association : various exchanges with the Privy Council regarding Immediate Past Président: Dr. H. V. Dicks. the structure of the proposed College. At the time of Vice-Presidents and Divisional Chairman: writing this Report it is not possible to say more than A. J. Oldham (South-Eastern) was made public at the Quarterly Meetings during R. W. Simpson (South-Western) the year and at the Adjourned Annual General W. V. Wadsworth (Northern and Midland) Meeting on 8 February, 1968. The Quarterly A. K. M. Macrae (Scottish) Meetings received reports couched in measured but James Mulligan (Irish) increasingly optimistic terms. The Adjourned Annual The Président further reported that the following General Meeting of 8 February, 1968, learned that had been elected Divisional Secretaries: in some respects the requirements of the Privy Council D. M. Leiberman (South-Eastern) were stricter than those which the Petition Committee E. B. McDowall (South-Western) had sought to have accepted. In other respects, Brian Ward (Northern and Midland) however, the Privy Council had improved on the G. C. Timbury (Scottish) proposais of the Petition Committee, most of whose J. V. Glass (Irish) members are satisfied that if the Petition is granted, and the following would be Représentative Members the College will be a stronger and better designed of Council for 1968-69: body than the one originally proposed on behalf of Divisions: B. Pinkey (South-Eastern); T. C. Waters the R.M.P.A. (South-Western); I. G. Bronks (Northern and In connection with the above work of the Petition Midland); W. D. Boyd (Scottish); R. Breakey Committee, considérable work was undertaken by (Irish). its members to make amendments to the proposed

2 new Bye-laws in accordance with the requirements including the Rt. Hon. Kenneth Robinson, M.P. and of the Privy Council. The Council of the R.M.P.A. Mrs. Robinson, and Sir Geoffrey Vickers. expressed particular thanks to the General Secretary At the November Quarterly Meeting Professor and Dr. John Howells for their work, which enabled A. D. B. Clarke delivered the Forty-second Maudsley the amendments to be available to the Adjourned Lecture entitled "Learning and Human Develop- Annual General Meeting of 8 February, 1968. These ment"; and in February, 1968 the second Blake amendments were passed by a unanimous vote of Marsh Lecture entitled "The Clinical Practice of the Adjourned Annual General Meeting. Mental Deficiency" was delivered by Dr. Alexander During the year a Working Party of the Special Shapiro. The May Quarterly Meeting was held at Committee of Council (Court of Electors) has spent Tone Vale Hospital, Taunton, by kind invitation much time in devising and designing the Examination of the Hospital Management Committee and for the Higher Qualification in a form which will Dr. K. C. Bailey. ensure a test of adequately high standard, while In May a Joint Meeting with the American allowing such flexibility of development as may be Psychiatric Association was held at Boston. British desirable in the light, for instance, of the Report of contributors to the Joint Meeting were Sir John the Royal Commission on Medical Education. The Wolfenden and Dr. W. L. Neustatter who spoke on Special Committee and its Working Party have "Law Reform in Relation to Homosexuality"; reported regularly to Council, which should be in a Professor T. Ferguson Rodger and Dr. J. G. Howells position to publish the proposals promptly if the who spoke on "Law Reform in Relation to Abortion", Petition is granted. and Drs. D. H. Clark, A. B. Monro, D. Stafford-Clark, Further evidence of the Association's assumption P. Sainsbury, and H. V. Dicks who spoke on aspects of collegiate function since the last Report is shown of the Impact of the National Health Service on in the fact that the Association has been invited to Psychiatry. Members took part in the A.P.A. Annual send observers to the Joint Consultants Committee, Meeting and many stayed on in America for post- to the Central Committee on Postgraduate Medical meeting tours. Education, and to the Scottish Postgraduate Medical Detailed arrangements have been made for the Association. Conference on Postgraduate Psychiatric Education During the year the Association has submitted (The Training of Psychiatrists) to be held in March, memoranda on Assizes and Quater Sessions to the 1969- Royal Commission ; on the Functions of the District The Sections and Divisions have held regular General Hospital to the Ministry of Health ; on the meetings, and the second series of Lectures "Recent Special Hospitals to the Estimates Sub-Committee Developments in Affective Disorders" delivered to of the House of Commons; on Health and Welfare the Research and Clinical Section have now appeared Services for Epileptics to the Ministry of Health; on the as a Special Publication of the British Journal of Organization of Medical Work in Hospitals; on the Psychiatry. Regional Organization of Postgraduate Education in Council takes this opportunity of recording its Psychiatry; and on the Questionnaire on Post- thanks to the Association's many members who graduate Training in Psychiatry. The Association's undertake an ever-increasing amount of work on its views were also made known to the appropriate behalf. Among these the Chairman and Secretaries authorities concerning the discharge of patients from of the Standing and Special Committees and the Special Hospitals at short notice; the salaries and Sections and Divisions are particularly mentioned. conditions of non-medical child psychotherapists; Council also wishes to record its sincere appreciation the voting rights of psychiatiic patients; and the of the enormous amount of work done by its Officers. allocation of Local Authority responsibility for patients Special thanks are recorded to the members of the of no fixed abode. It was gratifying to note that many Committees concerned with the presentation of the of the recommendations in the Association's memoran- Petition and the new Bye-laws. dum on Therapeutic Abortion were contained in the new Abortion Act. The Association's comments Report of the Treasurer have been sought and submitted on the new regu- The audited accounts for 1967 stood at the end of lations for Drug Control. the financial year (31 December) at £85,361. The At the 127th Annual Meeting held in London, income of the Association during 1967 amounted to Dr. H. V. Dicks was inducted to the Presidency. £30,479, and expenditure was £25,457, leaving a The Presidential Address was entitled "The Proper credit balance of £5,022, compared with a deficit of Study of Mankind". The Annual Dinner was held £1,669 i11 1966. Investments stood in the accounts at the Painters' and Stainers' Hall, the guests at £57,685, market value £61,431 on 31 December.

3 This surplus in 1967, instead of a deficit as in and in view of higher charges for printing and paper, 1966, was almost entirely due to the raising of sub- the Committee have recommended with regret that scriptions on 1 January, 1967. However, most the Journal Subscription rate shall be increased from expenses, including the cost of the Journal, have £7 ios. to £10 per annum, and the price of single continued to rise, and, with future developments in issues from I2S. 6d. to £1, as from January, 1969. the activities of the Association, are likely to rise The Editor-in-Chief and his colleagues would like further, so that a careful watch on expenditure to express their appreciation of the work done by the remains very necessary. The investments of the assessors and book reviewers during the year. Their Association were £10,285 more in value than in assistance is of great valué to the editorial staff and 1966 on 31 December, 1967, because of a rise in to the authors. their market value over the year.

Report of the Librarían Report of the Registrar The Library's work has continued on the usual lines. There have been another two successful Maudsley Increasing costs due to devaluation and other causes Bequest lecture courses. In February, 1968, 450 may restrict acquisitions for a time, but we have applied to attend the course, of whom 60 were non- been helped by some of our Journal reviewers who members promising to join the Association. In have donated books to the library instead of retaining January a course of lectures on Psychology was them, and it is hoped that others will contribute organized for those intending to sit for the D.P.M., in this way. Nevertheless, 224 books and other and 120 applied for tickets. publications were added during 1966. A list of these The Gaskell Prize examination was arranged to has appeared in the Journal. They include a few be held in Newcastle-on-Tyne in May, but at the dating from the early I9th century, notably Sir time of going to press the results were not available. Henry Halford's Essays and the Memoir of the Life of These will be announced at the Annual Meeting William Cowper by himself. An exceptional number in July, together with the award of any other prizes. of works on the history of psychiatry have appeared during the last year. Steps are being taken to improve Report of the Journal Committee the security of our more valuable books by the fitting The Journal Committee has met three times during of glass doors to a number of the shelves. the past year. We are now taking 94 journals regularly, either by The number of papers submitted for publication subscription or by exchange. Issues of books in 1967 has continued to rise, and the Committee have been numbered 669. Besides the usual requests for infor- pleased to note also an increase in the number of mation on a variety of subjeets from members, there letters sent in for the Correspondence column. have been opportunities for giving assistance to Dr. J. L. Crammer and Dr. J. C. Gunn have been students and research workers, mainly in historical appointed as additional Assistant Editors. fields. The first of the Joumal's Special Publications, A well-attended meeting on the History of "Recent Developments in Schizophrenia", has sold Psychiatry was held at the November Quarterly well and only about 300 copies now remain in stock. Meeting, when Dr. Palmai read a paper on the The second in the series, "Recent Developments in Centenary of Dr. Griesinger and your Librarían Affective Disorders", also edited by Alee Coppen and spoke on "The 1860's in Britain". Alexander Walk, will be published in the summer of 1968. The third is to consist of the papers given Report of the Education Committee during the symposium on "Aspects of Anxiety" which was arranged by the World Psychiatric The Education Committee met four times during Association in November, 1967. It will be edited by the year. Dr. M. H. Lader, and it is hoped to publish it in the Two memoranda were presented by Dr. P. Brook late autumn of 1968. and they have been accepted for publication in the Although the Journal's income from sales, sub- Journal. The first is on the Regional Organization scriptions, and advertisements was higher in 1967 of Postgraduate Education in Psychiatry and contains than in 1968, there was a corresponding rise in information on the appointments of psychiatric expenditure, and the deficit at the end of the year tutors in different Regions of the country. The enquiry was £6,114. It is hoped that sales of the Special embraced all psychiatric hospitals and psychiatric Publications will help to reduce this by the next units in general hospitals that are recognized by the financial year. However, because of this deficit Conjoint Board of the Royal Colleges of Physicians

4 and Surgeons (London) for the Diploma in Psycholo- Report of Parliamentary Committee gical Medicine. The memorandum also describes the Organization of postgraduate training in psy- The Parliamentary Committee met five times chiatry in the areas under Regional Boards and the during the year and the General Purposes Sub-Com- Northern Ireland Hospitals Authority. The second mittee twice. Working Parties were set up and have memorandum discusses the facilities for postgraduate prepared memoranda on behalf of the Association training in recognized and unrecognized psychiatrie on a wide variety of topics of current public policy. hospitals and psychiatrie units in general hospitals, These have included evidence to the Committee including teaching hospitals. It is concluded that the on the Functions of the District General Hospital, the training opportunities in many of these hospitals are Royal Commission on Assizes and Quarter Sessions stili insufficient, and recommendations are made to ( jointly with the Forensic Psychiatry Sub-Committee), improve this situation. the Ministry of Health Joint Sub-Committee re- viewing the Health and Weifare Services for The Gaskell Gold Medal and Prize examination Epileptics (jointly with the Sections of Child Psychi- was held this year in Newcastle as a trial in order to atry and Mental Deficiency), the Select Committee encourage potential candidates from the provinces. on Estimâtes of the House of Commons on the Special Professor Sir Denis Hill was nominated medicai Hospitals, and the Advisory Council on the Penal examiner to succeed Dr. R. K. Freudenberg. System review of the Operation of Détention Centres A particularly successful series of Maudsley (both the latter jointly with the Forensic Psychiatry Bequest lectures was organized by the Registrar. Sub-Committee). In many cases the written evidence The proposed Conference on Postgraduate Edu- has been supported by orai evidence on behalf of the cation in Psychiatry has been postponed, and will Association. Délégations have called on the sponsors now be held from 6-8 March, 1969. It will be possible of the Divorce Reform Bill at the House of Commons, to increase the number of participants, and repré- the Abortion Bill, 1967, at the House of Commons sentatives will be invited from the Sections of Child and of the Home Office, and a variety of centrai Psychiatry, Psychotherapy and Social Psychiatry, departments as well as the British Medical Association and Mental Deficiency. and the National Association for Mental Health. Preliminary discussions of the Report of the Royal The Abortion Act, 1967 received the Royal Assent Commission on Medical Education have taken place on 27 October and is now in opération, although the in the General Purposes Sub-Committee. social clause is still causing some concern. The Sexual A Sub-Committee has been formed to discuss the Offences (No. 2) Act 1967 provides that homosexual Report from the Royal College of General Practi- acts between consenting adults shall no longer be a tioners on the éducation of general practitioners in crime, increased penalties for the séduction of a psychiatry and psychology, and to make recommen- minor by an adult, and ensures that male prosti- dations on this subject. tution will be dealt with on similar lines to the present Dr. M. W. Annear has been appointed editor law on female prostitution. of a proposed new édition of the Handbook for Voting rights of psychiatrie in-patients have been Psychiatric Nurses. urged on the Home Office for some years in view of A letter has been sent by the Mental Nursing the fact that the present law exeludes from the Sub-Committee to the Ministry of Health expressing franchise psychiatrie in-patients who are otherwise concern that advertisements for equipment intended legally capable. A recent improvement in the overall for the restraint of patients should have appeared in situation has now been gained in the case of informai the nursing press and at the London Nursing patients who stili have a home address. It will be Exhibition. A reassurance has been obtained from the possible for such patients to be included in the Ministry that the manufacturers of the equipment in annual return as to residents now being provided question have agreed to withdraw the offending for use at the canvass this Coming Autumn for in- items from sale. clusion in the Electoral Register to be published in A joint working party of the Royal College of February, 1969. A pilot survey is being carried out Nursing and the Mental Nursing Sub-Committee by the National Association for Mental Health to has been formed to enquire into post-registration ascertain what proportion of informai patients is training for psychiatiic nurses, including those likely to benefit from this recommendation. working in mental subnormality. Aspects of the problem raised by psychiatrie Dr. A. Walk's ñame has been submitted to the patients of no fixed abode in relation to hostel Ministry of Health for re-appointment to the General provision and financial support have been reviewed, Nursing Council. especially those arising through conflicts with local 5 authorities. These problems are being raised directly weekend and to Dr. R. Little for his part in its with the central Ministries concerned. administration. The Spécial Committee appointed by Council to The choice of a date in early September presented review the Working Party Report on the Organiza- certain difficulties and the last weekend in September tion of Médical Work in Hospitals has expressed was selected for the next study weekend. Autumn général support for the document as a safeguard for does, however, seem to have advantages over the the place of clinical administration in District earlier practice of a date in May or June and this General Hospitals and in Teaching Hospitals. The time of year is likely to be chosen for a further year particular problems raised in the single Psychiatrie or two. Hospital are being closely watched and représentations The section meeting in July was held in London, are being made to the Minsitry Working Party. and the Hon. Mr. Justice Ormrod, who is also The absence of a psychiatrist on the Working Party medically qualified, delivered a paper entitled "The and the need of psychiatrie guidance have been Expert Witness in Child Cases", to a full audience. emphasized, as well as the need for the Chairman of The points of difference and of similarity between the of the Psychiatrie Division to be elected and his practice of the law and of child psychiatry were of position subsequently ratified. Flexibility should be great interest and should lead to greater under- maintained in order to meet particular local situ- standing between the professions. ations. In November a very large gathering crowded into A recent letter from the Ministry of Health the Elizabeth Garrett Anderson Hospital to hear the drawing attention to the liability in négligence of distinguished panel of Lord Piatt, Professor Donald consultants in relation to the security of detained Court and Professor Desmond Pond give their views patients has been noted and its implications explored. on the place of child psychiatry in medical education. After consultation with the légal advisers to the The stimulating discussion was continued until late Defence Societies, this letter has been accepted as a in the evening for, thanks to Dr. Portia Holman and correct appréciation of the law of négligence appli- the Staff of the Hospital, it was possible to hold the cable to detained patients. In this connection the Annual Dinner of the Section on the premises and so addition of a Restriction Order by the Criminal take a most successful meeting to a convivial con- Courts when a Responsible Médical Officer has only clusion. agreed to accepting the patient on a Section 60 A joint meeting with the Mental Deficiency Section Hospital Order has been discussed and misgivings was held in February, when Dr. W. Lumsden Walker have been ventilated. This topic has drawn attention and Dr. P. Sykes each delivered a paper on aspects to the overall lack of high security beds in the Spécial of work in delinquency, Dr. Walker on the "Role of Hospitals and the need for pilot projects in the the Child Psychiatrist in Delinquency" and Dr. Régions for médium security units. Sykes on "Delinquency from the point of view of the Mentally Subnormal". The undoubted success of this suggests that more joint meetings should be held in Report of the Child Psychiatry Section the future. The Section has held four ordinary and one spécial At the Spring Meeting held at Tone Vale Hos- meeting during this year and has also been glad to pital, Taunton, the meeting of the Section was held arrange for a party of 20 Dutch child psychiatrists as one of the Seminars on the morning of the first to visit clinics and hospitals mainly in the London day of the meeting and Dr. M. F. Bethel spoke on area and then to participate in the annual study "Autism in Children" and later members had the weekend. This exercise in international exchange opportunity of visiting Merrifield Children's Unit proved so pleasant and successful that it is hoped a at the hospital. repeat visit will take place shortly. The visitors vvere A Special Meeting of the Section was held at the entertained at the Tavistock Clinic, the Hampstead Royal Society of Medicine on the evening of 20 March Child Therapy Clinic, Bethlem Royal Hospital and to give members and their guests the opportunity by the London Borough of Newham, and they of hearing Professor Michael Shepherd and Dr. enjoyed a full day tour to the Park Hospital at Michael Rutter of the Institute of Psychiatry speak Oxford and Smith's Hospital at Henley before on the "W.H.O. Classification of Psychiatric Dis- returning to Whitelands College, Putney, for the orders in Childhood". The scheme of classification Section weekend. The papers presented a cross- was explained and a full and frank discussion ensued section of "Growing Points in Research in Child which was enlightening to all. Psychiatry" and the Section is grateful to Dr. W. As before, the Section working parties have been Warren who co-ordinated the academic part of the active and a document containing the final views of 6 the Section about its future in the new College, which on Hospitals, particularly in relation to size of had provoked active discussion and strong feelings hospitals and Ministry building notes, and the while in draft form, was accepted by Council and standardization of clinical notes. Other matters passed to the Special Committee, who took note of its which concerned them were consultant psychiatric contents. A working party on the function and training establishments in mental subnormality hospitals, the of school counsellors has commenced its investigations name of the Section, and the possibility of arranging as a sub-committee to consider discipline in schools. exchange programmes with continental registrars. Members nominated by the Section have served On 1 January, 1968, there were 541 members of on other committees reporting to the Council of the the Section. Association, and in conjunction with the Mental Deficiency Section submitted a report on the Note by the Department of Education and Science and Report of the Research and Clinical Section Ministry of Health on Responsibility for the Educa- Three meetings of the Section's Executive Com- tion of Mentally Handicapped Children in England mittee were held during the year, in July and and Wales. November, 1967 and February, 1968. As a result of an approach by the Section the On 1 January there were 2,076 members of the Council have agreed to support requests for an Section. improved salary structure and status for child The following members were elected to fill vacan- psychotherapists (non-medical), and the salary cies on the Executive Committee: Drs. B. M. differential between P.S.W.'s in the National Health Barraclough, J. Bowlby, J. B. Brierley, J. L. Gibbons, Service and in Local Authority employment has been N. Kreitman, W. O. McCormick and M. Valentine. a source of concern. The Committee elected Drs. P. Sainsbury and A satisfying number of child psychiatrists were in A.J. Coppen as their representatives on the Council. the party which travelled to the joint A.P.A./ Dr. J. Hoenig was elected as the representative on R.M.P.A. meeting in Boston, Mass. in May, and the Education Committee. accepted lecturing invitations afterwards. The following were elected Secretaries of the Sub- On i January, 1968, the number of members of the Committees: Clinical Psychiatry, Dr. J. Hoenig; Section was 1,100. Genetics, Dr. Valerie Cowie; Pathology, Biochemistry and Neurophysiology, Dr. J. A. N. Corsellis; Forensic Psychiatry, Dr. R. P. Brittain; Epidemiology, Report of the Mental Deficiency Section Dr. E. H. Hare. The Section held three meetings during the past The Section's series of lectures on Recent Develop- year. In May a joint meeting with the Scottish ments in Affective Disorders in being published by Section was held at Lennox Castle Hospital, at which the British Journal of Psychiatry as a Special Publication. Dr. John Campbell and Dr. Harry Hunter read The Section organized various successful meetings papers on the Scottish and English Mental Health in July, November, 1967 and in February, 1968. Acts, respectively. As a result of the subsequent The Epidemiology Sub-Committee is planning a discussion the Executive Committee decided to send joint W.P.A./R.M.P.A. meeting on Epidemiology a questionnaire concerning the name of the Section, in Britain in 1969. As a result of a meeting between which members were asked to return by 29 February, representatives of the Committee and Ministry 1968. Officials it was felt that useful working liaison At the Annual General Meeting of the R.M.P.A. between the Section and the Ministry could be made. in London in July, 1967, Dr. R. Wilkins, Senior Dr. Cawley drew up proposals for an invesgitation Medical Officer, Ministry of Health, read a paper on into the "Use of Psychiatric Man-Power". The "Services for the Mentally Subnormal" which Section has now started to draw up a register of provoked a lively discussion. The Edison Responsive members' research interests which it is hoped will Environment Teaching Machine was demonstrated be renewed annually. at the Teaching Centre in Portland Place. The November meeting in London was very well The Annual Reports of the Council, Officers and attended and papers were read by Drs. R. P. Brittain Standing Committee were adopted. and Harry Hunter on "Sex Chromosome Abnor- In reply to a query from a member about Voca- malities and Behaviour Disorders in the Mentally tional Training within the Regions, it was explained Subnormal". that this was dealt with in various memoranda of the During the year the Executive Committee con- Education Committees which would shortly be tinued its deliberations concerning Ministerial Policy published in the British Journal of Psychiatry.

7 THE ROYAL MEDICO-PSYCHOLOGICAL ASSOCIATION BALANCE SHEET, 31st DECEMBER, 1967

1966 1966 68,751£ £ £ GENERAL FUND (Schedule I) 71,934 FIXED ASSETS CURRENT LIABILITIES AND PROVISION Furniture, Fixtures and Fittings at 5,712 Creditors and Accrued Charges 6,200 4,994 cost, less depreciation 691 Subscriptions received in advance 227 CURRENT ASSETS 750 Provision for Repairs and Dilapidations 1,750 Quoted Investments at cost or value 7,153 8,177 58,226 at date of Acquisition .. .. 57,685 (Market Value £61,431 (1966: £51,146)) 8,740 Debtors and Prepayments .. .. 5,834 3,944 Balances at Banks and Cash in Hand 11,766 70,910

75,904 80,111 SPECIAL FUNDS 75,904 80,111 Maudsley Bequest SPECIAL FUNDS 2,086 Quoted investment at cost 2,086 Maudsley Bequest Market Value £1,046 (1966: 2,086 Capital Account 2,086 £1,099) 15 Income Account (Schedule III) 15 135 Balance at Bank 115 2,221 2,201 2,101 2,101 Gaskell Mernorial Fund 120 Creditors 100 2,225 Quoted investment at Cost 2,226 2,221 2,201 Market Value £2,168 (1966: Gaskell Mernorial Fund £2,267) 2,128 Capital Account 2,128 86 Debtors 127 405 Incoine Account (Schedule IV) 418 222 Balance at Bank 193 2,533 2,546 2,533 Appeal Fund Appeal Fund Capital Account 500 Investment at cost 500 Incoine Account—Interest Received 3 (Market Value £500) 503 Balance at Bank 3

HENRY V. DICKS, President WILFRID WARREN, Honorary Treasurer

£80,658 £85,361 £80,658 £85,361

REPORT OF THE AUDITORS TO THE MEMBERS OF THE ROYAL MEDICO-PSYCHOLOGICAL ASSOCIATION In our opinion the annexed accounts comprising a balance sheet and revenuse accounts give a true and fair view of the State of affairs of the Association on 31 Dcember, 1967 and of its surplus for the year then ended.

Alderman's House, Bishopsgate, BARTON, MAHYEW, & CO., London, E.C.2. Chartered Accountants. 2 ndFebruary, 1968. REVENUE ACCOUNT FOR THE YEAR ENDED 31st DECEMBER, 1967 1966 1966 £ £ £ DISPOSAI, OF INCOME £ JNCOME ESTABLISHMENT AND ADMINISTRATION 18,355 Members' Subscriptions .. .. 26,775 Salaries, National Insurance and 2,808 Interest and Dividends on Investments 2,891 6,267 Pension Contributions .. .. 6,345 149 Bank Interest 522 5,755 Rcnt, Rates and Insurance .. 6,264 Publication Sales 182 Lighting and Heating .. . . 215 231 "Report on Hallucinogenic Drugs" — 527 Repairs and Provisions for Dilapi- 1,018 Royalties dations 421 "Handbook for Psychiatrie Nurses" 291 1,315 Printing, Postage and Stationery .. 1,499 111 Telephone 128 683 Audit and Accountancy Charges .. 656 34 Committee Members' Éxpenses .. 184 Dépréciation of Furniture and Fit- 555 tings 537 15,429 16,846 Less: Amount chargeable to Journal 2,736 (Schedule II) 2,976 12,693 EDUCATION AND PUBLICATION 754 Library Expenses 670 5,611 Journal (Schedule II) 6,114 503 Journal Supplements 467 558 Year Book 678 1,777 Meetings 1,423 Deficit on Maudsley Bequest Lec- 119 ture (Schedule III) 152 9,322 OTHER EXPENSES 900 General Expenses 733 Legal Expenses (Including Ex- penses relating to amendment of 718 Royal Charter) 1,350 1,618 £23,633 £25,457 SURPLUS (DEFICIT) FOR THE YEAR TRANS- FERRED TO GENERAL FUND . . £21,964 £30,479 £1,669 GENERAL FUND SCHEDULE JOURNAL ACCOUNT SCHEDULE II FOR THE YEAR ENDED 3Ist DEGEMBER, 1967 "BRITISH JOURNAL OF PSYCHIATRY" FOR THE YEAR ENDED 3Ist DECEMBER, 1967 1966 £ £ £ 1966 70,828 BALANCE AT ISTJANUARY, 1967 .. 68,751 £ £ £ £ 408 Less : Loss on sale of Investments .. 1,839 INCOME 9,769 Subscribers 12,369 70,420 66,912 Special Publication No. 1 {1,669) Surplus/(Deficit) on Revenue Account 5,022 "Recent Developments in Schizo- — phrenia" ...... 733 £68,751 BALANCE AT 31 st DECEMBER, 1967 .. £71,934 9,769 13,102 4,298 Advertisements 4,821

14,067 EXPENDITURE 15,372 Printing Expenses 17,646 Postages, Wrapping and Dispatch to 1,525 Members 2,192 Sundry Expenses, including Com- 45 missioned. Articles ...... 53 Special Publication No. 1 "Recent Developments in Schizo- — phrenia" 1,170

16,942 21,061 2,736 Administration Expenses .. .. 2,967 19,678

£5,611 DEFICIT CARRIED TO REVENUE ACCOUNT £6,114 MAUDSLEY BEQUEST ACCOUNT SCHEDULE III GASKELL MEMORIAL FUND SCHEDULE IV FOR THE YEAR ENDED 31st DECEMBER, 1967 FOR THE YEAR ENDED 3 Ist DECEMBER, 1967 1966 1966 £ £ £ £ £ £ £ £ INCOME INCOME 73 Interest on Investments .. .. 73 113 Interest on Investment .. .. 148 6 Bank Interest ...... 5 11 Bank Interest 9 79 78 124 157 EXPENDITURE EXPENDITURE Lecture Courses 75 Prizes and Medals ...... 75 53 Fee 53 23 Engraving Medal ...... 25 17 Expenses ...... 9 40 Examination Fees and Expenses .. 44 25 HireofRooms 29 138 144 51 Printing and Stationery .. .. 81 50 Postages ...... 56 (14) SURPLUS/ (DEFICIT) FOR YEAR .... 13 2 Sundry Expenses ...... 2 BALANCE BROUCHT FORWARD AT IST 198 230 644 JANUAR Y, 1967 405 Less: 119 DEFICIT FOR THE YEAR ...... 152 419 225 Loss on Sale of Investments .... — Less: BALANCE CARRIED FORWARD, 3IST BALANCE BROUGHT FOR WARD AT IST £405 DECEMBER, 1967 £418 15 J ANUARY, 1967 ...... 15

104 137 119 TRANSFER FROM GENERAL FUND .. 152 BALANCE CARRIED FOR WARD AT 3 IST £15 DECEMBER, 1967 £15 Report of the Proceedings of Council Meetings At the request of a member, Professor T. Ferguson held on Tuesday, 9 July, 1968 Rodger, who had been in the Chair at the meeting, and Saturday, 8 June, 1968 reported on the Special Meeting of Council held on 8June, 1968. The General Secretary read the following report : "The Council met six members who had signed a Council met on 9 July, 1968 at Moorhaven letter to the medicai Press about the proposais for a Hospital. Royal College of Psychiatrists, and one member who Council accepted, with minor amendment, the had not signed the letter, as well as one signatory who Report of the Petition Committee which will be read was not a member. These doctors emphasized that they later during this meeting. were in no way représentatives of a group and could A report was received on the recent Joint Meeting only speak individually for themselves; they had no of the American Psychiatric Association and the spokesman and further questions failed to elicit who R.M.P.A. at Boston, indicating that the Meeting had written the letter or organized its circulation. had been successful and had resulted in a useful Dr. Noble was asked to undertake the rôle of spokes- exchange between the two Associations. man for the purpose of the meeting and the doctors Dr. Markowe reported on recent exchanges with were asked if they had a grievance. In answer they the Psychological Medicine Committee of the B.M.A., said they had no grievance but were worried. We and arrangements were made to strengthen the then attempted to elicit the nature of their worry. consultative machinery between that Organization They were asked whether they were concerned and the R.M.P.A. about their own position. They said they did not The Editor-in-Chief reported that the second in the feel this was important. They also said they did not series of Special Publications, "Recent Developments worry about themselves because they recognized in Affective Disorders", had now been published. that they were a well-trained and privileged group. The Report on the Questionnaire on Continuing At one point they did say they represented 50 per cent, Postgraduate Education in Psychiatry for General of the membership (there are 3,500 members) who Practitioners was received and approved with minor thought the same way, although they did not say amendments, and will appear in the Journal. The how they had obtained this information. Education Committee indicated that they had had a "The point was put to these young men that in preliminary discussion on a letter from the Ministry founding a College it was necessary to have some of Health asking for considération of certain specific standard for Membership, and the suggestion that there questions raised by the Royal Commission on Médical should be a transitional period without examination Education. They indicated that they should be in would not be acceptable to the Privy Council. In a position to report more fully on this extremely spite of this they appeared to believe that Council important topic at the November meeting. The should persist in endeavouring to obtain permission General Purposes Sub-Committee had arranged to for such a period. They did not seem to think that it discuss ali the issues in detail, and Council empowered was important that this might resuit in an indefinite them to co-opt members from their Committees or postponement of the establishment of the College. Sections as might be appropriate. At one point Dr. Skottowe asked whether they felt The Papers and Discussions Committee reported that what they had done was in accordance with that the morning session in November would be their obligation as members. At first they said it devoted to the subject of Alcoholism. In February the was, and then they decided that even if it was not it Seminars would be on the subject of "Difficult was unimportant because it was in the interests of Patients". The Study Tours Sub-Committee reported the College that they should proceed along this that a Tour would be arranged in France in 1969 and line. it was hoped to have a Tour of Scandinavia in 1971 "The doctors then said that there had been a and Israel in 1973. growing feeling over the past three years that the Council approved the Memorandum prepared by form of the College, if it came into being, would be the Mental Deficiency Section and the Child Psy- out of date and out of line with the recommendations chiatry Section on "Responsibility for the Education of the Royal Commission's Report. If we waited a of Mentally Handicapped Children in England and few years we might be able to get a new College with Wales". a new type of constitution which might be able to Council also approved their Special Committee's lead the way. A statement was handed round, which Memorandum to the Committee on Hospital had been approved by Council last year, regarding Scientific and Technical Services (Zuckerman the function of the examination, which Council felt Committee). met their objections, but even after reading this the

12 group persisted that the role of the examination was I got, or at any rate, I understood I got, on this being over-emphasized. occasion was that the obligation was no longer "The Chairman pointed out that the information acceptable to some of those present, and I said, and given to them was in confidence, and this had been I assure you that these are my very words, 'In that emphasized by the General Secretary at various event, would not the honourable course be to with- meetings. It was also pointed out that the negotiations draw from the Association?' I never mentioned the with the Privy Council were highly confidential and word 'expulsion'." the R.M.P.A. had been specially privileged to be After considerable discussion about whether or allowed to negotiate beforehand the terms on which a not the word 'expulsion' had been used during the Petition might be drawn up to ensure success. At Special Council Meeting, a statement was made from one point a member of the group suggested that the the platform that it was believed that the word Association might become a College and not persist 'expulsion' had been used. An assurance was given in its attempt to become a Royal College, and com- from the platform that the use of the word was not parison was made with the College of Pathologists. intended to imply any threat to any member. It was However, it was pointed out that the Association indicated from the platform that this was the view of was already under Royal Charter. Council which had been endorsed by Council on the "It was pointed out by the Chairman that if the previous afternoon. The Meeting proceeded to Association did become a Royal College, it would be consider the next item on the Agenda. in a position to negotiate as an equal with other Royal Colleges during a time when the future of the Report of the Special (Petition) Committee specialist would be in a difficult state, and that to to the Annual General Meeting postpone inception of the College until after this The General Secretary read the Report of the period would be to render the Association impotent Special (Petition) Committee. to secure proper conditions for psychiatrists. No The Petition Committee met six times during the reasonable response was made. past year, and on 17 June, 1968 their Privy Council "The group were asked to consider further between agent was present. They learned with pleasure about themselves, in the light of the information which had the progress made in exchanging information with been given to them, whether they would be prepared the Privy Council Secretariat about the draft to withdraw their signatures from the proposed letter Petition, Charter and revised Bye-laws. They learned and persuade others to do the same. After private that, following the special Council Meeting of 8 June, discussion, they returned and stated that each of representatives of the Association with their agent them was prepared to consider the matter and decide had talked with the Secretariat of the Privy Council. individually whether or not he would withdraw They understood that any request that might be his signature. Their suggestion that the R.M.P.A. made for an interim period for admission of Founda- might inform the other signatories to the letter was tion Members would not be granted; and that any refused on the grounds that their action was no part suggestion to alter the standard for admission to of the business of the Association." Foundation Membership to less than Consultant Dr. Noble added some of his impressions of the status in the Health Service, or its equivalent, would meeting, and in response to questions from members not be acceptable. It appeared that approval would about the position of those who had signed the letter not be given to a Royal College of Psychiatrists to in relation to their membership of the R.M.P.A., conduct an examination for Membership at the level the President asked Dr. Skottowe to elucidate. suggested in the Royal Commission's Report until it was agreed that all Royal Colleges should do so. Dr. Skottowe reported "What Ian Skottowe really The probable (indeed almost certain) effect of said: I read out the Membership Obligation and petitioning for any of these things would be the asked those of our visitors who were members rejection of the Petition, which could not then be whether they had signed it on joining the Association. presented again for five years at least. I asked whether they thought they were fulfilling This information made it clear to the Petition their Obligation by their actions in sending this Committee that only three courses of action are letter. At first the answer I got was 'yes'. There was a possible : little discussion about something else. I wasn't happy about this answer and came back to it and asked (i) To accept what we believe the Privy Council once more 'Do you really mean that by sending a Council will require of us; letter such as you propose you will be serving the (ii) To petition for an interim period and lower best interests of the Association?' The answer that standard of admission to foundation member-

13 ship, or of examination, and have our Petition reads as follows: "The content and form of rejected; the Examination will be kept under constant (iii) To delay submission of a Petition until the review by the Court of Electors so that they situation regarding the Royal Commission's may be modified in the light of developments Report (on medical education) and the Green in post-graduate education, particularly as Paper has clarified. to the intention to place greatest emphasis The Petition Committee felt that courses (ii) and on the assessment of a candidate's training (iii) are quite unacceptable. As regards course (iii), experience". a careful estimate of the time required for clarification The Petition Committee therefore re-affirm the and legislation is three years at least. This three-year overriding importance of pressing for Royal College period is one in which there will be exchanges of status as quickly as possible, and state their opinion view and crystallization of ideas on the structure of that the requirements they expect from the Privy the Health Service, which are intended to set the Council can be met without unfairness or hardship pattern for 30 years. It is vital that psychiatry should to members of any degree of seniority and without be represented during this time by a representative any prejudice to the prospects of future aspirants to body of the highest status—in short, that we should Membership, having regard to possible changes resul- become a Royal College before discussions of the ting from the Royal Commission's Report. Royal Commission's Report begin; otherwise the The Report was received with applause. pattern will be fixed by physicians and surgeons for the clinical life-time of all those now entering psy- chiatry. This is unthinkable. It follows, therefore, Motion Proposed by Members that to press now for points believed to be unacceptable The following Motion stood on the Agenda paper: to the Privy Council will either wreck the prospects "That for an interim period of four years for a Royal College or delay attainment of collegiate Membership should be granted to all who hold the status until it is too late for the College to exercise D.P.M., or an equivalent diploma, and have authoritative influence and achieve proper recognition undergone psychiatric training satisfactory to the and benefits for the present generation of psychiatrists. College. A consultant or senior lecturer appoint- The Petition Committee therefore with complete conviction ment in psychiatry during this period would recommend acceptance of those requirements, which after normally be taken in itself as evidence of satis- enquiry, they have reason to believe will be insisted on by the factory training." Privy Council. Proposed by Dr. P. D. Rohde; seconded by The Committee wish to stress that they, and Dr. P.J. Noble. Council, are well aware of the difficulties arising from presenting a Petition during a period of changing THE PRESIDENT observed that in applauding the patterns. They would like to remind members of the Report of the Petition Committee the Meeting Association : obviously approved of the line taken by them in (i) That provision has been made for those with steering a difficult middle course between the qualifications which would normally be Association's own aspirations and the conditions sufficient to obtain Consultant status, especially laid down by the body which alone could allow or in those branches (e.g. academic psychiatry) prevent these aspirations being fulfilled. This body in which such status is liable to be obtained was not by any means impressed with the fact that relatively late in a career. Such people may be another Royal Commission Report had recently admitted to Foundation Membership, and if appeared. We might have to enter Royal College not so admitted may appeal. status in an ancient form, but we could bring new practice into it. The Royal Commission itself had (ii) Bye-law 138 allows of exemption from all said that there would be no difficulty in harmonizing parts of the examination except the final viva. our recommendations with theirs. The Privy Council, The Court of Electors may be relied upon to however, disliked the bandying about in the press, deal with this provision with integrity, fairness lay or medical, of arguments about delicate negotia- and a proper appreciation of the circumstances tions being carried on with them, and this was the of individual applicants for Membership. question of breach of confidence that some Council Council has also adopted the principle that the members were anxious about. fee to be charged for the examination itself shall be enough simply to cover the cost. DR. ROHDE, in proposing the Motion, stressed that (iii) An extract from the proposals foi the Member- he supported the concept of a College and was grate- ship Examination, approved by Council, ful to the Petition Committee for the work they

H had done. However, ever since the Adjourned Annual DR. NOBLE, in seconding the Motion, referred to Meeting in February at which the draft Bye-laws the serious staffing situation, especially in the of the College had been approved, some members provinces, and particularly in the North, and said had been concerned about the procedure for admis- that a progressive training programme, with a broad sion of Members of the College. They accepted the clear path of entry to the College, would attract assurances given them that the Court of Electors recruits. The prestige of psychiatry depended on the would use liberally their powers to exempt from parts quality of its entrants and the quality of the training of the examination, but they still thought that they received, not on the precise time when a Royal Council underestimated the resentment generated College was formed. The present proposals lacked the by these proposals to subject relatively senior formal approval of the vast majority of members, and psychiatrists to an examination in any form. a referendum would be a simple way to avert the Although in February they had not voted against danger of a split. the Bye-laws they now felt that the debate ought to DR. R. H. S. MINDHAM proposed the following as be reopened. The Report of the Royal Commission an amendment to Dr. Rohde's motion : on Medical Education had recommended that "That a referendum of the membership of the evidence of satisfactory training, with progressive R.M.P.A. be held promptly to determine whether assessment during the training period, should replace the proposed new Bye-laws be amended to provide single "pass or fail" examinations as a principal that: criterion for admission to specialized Colleges. The (a) During an interim period of four years from letter which they had submitted in the first place to inception those eligible to apply for Founda- the British Journal of Psychiatry and afterwards to the tion Membership shall include all who have B.M.J, expressed anxiety and concern about the undergone psychiatric training satisfactory to retention by our proposed College of the older type of the College. A consultant or senior lecturer examination, and its signatories included just under appointment in psychiatry during this interim I oo members of the Association. They believed that period would be taken in itself as evidence of if this had been more widely circulated it would have satisfactory training. received even more support. (b) That qualification for eligibility as Members They realized that, as the Council had told them, be based primarily on certification following any amendment of the Bye-laws on the lines they satisfactory training, as visualized by the recent advocated would not be acceptable to the Privy Report of the Royal Commission on Medical Council, and that if their Motion was passed it might Education." in fact delay the creation of a College. They were He referred to the 1964 ballot, and pointed out that torn between Council's advice that the course they at that time 67 • 8 per cent, of the membership voted, were proposing was a wrecking one and their convic- and of these only 72 • 3 per cent, voted in favour of a tion that many members felt disquiet and resentment College; the actual number was 1,382, and of these at what was being done. They therefore felt that the again 1,118 also favoured a higher qualification. most equitable solution would be to hold a Even if these last could be said to favour the parti- referendum of the membership ; and if the vote was cular type of examination now proposed they could in favour of the alterations they were proposing not be said to represent the present membership of Council would then be able to make a fresh approach the Association, which had in the meantime grown to the Privy Council, using to the full its new mandate from 2,657 to over 3,5°o. as well as the recommendations of the Royal Com- mission. The situation was similar to that in 1964, He went on to emphasize the reasons why a request when the controversy as to whether a College was for a referendum came at that particular time and wanted at all was solved by the holding of a ballot. from the younger members of the specialty. These They believed that if a referendum were now held, members would have to live and work with the and their case was skilfully presented and supported College for the next 30 or 40 years, and yet by the by a new mandate, the Privy Council might receive proposed Bye-laws they would lose their status different advice from its medical advisers. as full members of the Association. They had asked Council's permission to substitute DR. J. B. FROST seconded, and referred to the for the present Motion one asking for a referendum, Spring Meeting of the Northern and Midland and they regretted that Council had felt unable Division at which Council had been asked not to to allow this. He therefore proposed the original proceed too rapidly in achieving its desires but rather Motion in the hope that an amendment would be with reflection and care. He hoped that the procedure suggested from the floor. now suggested would not be considered as leading to

15 "wrecking", but on the contrary as one which by had acquired a very healthy respect for the integrity giving every member an opportunity to vote would of the Petition Committee. He had proposed amend- avoid unnecessary schism. ments to the then Bye-laws to bring about a proper interim period for Foundation Membership, and this At this point the question was raised whether had been accepted by the Association and submitted Dr. Mindham's proposai could properly be regarded to the Privy Council, but the Privy Council would as an amendment or was a substantive Motion which not have it. He personally would have liked an was out of order. It was pointed out that Council had interim period and also a différent form of examina- considered the matter on the previous day and had tion, but it would wreck things if they tried to insist decided that it was in fact a substantive motion and at this stage, and they had to give their backing to could not be considered, as the proper notice had Council. As for the future, if they had a Royal College not been given. It was suggested that the question they could join with the existing Royal Colleges in should be put to a vote of the meeting, but eventually discussing what the future model should be; but if it was decided to adhéré to Council's décision. they did not have a College then others would decide In the course of this discussion, DR. ROHDE con- and they would have no say. Even if they had to have tended that the proposai for a referendum was in the an archaic College now, they would have a better spirit of the originai intention to raise matters relating one later and the other Colleges would be better too. to the conditions for admission to membership, It could surely not be said that new entrants would although the actual wording was différent. be more attracted by a soft option than by an PROFESSOR STENGEL said that what was being assurance of proper training. All the new entrants he asked for was a new referendum as to whether they met these days were saying that they wanted to take a wanted a College or not. He also said that Dr. Rohde good examination in psychiatry, and they were quite had given an incorrect version of the Royal Com- satisfied with the integrity and intentions of Council. mission's views about examinations. They had in fact DR. ROHDE here asked leave to withdraw his opened the door for a whole series of examinations Motion, but the President feit that it would be more in the course of training, maybe one every year. satisfactory for a vote to be taken. DR. FELIX BROWN pointed out that, although the Dr. M. MARKOWE proposed as an amendment Privy Council had laid down conditions which must "That the Association has full confidence in the way be adhered to at present, there would come a time in which the Court of Electors will exercise their when the younger members would be on the College discretionary powers". He proposed this in view of the Council and would be able to make what modifica- weighty and masterly Report of the Petition Com- tions they wished. mittee, the promising situation that had been DR. HOWELLS stressed that the Motion now being achieved after immense labours, as had been recog- proposed as an amendment was quite différent from nized by the proposers of the original Motion, and the the one that had been circulated, and had it appeared urgent need for a College at the earliest possible date. on the Agenda the composition and numbers of this DR. R. W. SIMPSON seconded, and pointed out that meeting would have been quite différent. It would ali the anxieties that had been expressed had in fact be quite wrong to vote on a Motion which had not been anticipated by Council, and that the Court of been communicated to the whole Association. Electors would have power to deal with the situation DR. SKOTTOWE referred to the Bye-laws, and fairly and generously. pointed out that Council had decided that the THE PRESIDENT, however, ruled that the proposai proposed "amendment" could not be introduced. was a new Motion and could not be put to the After it had been ruled accordingly, Dr. D. C. R. meeting. If members wished to express confidence in PITCHER proposed a minor amendment to the the Council and Committees this could be done by Motion, namely that the words "the Bye-laws relating voting against the original Motion. to Membership of the Royal College be amended The President then put the amended motion, as so that" be inserted after the word "That". This was follows : accepted. "That the Bye-laws relating to membership of DR. I. G. CHRISTIE, speaking as "a former rebel", the Royal College be amended so that for an said that years ago he had written letters to the interim period of four years Membership should be B.AÌ.J. on the same question now being raised, but granted to all who hold the D.P.M. or an so far from being expelled from the Association he had équivalent diploma and have undergone been elected to Council ; he had served for a year and psychiatrie training satisfactory to the College. 16 A consultant or senior lecturer appointment in Auditors psychiatry during this period would normally Messrs. Barton Mayhew were re-appointed the be taken in itself as evidence of satisfactory train- Association's Auditors for 1968-69. ing." Dates of Meetings, 1968-1969 A ballot was taken with the following resuit : For the Motion ...... 5 The following dates were approved: Against the Motion ...... 87 Thursday and Friday, 14 and 15 November, 1968 There were 45 abstentions. (London) ; Wednesday and Thursday, 5 and 6 February, 1969 (London); Tuesday and Wednes- day, 6 and 7 May, 1969; 8-11 July, 1969 (dates Subscription Rates and places to be confirmed). It was agreed that the following subscription rates should become effective at Inception of the College: Election of Members Foundation or Initial Payments for Fellows and The following were unanimously elected: Members to be paid at Inception of the College or at Election. Annual subscriptions to be effective HONORARY MEMBERS from 1 January of the year immediately following R. W. ARMSTRONG, formerly Physician Superintendent, the date of Inception, so long as notification is Littlemore Hospital, Oxford. (General Secretary, I 1 : received in good time for this to be administra- 95°- 957 President, 1957-1958.) tively possible. Proposed by Dr. Francis Pilkington, Dr. H. V. Dicks, Dr. Alexander Walk, Dr. W. Warren, Dr. William Initial Sargant. Payment at Annual L. C. COOK, formerly Physician Superintendent, Bexley Hospital, Dartford Heath, Kent. Secretary, Papers and Foundation Subscription Discussion Committee, 1946-1958; Chairman, 1959- or Election 1967; President, 1958-1959. £ £ Proposed by Dr. Francis Pilkington, Dr. H. V. Dicks, Fellows 20 20 Dr. Alexander Walk, Dr. W. Warren, Dr. William Overseas Fellows 20 17 Sargant. Members 10 15 HENRY W. BROSIN, President, American Psychiatric Overseas Members 10 12 Association. Foundation Members becom- Proposed by Dr. Francis Pilkington, Dr. H. V. Dicks, Dr. Alexander Walk, Dr. W. Warren, Dr. William ing Fellows within 2 years 10 20 Sargant. Affiliâtes 10

Overseas Affiliâtes — 8 CORRESPONDING MEMBERS Associates — 7 H. AKIMOTO, Professor of Psychiatry, University of Tokyo. Inceptors — 4 Proposed by Dr. Francis Pilkington, Dr. H. V. Dicks, Fellows over 40 years Dr. W. Warren, Dr. Denis Leigh. Members membership of LAWRENCE KOLB, 6645 32nd Street, N.W., Washington, Affiliâtes Association nil 2 D.C., U.S.A. Associates and/or College Proposed by Dr. Francis Pilkington, Dr. H. V. Dicks, Fellows Dr. W. Warren, Dr. Denis Leigh. less than Members A. SNEZHNEVSKY, Professor of Psychiatry, Institute of •40 years Affiliâtes nil 4 Psychiatry, Academy of Médical Science, Moscow. but retired Associates Proposed by Dr. Francis Pilkington, Dr. H. V. Dicks, Dr. W. Warren, Dr. Denis Leigh. Joint Subscription (husband and wife) : H. UTENA, Professor of Psychiatry, University of Tokyo. Initial payment as appropriate and double Proposed by Dr. Francis Pilkington, Dr. H. V. Dicks, Dr. W. Warren, Dr. Denis Leigh. subscription minus £5 (one Journal only). (Initial Payment (if any) and half subscription ORDINARY MEMBERS if taken up after 1 July in any year.) AFFARA, ABDULLAH SALEH, L.R.C.P., L.R.C.S.(E.), L.R.F.P.S.(G.), D.P.H., D.T.M.&H., D.M.S.A., As- sistant in Psychiatry, Gogarburn Hospital, Cor- Presidential Grant storphine, Edinburgh. The usuai Grant to the President during his year Proposed by Dr. T. L. Pilkington, Dr. A. K. M. Macrae, of office was approved. Dr. G. M. Bell. 17 AGGARWAL, ANIL KUMAR, M.B., B.S., Registrar, Bangour FORDER, PATRICIA AUDREY, M.B., Ch.B., Registrar, Village Hospital, Broxburn, West Lothian. Rosslynlee Hospital, Roslin, Midlothian. Proposed by Dr. F. G. Lassalle, Dr. J. B. Rae, Dr. M. Proposed by Dr. A. B. Hegarty, De. W. M. Mason, Ashraf. Dr. P. W. E. Hayward.

ALLAMENOS, DEMETRIOS CHR., M.D., Registrar, Leavesden GWINNER, PAUL DUDLEY VALENTINE, M.R.C.S., L.R.C.P., Hospital, Abbots Langley, Watford, Herts Trainee Psychiatrist, B.M.H. Munster, B.F.P.O. 17, Proposed by Dr. L. Arenillas, Dr. J. T. R. Bavin, B.A.O.R. Dr. E. G. Essery. Proposed by Dr. D. C. V. Stewart, Dr. H. C. Ferguson, BALL, DOROTHEA HELEN, M.B., Ch.B., Clinical Assistant, Dr. R. S. Britton. Department of Psychological Medicine, University HENRYK-GUTT, RITA, M.B., M.R.C.P., D.C.H., Senior College Hospital, W.C.i. House Officer, Academic Department of Psychiatry, Proposed by Dr. H. H. O. Wolff, Dr. R. F. Tredgold, St. Bartholomew's Hospital, E.C. 1. Dr. M. Balint. Proposed by Professor W. Linford Rees, Dr. C. M. B. BURMAN, ANTHONY STUART, M.B., B.S., Senior House Pare, Dr. M. N. McGuinness. Officer, Psychiatric Department, St. Olave's Hospital, Lower Road, S.E.16. HEYES, JANET MCRAE, M.B., Ch.B., 14 Adelaide Terrace, Proposed by Dr. E. R. Herst, Dr. A. J. Oldham, Waterloo, Liverpool, 22. Dr. A. Graham. Proposed by Professor F. J. Fish, Dr. J. B. Frost, Dr. J. T. Quinn. BUTTSWORTH, FRANCIS JOHN, M.B., B.S., Psychiatric Medicai Officer, Psychiatric Research Unit, Callan HOWELL, DAVID DOUGLAS, B.SC., M.B., B.Ch., D.P.M., Park, Rozelle, New South Wales, Australia. Assistant Psychiatrist, Department of Child Psychiatry, Proposed by Dr. D. S. Bell, Dr. C. M. Rosenberg, St. George's Hospital, S.W.I. Professor L. G. Kiloh. Proposed by Dr. G. S. Prince, Dr. Camilla Bosanquet, CARD, ISOBEL RINTOUL, M.B., Ch.B., M.R.C.P., Regis- Dr. R. F. Hobson. trar, St. James' Hospital, Leeds. INGHAM, CHARLES WILLIAM JOSEPH, M.A., M.D., B.Ch., Proposed by Dr. J. M. Roberts, Professor Max Hamil- B.A.O., Principal Medicai Officer, Greater London ton, Dr. R. McDonald. Council and Inner London Education Authority; 42 CONRAN, GORDON ERIC VICTOR, M.B., B.S., Principal Hillcrest Gardens, Esher, Surrey. in Partnership in General Practice, 128 Yorkland Proposed by Dr. A. B. Monro, Dr. J. J. Cockburn, Avenue, Welling, Kent. Dr.J. S. Bearcroft. Proposed by Dr. M. Radzan, Dr. A. Norton, Dr. D. M. IQBAL, MOHAMMAD JAVED, M.B., B.S., D.P.M., Registrar, Leiberman. Bangour Village Hospital, Broxburn, West Lothian. DURRANI, SARDAR SALAHUDDIN, B.SC., M.B., B.S., Proposed by Dr. J. B. Rae, Dr. M. Ashraf, Dr. F. G. Registrar, Warlingham Park Hospital, Warlingham, Lassalle. Surrey. ISKANDER, TREVOR NAGIB, M.B., Ch.B., Resident in Proposed by Dr. A. Graham, Dr. C. E. Salter, Dr. Psychiatry, University Hospitals, Columbus, Ohio, J. D. W. Fisher. U.S.A. EDWARDS, GRAHAM ARTHUR, M.B., B.S., D.P.M., Proposed by Dr. R. M. Patterson, Dr. I. Gregory, Psychiatrist, North Ryde Psychiatric Centre, Sydney, Dr. A. Walk. Australia. Proposed by Dr. F. F. Bryant, Dr. D. N. Scott-Orr, JESSON, JOHN GARRETT, M.B., B.S., M.R.C.S., L.R.C.P., Dr. R. J. Sureck. D.P.M., Consultant Psychiatrist, Knowle Hospital, Fareham, Hants. EL BADAWY, MOHAMED MOSTAFA, M.B., B.Ch., D.P.M., Proposed by Dr. J. S. I. Skottowe, Dr. A. J. Galbraith, Registrar, Gogarburn Hospital, Edinburgh, 12. Proposed by Dr. D. M. MacGregor, Dr. D. L. Aspinall, Dr. S. MacKeith. Dr. J. O. Jones. KENNEDY, DAVID, M.B., Ch.B., D.P.H., D.P.M., Senior EMERY, FLORA MARY, M.B., Ch.B., D.P.M., Psychiatrist, Registrar in Psychiatry, North-Eastern Regional Adolescent Service, Paramatta Psychiatric Centre, Hospital Board (Scotland), 18 Beechgrove Avenue, Sydney, Australia. Aberdeen. Proposed by Dr. B. Kirman, Dr. G. H. L. Bullmore, Proposed by Dr. R. A. Y. Stewart, Dr. G. E. Faulkner, Dr.J. H. Watkin. Dr. D. J. Muller. ESROCK, BEREL, M.B., B.Ch., D.P.M., Senior Registrar, KENWRIGHT, SIMON, M.A., B.M., B.Ch., Senior House Tavistock Clinic, Belsize Lane, N.W.3. Officer, Psychiatric Unit, London Hospital, White- Proposed by Dr. A. G. Thompson, Dr. R. Gosling, chapel, E.i. Dr. B. A. Snowdon. Proposed by Dr. S. I. Cohen, Dr. T. H. D. Arie, FENN, BAKER, M.B., B.S., D.P.M., Senior House Officer, Dr. D. Prodiero. Royal Edinburgh Hospital, Morninsgide Park, Edin- LEITH, JAMES WILLIAM, M.B., Ch.B., Consultant Psy- burgh, 10. chiatrist, Gogarburn Hospital, Edinburgh, 12. Proposed by Dr. W. D. Boyd, Dr. A. D. Forrest, Proposed by Dr. T. L. Pilkington, Dr. A. K. M. Dr. Sallie Gray. Macrae, Dr. G. M. Bell.

18 MCIVOR, ELIZABETH, MARY HASSARD, M.B., B.Ch., WEBB, ROBERT ARTHUR JOHN, M.B., B.S., M.R.C.S., Senior House Officer, Northern Ireland Hospitals L.R.C.P., M.A.N.Z.C.P., M.P.H., D.P.M., Psychiatrist, Authority, 13 Kincora Avenue, Belfast. Gladesville Hospital, New South Wales, Australia. Proposed by Dr. W. O. McCormick, Dr. M. T. Ken- Proposed by Dr. J. M. Collins, Dr. K. M. Koller, nedy, Dr. V. H. A. Black. Dr. R. L. Migodzinski. MASSEY, ROBINSON MICHAEL, M.B., B.S., Registrar in WILLIAMS, MERVYN RALPH PENRY, B.Sc., M.B., B.Ch., Child Psychiatry, Royal Hospital for Sick Children, M.R.C.S., L.R.C.P., D.P.M., Principal Medical Glasgow. Officer, H.M. Prison, Wakefield, Yorks. Proposed by Dr. F. H. Stone, Dr. Isabel Sutherland Proposed by Dr. I. G. W. Pickering, Professor E. Dr. M. O'Gorman. Stengel, Dr. D. O. Topp. MOSLEH-UDDIN, KHONOKER, M.B., B.S., Registrar, WOHL, MYER, M.R.C.S., L.R.C.P., Consultant Psy- Stratheden Hospital, Cupae, Fife. chiatrist, Brent Consultation Centre, London Borough Proposed by Dr. D. M. MacGregor, Dr. D. Ross, of Brent ; 130 Harley Street, W. 1. Dr. I. R. Sherret. Proposed by Dr. M. Glasser, Dr. M. H. Friedman, NAIR, NARAYANAPILLAI CHANDRASEKHARAN, B.Sc., M.B., Dr. H. Stewart. B.S., D.T.M. & H„ Registrar, Stratheden Hospital, WREN, PETER JOHN JAMES, V.R.D., M.D., J.P., Medical Cupar, Fife. Officer, Lisieux Hall Mental Nursing Home, Whittle-le- Proposed by Dr. D. Ross, Dr. I. R. Sherret, Dr. A. Woods, near Chorley, Lanes. Morrison. Proposed by Dr. J. C. Denmark, Dr. A. B. Masters, PARSONS, PETER LYNN, B.SC., M.D., D.P.M., Consultant Dr. D. P. Oakley. Psychiatrist, North Wales Hospital, Denbigh. Proposed by Dr. M. A. Hill, Dr. R. E. Owen, Dr. A. M. ASSOCIATE MEMBERS Rouncefield. CHU, MAY, B.A., Clinical Psychologist, Long Grove REVILL, MICHAEL GEORGE, M.B., B.S., M.R.C.S., Hospital, Epsom, Surrey. L.R.C.P., Registrar, Warlingham Park Hospital, Proposed by Dr. A. B. Monro, Dr. A. A. Black, Dr. H. Warlingham, Surrey. H. Steadman. Proposed by Dr. E. A. Harvey-Smith, Dr. J. D. W. HUDDY, MARY ALICE, B.A., Dip.Clin.Psych., Assistant Fisher, Dr. A. Graham. Lecturer in Clinical Psychology, The Royal Infirmary, RICHARDSON, BARBARA, M.B., Ch.B., Director, Child Manchester. Guidance Clinic, Scarborough. Proposed by Dr. J. Hoenig, Dr. W. A. Anderson, Proposed by Dr. L. W. Robinson, Dr. T. M. Cuthbert, Dr. B. H. Burns. Dr. D. D. Webster. SKELLERN, F. EILEEN, S.R.N., R.M.N., S.T.D., Superin- RODRIGUEZ, ANTONIO GARCIA, L.A.H., D.P.H., D.P.M., tendent of Nurses, Bethlem Royal and Maudsley Senior Registrar in Psychiatry, Liverpool Regional Hospitals. Hospital Board, and Greaves Hall Hospital, Banks, Proposed by Dr. H. V. Dicks, Sir Denis Hill, Professor Southport, Lancashire. W. Linford Rees. Proposed by Dr. W. Sharp, Dr. F. H. Corbitt, Professor THOMPSON, WALTER GERALD, M.A., Dip.Ed., Dip.Psych., E. Stengel. Principal Psychologist, Long Grove Hospital, Epsom, ROGERS, JOHN NEVILLE, M.B., Ch.B., D.P.M., Registrar, Surrey. Halliwick Hospital; 74 London Road, Shenley, Herts. Proposed by Dr. A. B. Monro, Dr. A. A. Black, Dr. Proposed by Dr. J. T. Bruce, Dr. I. Sutton, Dr. L. C. H. H. Steadman. Kreeger. STEWART, SARAH EMILY, B.S., M.D., Resident in Psy- Honours chiatry, Mendocino State Hospital, Talmage, Cali- Dr. J. D. Sutherland was congratulated on the fornia, U.S.A. Proposed by Dr. W. G. Burrows, Dr. A. Walk, Dr. recent award of a C.B.E. G. S. Clouston. URWIN, WILLIAM, M.B., Ch.B., Registrar, Middlewood World Psychiatric Association Hospital, Sheffield, 6. Dr. R. W. Simpson gave details about individual Proposed by Dr. A. Kelly, Professor F. A. Jenner, membership of the W.P.A. and asked that anyone Dr. R. J. Kerry. who was interested should contact Dr. Bancroft at VERGHESE, ABRAHAM, B.SC., M.B.. B.S., M.D., D.P.M., Reader in Psychiatry, Christian Medical College the Maudsley Hospital. Hospital, Vellore, South India. Proposed by Dr. R. Chacko, Dr. B. Davies, Dr. R. H. Paper Hook. Dr. Francis Pilkington announced that because of WATERS, ROBERT CHRISTOPHER, M.B., Ch.B., D.P.M., Senior Registrar, Warneford Hospital, Oxford. the lateness of the hour Professor Gruenberg's paper, Proposed by Dr. H. G. Smyth, Dr. J. P. Mellon, which should have been presented before lunch would Dr. A. W. Drummond. now be delivered on Thursday morning.

19 Adjournment of Annual Meeting Presidential Address

It was proposed, seconded, and carried unani- The President then delivered his Address entitled mously that at the end of the present proceedings "TWENTY YEARS A-GROWING". the Annual General Meeting be adjourned. The Vote of Thanks to the President for his Address was proposed by Dr. L. C. Cook and seconded by Lunch Dr. Kenneth Weeks. Members and their wives were entertained to a Civic Lunch at the Guildhall by the Lord Mayor.

General Vote of Thanks Afternoon Session Vote of Thanks to Officers and Council The General Secretary, Dr. A. B. Monro said that it was always a great pleasure to him to propose In proposing the Vote of Thanks, Professor this Vote of Thanks which expressed the Association's Desmond Curran expressed the Association's grati- appreciation of the work and effort of all those people tude to the Officers, to Council and to the Commit- who had contributed to the success of the meeting. tees of Council for the great and ever increasing The first persons to be congratulated was Dr. Francis amount of work done by them, mentioning in par- Pilkington for the excellence of all the arrangements ticular the great bürden carried by the Special during the meeting. Thanks were also due to him (Petition) Committee. Professor Curran also ex- and Mrs. Pilkington for the most enjoyable dinners pressed the Association's appréciation of the work attended by members of Council and their wives and, done by the office staff. The Vote of Thanks was in advance, for the Ladies' outing to Buckland Abbey, seconded by Dr. R. F. Barbour who also referred to Dartmeet and Dartington Hall. the work of the Officers and Committees of the Divisions and Sections. Thanks were also due to the Lord Mayor of Ply- mouth for the splendid reception and lunch so recently enjoyed by Members and their wives and also Induction of New President for enabling much of the Annual Meeting to be held Dr. H. V. Dicks invested Dr. Francis Pilkington at the Guildhall. Members were also grateful, in with the Presidential badge and Dr. Pilkington advance, for the arrangements made for the Recep- conferred the Past-Presidential badge on Dr. Dicks. tion at the Civic Centre. The Association also wished The following delegates were then presented to to express its gratitude to the Town Clerk, Mr. Dr. Pilkington: Lloyd James; the Entertainments Officer, Mr. DR. D. G. MCKERRACHER, who read a message of Botton ; and the City Librarian, Mr. Best-Harris, for good wishes from the Canadian Psychiatric all their help. Association. A very special debt of gratitude was due to the Moor- DR. H. S. ALPERT, representing the American haven Management Committee and its Chairman, Psychiatric Association. Professor R. J. Brocklehurst, and also the Vice- DR. N. W. DE SMIT, representing the Netherlands Chairman, Mrs. Osborne, who had welcomed Association for Psychiatry and Neurology. members to lunch on the previous day. He also DR. LARS NILSSON, representing the Swedish Psy- expressed gratitude to the Group Secretary, Mr. R. chiatric Association. W. Hampshire and his staff; the Catering Officer, The parchment of Honorary Membership was Mr. Green and his staff; the Matron, Miss I. Britton; presented to Dr. L. C. Cook, and it was agreed that the Chief Male Nurse, Mr. J. Greene; the Tutorial the parchments of the other newly elected Honorary Staff; and all the nursing staff and patients. Members and the Corresponding Members who had Thanks were also due to the South-Western been unable to attend that day should be sent to Regional Hospital Board for their help, and in them with the congratulations and good wishes of the particular the R.M.P.A. wished to thank the Board Association. and its Chairman, Mr. W. J. English, for the lunch The President presented the Gaskell Gold Medal at which members would be entertained on the and Prize to Dr. David Goldberg and the Bronze following day. Medal to Dr. J. P. Watson. Finally, the General Secretary thanked the Joint It was announced that the Maudsley Lecturer in Management Committee and its Chairman, Coun- 1968 would be Dr. William Sargant, whose subject sellor Washburn, for the Reception held at the would be "The Physiology of Faith". Plymouth Nuffield Clinic on the previous evening.

20 Annual Dinner meeting of the Child Psychiatry Section held at the The Annual Dinner was held at Moorhaven Plymouth Nuffield Clinic. Hospital and, in addition to the delegates presented At the meeting of the Psychotherapy and Social to the President earlier in the day, the guests included Psychiatry Section Dr. Margaret Tonnesman read a Lord Bainiel, M.P., Dame Joan Vickeis, M.P., Dr. paper entitled "Socio-Psychodynamic Aspects David Owen, M.P., the Lord Mayor and Lady of The Mental Hospital Community". Mayoress of Plymouth, Mr. and Mrs. English, Dr. The Mental Deficiency Section visited the and Mrs. J. S. Westwater, and Professor R. J. Plymstock Junior Training School and Hostel. Brocklehurst. There were the following Toasts: "THE QUEEN" SOUTH EASTERN DIVISION

"THE ROYAL MEDICO-PSYCHOLOGICAL ASSOCIATION" THE SPRING DIVISIONAL MEETING was held at proposed by Lord Bainiel Warlingham Park Hospital, Warlingham, Surrey, on replied to by the President. 4 April, 1968 by kind invitation of the Hospital Management Committee and Dr. Arthur Graham, Chairman of the Medical Committee. THURSDAY, n JULY, 1968 Members met at Rees House, the new Mental The following papers were presented: Health Centre, 2-4 Morland Road, Croydon, at "From Practice to Theory: Re-Writing our 10 a.m. Dr. J. W. D. Fisher then addressed them on Theories of the Psychoses in the Light of the subject of the Mental Health Centre, after which New Community Programmes", D. Ernest M. they were escorted on a tour of inspection. This Gruenberg (New York). very fine addition to the psychiatric services of "The Medical Manpower Problem", Dr. David Croydon incorporates a Psychiatric Day Hospital Owen, M.P. under the direction of Dr. Fisher, and in the same "Evaluation of the Plymouth Nuffield Centre", building facilities for the work of the Mental Welfare Dr. K. Weeks and Professor Neil Kessel. Department of the Local Authority. "A Survey of Objective Difficulties in Develop- Members then adjourned to Warlingham Park ment Psychiatric Services in a Large Popu- Hospital, where they were taken on conducted tours lation Area", Dr. M. W. Annear. to inspect various centres, including the Addiction "A Psycho-Geriatric Service in a Rural Com- Unit, the Occupational Therapy Department and the munity", Dr. T. S. Wilson. Arts Centre. "The Role of The G.P. in Hospital Out-Patient At lunch the Division was welcomed by the Psychiatry", Dr. R. Playfield. Chairman of the Hospital Management Committee, Sir Cecil Crabbe. In reply, Dr. Gilsenan, Chairman Members were entertained to lunch at Moorhaven of the Division, thanked Warlingham Park on behalf Hospital by the South-Western Regional Hospital of the Association. He reminded members of the late Board. Wives of members went on a coach tour Dr. T. P. Rees, famous for his progressive work in with Mrs. Pilkington, visiting Buckland Abbey, psychiatry, and emphasized how this work was Dartington Hall, and lunching at Dartmeet. In the obviously continuing under Dr. Graham and his evening members were guided round the Plymouth colleagues. Civic Centre. The Secretary read the report of the Divisional Committee of Management, in which mention was made of a letter from Dr. J. H. Willis on the subject FRIDAY, 12 JULY, 1968 of drug addiction; Dr. Willis emphasized the prime Section Meetings problem to be that of the "maintained" heroin Professor Linford Rees took the Chair at a meeting addict. of the Research and Clinical Section at which Nominations for appointment to the North-East Dr. Mögen Schou spoke on "Lithium, Clinical and Metropolitan and South-West Metropolitan Regional Pharmacological Properties" and the Discussion Hospital Boards, of Dr. A. B. Monro and Dr. J. E. was opened by Dr. D. Blackwell and Professor M. Glancy had been submitted by the Committee, and Shepherd. the next Divisional Meeting had been arranged to Dr. Peter Matthews read a paper entitled "Emo- take place at Darenth Park Hospital, Dartford, Kent. tional Difficulties Encountered in Naval The Secretary reminded the meeting that when Families—A Child Guidance Analysis" to a the proposed Royal College of Psychiatrists came

21 into being, the Division would cease to exist. It was FALKNER, ISABEL MARY PLUNKET, M.R.C.S., L.R.C.P. intended that the final Meeting be held at Long Médical Assistant, St. Clement's Hospital, Ipswich, Grove Hospital as a tribute to the Association's Suffolk. General Secretary, Dr. A. B. Monro. Proposed by Drs. I. J. Davies, D. L. C. Thomas, J. V. Fennell. The following were elected: FRY, ANTHONY HAROLD, M.B., B.S., M.R.C.S., L.R.C.P. Chairman: Dr. A.J. Oldham. Senior House Officer, Department of Psychological Medicine, King's College Hospital, S.E.5. Secretary: Dr. D. M. Leiberman. Proposed by Drs. D. W. Liddell, H. S. Greer, A. W. T. Assistant Secretary : Dr. R. Payne. McDowall. Junior Representative on Council: Dr. B. Pinkey. GARDINER, ALLAN BRUCE, M.B., B.S. Registrar, Claybury Committee Members : Dr. P. E. Sylvester, J. E. Glancy, Hospital, Woodford Green, Essex. A. A. Robin, H. R. Rollin, M. Roderic-Evans, M. Y. Proposed by Drs. R. M. C. Welldon, B. Pitt, J. Pippard. Ekdawi, J. A. Stewart, B. L. Mallett, P. H. Mitchell, GARDNER, RAMON, M.B., B.S., M.R.C.P., D.P.M. C. Finn, M. S. Perinpanayagam, J. H. Patterson, Senior Registrar, Bethlem Royal and Maudsley G. S. Gladstone, O. E. Hodgson, P. Grahame Woolf, Hospital; 19 Little Brownings, Sydenham Rise, S.E.23. S. Bookner, M. D. Eilenberg, E. R. Mellon. Proposed by Drs. P. Flor-Henry, I. D. Chisholm, P. J. Noble. GOKTEPE, ESAT OGUZ, M.D., Senior House Officer, The following were elected Ordinary Members of Shenley Hospital, St. Albans, Herts. the Association: Proposed by Drs. M. P. Joyston-Bechal, M. D. Eilen- berg, R. D. Hinshelwood. BAL, SUBIR, M.B., B.S., D.P.M., Registrar, Friern Hos- pital, New Southgate, N. 11. GROSS, GRETE, B.A., M.B., Ch.B. Registrar, Napsbury Hospital, St. Albans, Herts. Proposed by Drs. J. J. Bradley, I. Sutton, B. S. Adams. Proposed by Drs. A. M. Edwards, W. R. Layland, BLACK, PAULA DOROTHY, L.M.S.S.A., D.Obst.R.C.O.G. J. H. Patterson. Registrar, Horton Hospital, Epsom, Surrey. HAMADAH, KAMEL, L.M.S.S.A., M.B., B.Ch., D.P.M. Proposed by Drs. J. H. Watkin, H. R. Rollin, W. L. Médical Assistant, Tooting Bec Hospital, S.W. 17. Neustatter. Proposed by Drs. T. Maguire, J. Colville, R. D. BLEND, DAVID MAURICE, M.B., B.S. Junior Medical Watson. Officer, Shenley Hospital, near St. Albans, Herts. HESTER, RICHARD MURRARY, M.B., B.S. Registrar in Proposed by Drs. Beryl Margolis, A. R. M. Freeman, Psychiatry, The London Hospital, Whitechapel, E.i. S. T. Hayward. Proposed by Professor D. A. Pond, Drs. M. J. Pritchard, BULL, MEGAN PATRICIA, M.Sc., M.B., Ch.B., D.C.H. D. Prothero. Medical Officer, H.M. Prison, Holloway N.7. HETTIARATCHY, NIHAL BERNARD, M.B., B.S. Senior Proposed by Professor Martin Roth, Drs. P. T. D'Orban, House Officer, Fairfield Hospital, Stotfold, Hitchin, L. C. Kreeger. Herts. BURROWS, MILES JAMES EDWIN, M.A., M.B., B.Ch. Proposed by Drs. K. S. Perinpanayagam, G. Kana- Senior House Officer, Fulbourn Hospital, Cambridge. karatnam, Betty Chester. Proposed by Drs. A. R. K. Mitchell, G. G. Stimpson, IBRAHIMI, GHULAM SARWAR, M.B. Registrar, Cane Hill P.J. Mannion. Hospital, Coulsdon, Surrey. COLLINS, MARGARET TOWL, M.B., B.S., D.P.M., D.C.H. Proposed by Drs. A. D. Isaacs, D. Naidoo, J. T. Psychiatrist, Paediatric Department, Whittington Hos- Hutchinson. pital; 19 College Crescent, N.W.3. JARMAN, CHRISTOPHER MICHAEL BRITTAIN, M.A., B.M., B.Ch., M.R.C.S., L.R.C.P. Senior House Officer, Proposed by Drs. H. J. Altschulova, Mary Lindsay, St. Thomas's Hospital; 24 Ormonde Gate, Chelsea, J. Redfearn. S.W.3. COPE, JENNIFER ROBIN, M.B., B.S. Registrar, Litdemore Proposed by Drs. R. H. Cawley, C. McDonald, S. R. Hospital, Oxford; 4 Upper Wimpole Street, W.i. Hirsch. Proposed by Drs. F. J. J. Letemendia, F. Arroyave- JENKINS, DAVID GRIFFITH PICTON, B.SC., M.B., B.Ch., Portela, P. J. A. Willems. D.P.M. Registrar, Belmont Hospital, Sutton, Surrey. CROCKET, BEATRICE MARGARET, M.B., Ch.B., Dip.Psych. Proposed by Drs. W. Sargant, E. West, C. J. S. Walter. Ed., Psychiatric Consultant, N.E. Essex Child Guidance JOSAFAT, MATTHEW D., M.D. Senior House Officer, Clinic, Colchester ; 13 Balgores Crescent, Romford. Long Grove Hospital, Epsom, Surrey. Proposed by Drs. J. H. Kahn, J. N. Rune, R. T. St. Proposed by Drs. A. B. Monro, J. R. O'Brien, J. J. Blaize-Molony. Cockburn. FADHLI, ADNAN ABBAS, M.B., Ch.B., D.P.M. Psychiatrist, JUDELSOHN, FELICITY ANN, M.B., Ch.B. Psychiatric Queen Mary's Hospital, Carshalton, Surrey. Registrar, Charing Cross Hospital, W.C.2. Proposed by Drs. B. H. Kirman, E. C. Donoghue, Proposed by Drs. J. Randell, G. B. Oppenheim, M. E. Miss Elspeth Stephen. Caple.

22 KELLEHER, MICHAEL JOSEPH, B.SC., M.B., B.Ch. Registrar, Dr. Arthur Graham spoke on the topic of "Ward 1, Maudsley Hospital, S.E.5. Mayday". In this paper he outlined the functions and Proposed by Professor M. Shepherd, Drs. J. P. Watson, work of a psychiatric ward of the Mayday General D. P. Goldberg. Hospital, Croydon. This unit had been functioning MOSES, EDWARD A., M.B., Ch.B. Registrar, Horton for a number of years and proved efficient in the Hospital, Epsom, Surrey. handling of a wide variety of acute and sub-acute Proposed by Drs. J. H. Watkin, H. R. Rollin, R. psychiatric disorders. Maclean. NARAGHI, MANOOCHEHR MODRESS, M.D. Registrar, Dr. J. D. W. Fisher then described "The Develop- Bexley Hospital, Dartford, Kent. ment of the Croydon Comprehensive Community Proposed by Drs. A. Norton, M. Radzan, D. M. Mental Health Service". Dr. Fisher described his Leiberman. work as a Joint Consultant with the Regional PARMAR, JASHAVANT SHIVLAL, M.B., B.S., D.M.P. Hospital Board and the Local Health Authority. Registrar, Long Grove Hospital, Epsom, Surrey. In this field his work was concentrated on community Proposed by Drs. A. B. Monro, A. A. Black, L. J. Clein. problems, and with him at Warlingham Park and at PONCIA, JOHN, M.B., Ch.B., D.P.M. Registrar, Dept. of the new Rees Centre he had the services of the Mental Psychiatry, St. George's Hospital, S.W.i. Health Social Workers in his day to day work. Proposed by Drs. P. Hays, J. Steinert, A. Liakos. PORTER, RUTH, M.B., Ch.B., M.R.C.P., D.C.H. Clinical Finally, Dr. E. A. Harvey-Smith read a paper on Assistant, Psychiatric Dept., Royal Northern Hospital, "Career Structure and Career Planning—Recent N.7. Discussions Between the J.C.C. and Ministry of Proposed by Drs. W. L. Neustatter, M. G. Gelder, I. M. Health". In this paper Dr. Harvey-Smith described Marks. negotiations in which he had taken part relating to RIPLEY, GODFREY DAVID, M.B., B.S., M.R.C.S., L.R.C.P., the future career structure of doctors entering M.R.C.P.G. General Practitioner, 9 Folly Close, psychiatry in this country. A particular problem Radlett, Herts. faced was that of the Medical Assistant grade. Young Proposed by Drs. C. Hodes, M. D. Eilenberg, Freda doctors going into psychiatry needed a reasonable Reed. prospect of rapid promotion, and it was considered SAAD, ABUL GASIM. M.B., B.S., Clinical Assistant, Bethlem Royal Hospital. that this should be largely automatic up to the grade Proposed by Drs. E. Hare, A. H. Ahmed, I. D. Chisholm. of Medical Assistant. Senior Registrar status would SCOTT, ROBERT DENNISTOUN, M.B., B.Ch., M.R.C.P., need special qualifications and should normally lead D.P.M. Consultant Psychiatrist, Napsbury Hospital, to a Consultant appointment. St. Albans, Herts. After each of the above three papers, a general Proposed by Drs. J. H. Patterson, A. M. Edwards, and lively discussion occurred in which many G. S. Gladstone. members took part. SPRATLEY, TERENCE ARTHUR, M.B., B.S., M.R.C.P. Registrar, Bethlem Royal and Maudsley Hospitals. Proposed by Drs. M. G. Gelder, L. K. Hemsi, D. Abrahamson. NORTHERN AND MIDLAND DIVISION STEVENS, ANTHONY GEORGE, M.A., B.M., B.Ch. Registrar, Horton Hospital, Epsom, Surrey. THE AUTUMN MEETING of the Northern and Proposed by Drs. H. R. Rollin, J. H. Watkin, W. L. Midland Division was held at the John Conolly Neustatter. Hospital, Rednal, Birmingham, on 11 October, 1967, STOOKES, ALIZON FRANCES, M.B., B.S., D.T.M. & H., by kind permission of the Hospital Management D.P.M. Registrar, Bexley Hospital, Dartford, Kent. Committee. Proposed by Drs. M. Radzan, G. K. Shaw, D. M. In the morning there was a tour of inspection of Leiberman. TAKRITI, ADNAN, M.D. Clinical Assistant, Maudsley the hospital. Hospital, Denmark Hill, S.E.5. Proposed by Drs. J. Bancroft, J. R. Colville, E. R. Herst. The Divisional Committee of Management re- VV'HEATLEY, DAVID PEARSE, M.A., M.D., M.R.C.P., ported that the question of finances being available General Practitioner, 325 Staines Road, Twickenham, to the Branches of the proposed College had been Middx. raised with the Treasurer, who had referred it to the Proposed by Drs. J. M. Mungavin, A. Walk, Professor Bye-Laws Committee. A reply had been received T. F. Rodger. from the Secretary of the Education Committee WOODS, GRÂCE EMILY, M.D., M.B., B.S., D.P.H., D.C.H., regarding fees paid by Trainee Psychiatrists attending Médical Administrator and Consultant Psychiatrist, Postgraduate University D.P.M. Courses. It was St. Ebba's Hospital, Epsom, Surrey. noted that the Ministry of Health had recently Proposed by Drs. B. Kirman, Valerie Cowie, G. Bullmore. issued H.M. (67) 27 which resolved the difficulties. 23 The following were elected to Ordinary Member- WHITE, KEVIN, M.B., Ch.B., D.P.M. Senior Registrar in ship of the Association : Psychiatry, Sefton General Hospital, Liverpool. Proposed by Drs. I. Leveson, G. Egan, H. Jarvie. AHEARNE, MARY CATHERINE, M.B., B.Ch., B.A.O. Médical Officer, H.M. Prison and Borstal Service; PAPERS 55 Bowerfield Lane, Heaton Norris, Stockport, Cheshire. Proposed by Drs. I. G. W. Pickering, M. A. B. Fenton, The following papers were presented : J. H. Orr. "The Development of the Therapeutic Com- BALE, RODERICK NORMAN, M.B.,B.S., M.R.C.S.,L.R.C.P., munity", by Dr. F. H. Taylor, O.B.E., M.D., M.R.G.P.E., D.P.M. Régistrar, John Conolly Hospital, D.P.H., D.P.M. Consultant Psychiatrist, John Rednal, Birmingham. Conolly Hospital, Birmingham. Proposed by Drs. J. Wardell-Yerburgh, R. G. R. An account was given of the early development Bensa, M. R. Morton. of the therapeutic community in the "Northfield BEACON, SAMUEL, M.B., Ch.B. Clinical Assistant, Psy- chiatric Unit, Sefton General Hospital, Liverpool. Experiment". Mention was made of the various other Proposed by Drs. A. C. Barry, G. P. Walsh, I. Leveson. therapeutic community approaches, with particular BRIGGS, GODFREY JOHN FRANK, M.B., B.S. Clinical reference to that developed by Maxwell Jones at the Assistant, Winwick Hospital, Warrington. Social Rehabilitation Centre, Belmont, later called Proposed by Professor W. I. N. Kessel, Drs. B. H. Henderson Hospital. Burns, J. Johnson. BURGES-WATSON, IAN PATRICK, M.B., B.Ch., D.P.M. "The Development of the John Conolly Registrar in Child and Adolescent Psychiatry, Scalebor Hospital as a Therapeutic Community", Park Hospital, Burley-in-Wharfedale, Yorkshire. by Dr. M. R. Morton, M.B., B.S., D.P.M., Proposed by Drs. I. Berg, P.M.J., O'Brien, J. L. Barton. Senior Registrar, John Conolly Hospital, Cox, JOHN RODGERS, M.D., M.R.C.S., L.R.C.P. Con- sultant Psychiatrist, Middlewood Hospital, Sheffield. Birmingham. Proposed by Drs. R. J. Kerry, F. G. Spear, D. A. Kent. A general comment on the accepted ideas of the DAVID, CHARLES JACOB, M.B., B.S., D.P.M. Registrar, therapeutic community was followed by an historical North Wales Hospital, Denbigh. account of the establishment of the John Conolly Proposed by Drs. A. Craig, D. A.Jones, R. E. Owen. Hospital and its development along therapeutic ELEY, BRENDA MAY, M.A., M.B., B.Chir. Médical community lines. A description of the day to day Officer, Public Health Department, Nottingham City regime and some brief account of how this served to and County. help patients and staff followed. Discussion of the Proposed by Drs. S. W. Hardwick, Joan M. Ridley, possible points of contrast between this mode of P. K. Bridges. practice of psychiatry and the more traditional HOLT, DONALD INGRAM, M.B., B.S. Registrar in Psy- chiatry, Doncaster Royal Infirmary. medicai models concluded this paper. Proposed by Drs. E. Howarth, M. Quinn, F. T. Thorpe. MCCOUBRIE, MALCOLM, M.B., B.S. Clinical Assistant, "The Development of a Therapeutic Com- Storthes Hall Hospital, Kirkburton, Yorkshire. munity in a Refractory Ward", by Dr. Proposed by Drs. M. Segal, D. M. Ropschitz, A. L. G. J. C. N. Tibbits, M.B., Ch.B., D.P.M., Con- Smith. sultant Psychiatrist, John Conolly and Holly- MILLER, MABEL EMMA, M.B., Ch.B. Clinical Assistant, moor Hospitals, Birmingham. Shelton Hospital, Shrewsbury. The paper gave an account of the development Proposed by Drs. J. C. Barker, M. D. Enoch, F. Kane. of a refractory ward in a provincial hospital from the MORCOS, VICTOR HANNA, M.B., B.Ch., D.P.M. Senior House Officer, AU Saints' Hospital, Birmingham, 18. stage before the open door and drugs really made Proposed by Drs. E. R. Sethna, M. H. Davies, C. D. impact through to its present state, running along Neal. therapeutic community lines. Some of the problems SIMS, ANDREW CHARLES PETTER, M.A., M.B., B.Chir., and limitations of this type of work within the con- D.R.C.O.G. Registrar, Department of Psychiatry, text of an enlightened traditional mental hospital Manchester Royal Infirmary. were discussed. A review of the effects and comments Proposed by Drs. J.Johnson, C. S. Mellor, B. H. Burns. about its value and feasibility were offered. SKENTELBERY, ALBERT JOSEPH, M.B., B.Ch., B.A.O. Médical Assistant, Royal Albert Hospital, Lancaster. "After-Care Developments and the Thera- Proposed by Drs. A. M. Gregory, W. Graham, S. peutic Community", by Dr. R. N. Baie, M.B., Smith. SPENCER, PAMELA VICTORIA, M.B., Ch.B. Registrar in M.R.C.P. (Ed.)., D.P.M. Registrar, John Psychiatry, Leeds General Infirmary. Conolly Hospital, Birmingham. Proposed by Drs. C. M. Tonks, S. B. Mahapatra, The place of the hospital in the wider community W. McC. Anderson. was discussed. A description was given of a year's

24 experience on domiciliary nursing, the formation Child & Family Psychiatry, Playfield House, of a social club within the catchment area and the Cupar, Fife. developing association with the Birmingham Indus- Proposed by Drs. J. D. Haldane, P. A. Lavelle, A. trial Therapy Association. The issues arising out of Morrison. these activities were considered. Dr. R. W. Simpson addressed the Division on the aims of the World Psychiatric Association. SCOTTISH DIVISION THE SPRING MEETING of the Scottish Division was The programme for the day consisted of a discussion held at the Royal College of Physicians, Edinburgh, of the First Report of the Joint Working Party on the on 8 March, 1968, Dr. A. K. M. Macrae in the Organization of Medical Work in the Hospital Chair. Service in Scotland (Brotherston Report). The various sections of the Report were described and The Division noted with regret the death of Dr. discussed by Drs. J. G. M. Hamilton, Cyril Bain- A. Ninian Bruce. bridge, M. A. Heasman, G. C. Timbury, J. W. Affleck, The report from the Committee of Management I. M. Ingram, H. J. B. Millar and Maxwell Jones. was read and accepted. It was noted that— Many other members of the Division contributed to (a) The Division would receive £50 a year from the discussion and the following summary of the the Association to meet expenses of visiting views expressed has been forwarded to the Scottish speakers. It was remitted to the Secretary of Home and Health Department: the Research and Clinical Section to arrange 1. The R.M.P.A. (Scottish Division) met to discuss the an autumn meeting in collaboration with other Report on 8 March, 1968 and was addressed by two Sectional Secretaries. members of the Working Party, Drs. J. G. M. Hamilton (b) The Revised Bye-Laws of the proposed College and C. Bainbridge. had been approved at the Adjoumed Annual 2. The R.M.P.A. (Scottish Division) welcomed this Meeting in London on 8 February, 1968. opportunity to comment on the Report, but considered Professor Batchelor suggested that the question of that the Report was not primarily concerned with the Psychiatric Hospitals whose Organization, is, in many payment of expenses for Branch Représentatives respects, différent from that found in general hospitals. should be considered. 3. The R.M.P.A. (Scottish Division) feit strongly that it should be represented on any future Working Party Dr. A. K. M. Macrae was elected as the Division's (para. 229) whose recommendations might affect représentative to the Scottish Joint Consultants Psychiatric Hospitals. Committee. 4. With regard to Clinical Organization (Chapter I), The following Office Bearers were elected: the R.M.P.A. (Scottish Division) considered that in Chairman ...... Dr. A. K. M. Macrae most Psychiatric Hospitals a "Divisionai System" Hon. Secretary . . . . Dr. G. C. Timbury was already in existence, but that the position of the Hon. Assistant Secretary .. Dr. J. W. Macpherson Physician Superintendent as an "Appointed Chairman" Junior Représentative on had not been recognized in the Report. It was con- sidered that the psychiatrie services had an important Council Dr. W. D. Boyd Regional or Area element (para. 51) and that appoint- Committee of Management: Drs. P. G. Aungle, J. M. ment of a Chairman might therefore be desirable. Carlisle, H. B. Craigie, H. Gillies, C. M. Hamilton, However, it was accepted that some means of reviewing J. H. Henderson, J. P. Mellon, I. M. Ingram, the duration of tenure of such an appointment might A. N. Munro, S. S. Sutherland, M. M. Whittet, be required. The R.M.P.A. (Scottish Division) S. Woolf. considered that local opinion should always be sought Dr. J. W. Affleck was re-appointed to the Scottish in making a décision for or against appointment of a Central Committee for Hospital Medical Services for Chairman and that no change in the present system the Session 1968/69. should be made without such consultation. : Professor I. R. C. Batchelor was appointed as the With regard to Psychiatric Units in general hosp tals. it was feit that "cross-membership" of Divisions might Division's Observer at the Scottish Postgraduate be appropriate (e.g. a small general hospital psychiatrie Medical Association. unit might, for some purposes, be considered along with a Division of Medicine and also with a larger The following was elected as an Ordinary Member Division of Psychiatry based on the neighbouring of the Association : psychiatrie hospital. A large psychiatrie unit in a LORIA, SABINA ADELE, M.R.C.S., L.R.C.P., D.Obst., general hospital might on the other hand be a separate R.C.O.G., D.C.H., Registrar, Department of Division within that hospital). 25 Where an Area Psychiatric Service has developed to St. Otteran's Hospital over a Two-Year involving several hospitals and special units, a Chair- Period" was read by Dr. T. Lynch. man might be elected (or appointed) in addition to Dr. Lynch said that St. Declan's Unit was a the Physician Superintendents of the individual 46-bedded Unit situated in a General Hospital in hospitals concerned, although a Physician Superin- tendent could also be Chairman of an Area Psychiatrie Co. Waterford. The population of Waterford is Service. 75,000. This Unit was formally opened in June, 1965, The R.M.P.A. (Scottish Division) anticipâtes and and the cases reviewed by Dr. Lynch were over a welcoraes the development of Comprehensive Area period of two years from August 1965 to August 1967. Mental Health Services involving Local Authority, Düring that period the Unit admitted 865 patients, General Practitioner and Hospital-based elements. all voluntary. The average length of stay was four 5. On Chapter II (Medical Staffing) it was again feit weeks. that the special problems of Staffing in psychiatrie Düring the first year 65 patients were transferred hospitals had not been speeifieally considered. Ex- from the Unit to the Parent Hospital, St. Otteran's— pansion of the Medical Assistant Grade was viewed approximately 15 per cent. In the second year the with great concern as a possible disincentive to recruit- number dropped to 25, or 6 per cent. The admissions ment in psychiatry, and as leading to a possible decline in standards of patient care, since the quality to the Parent Hospital, St. Otteran's, also dropped of applicants to this grade has generally been poor. over the two year period. It was feit most strongly that a further review of Dr. Lynch broke down the admissions into their Consultant Staffing in psychiatrie hospitals was urgently various age groups and clinical diagnoses. needed. The paper was discussed with interest by Drs. It was recognized that the whole question of training McCormick, Hayes, Moore, Egan, Shea, Fennelly, and Staffing was the subject of other reports and dis- Bradley, Dolphin, McGrath, Meenan, Ryan, Lawler, cussions (e.g. the Royal Commission on Medical Hanniffy, E. O'Brien, and Eustace. Education). A letter was read from the Department of Health 6. The suggestions in Chapter III (Alternatives to Tradi- asking for a nomination to the National Health tional Systems of Hospital Care) were approved. Many Council. The Secretary was instrueted to ask Pro- of these suggestions are already incorporated into the Organization of psychiatrie hospitals. fessor Browne if he was Willing to go forward again. It was feit, however, that a review of the appropriate If not, Professor Tom Lynch was agreed on by the establishment of ancillary staff (medical secretaries, members. social workers, occupational therapists, recreational A letter was read from Dr. W. F. McAuley therapists, etc.) was urgently needed, and that in many enclosing a formal proposai for the formation of an hospitals these personnel were not available in adequate Irish Committee or Section of Child Psychiatry. numbers. The matter was deferred until the next meeting. 7. The need for Operational Research (Chapter IV) is

fully acknowledged, and the R.M.P.A. (Scottish THE SUMMER QUARTERLY MEETING was held on Division) has no comments to make on this Chapter. 6 April, 1968, by kind invitation of the Medical 8. The R.M.P.A. (Scottish Division) welcomed the Superintendent, the Medical Staff and the Hospital emphasis which has been placed on good communi- Management Committee, at Holywell Hospital, cations (Chapter V), and would hope to be repre- Antrim. sented on any Standing Committee which might be set up to review this topic (para. 220). The value of multi-disciplinary consultation and Moming Session discussion and of the involvement of patients and staff DR. LUKIANOWICZ read a communication on in the "therapeutic community" of psychiatrie hospitals "Attempted Suicide in Children". His paper was was stressed, and the R.M.P.A. (Scottish Division) based on a group of 120 children referred to the two considered that this concept had some application to Child Guidance Clinics in Antrim in 1965. Attempted the general hospital field. suicide is often unknown to the world, in contra- distinction to actual suicide. The group was classified under five headings—actual, attempted, threatened, IRISH DIVISION contemplated and token, and Dr. Lukianowicz THE SPRING QUARTERLY AND CLINICAL MEETING described case histories to illustrate each group, was held at the Lecture Theatre, Jervis Street the choice of means, etc. and the treatment, which Hospital, Dublin, by kind permission of the Reverend was usually directed to improve the environment, e.g. Mother, on 24 February, 1968. the home or the school. A Paper entitled "St. Declan's Unit—A Statisti- In the unavoidable absence of Dr. MacAuley, cal Comparison Between Admissions There and Professor Gibson opened the discussion, and the

26 following members took part: Drs. Nixon, Sullivan, The discussion was opened by Dr. Clenaghan, Mulligan, Pringle, Lanigan and McQuaid. and the following members took part : Drs. Sullivan, DR. IRWIN read a paper on "Attempted Suicide Robinson, King, McCormick, Breakey, Lukianowicz, in Adolescents". Dr. Irwin said that in the io—19 Fennelly, and Weir. Professor Gibson gave the age group suicide was a very important cause of concluding address. death. There were more attempts in this age group than in any other. There was usually a previous The following Officers were elected : psychiatrie history. Dr. Irwin broke down her group Chairman: Dr. J. Mulligan, proposed by Dr. Glass, into various catégories, e.g. sex, age, at time of attempt, also the time of the day and week. seconded by Dr. Sullivan. A discussion on this paper was opened by Dr. J. Secretary : Dr. J. V. Glass, proposed by Dr. M. Walsh, and the following members took part: Sullivan, seconded by Dr. J. Mulligan. Professor Gibson, Drs. Glass, Norris, McCormick, Assistant Secretary: Dr. M. Sullivan, proposed by Nixon and O'Malley. Dr. Glass, seconded by Dr. Robinson. Members were then entertained to lunch by the Junior Représentative on Councul: Dr. R. Breakey, Hospital, and a Vote of Thanks was proposed by proposed by Dr. McCormick, seconded by Dr. Dr. Glass. Members were then taken on a conducted Kennedy. tour of the hospital. The Committee of Management to continue as before; this was proposed by Dr. Glass and seconded Afternoon Session by Dr. O'Malley. A Vote of Thanks was proposed by Dr. Mulligan DR. P. D. MCCARTHY read a paper on "Attempted for the work of the outgoing Secretary and carried by Suicide in Adults and the Elderly". He discussed acclumation. a series of cases—168 in ali—of attempted suicide The formation of a Committee or Section of which came to his notice in the year 1962. In the Child Psychiatry of Irish Di vision was proposed by over-65 age group males predominated. The speaker Dr. Nelson and seconded by Dr. Lukianowicz. The broke down the group into their various classifi- Secretary was instructed to write to Council for their cations, and described the various methods used in permission. the attempts. He compared the suicide rate in Ireland, which was very low, with other countries, The following Ordinary Members were elected : highest being in West Berlin, followed by Austria, Dr. Mary Collete Connolly and Dr. Deborah Finland and Japan. M. T. J. Keelan (née Cronin). NOTICES BY THE HONORARY LIBRARIAN

The Library is open to members between the hours Annales Médico-Psychologiques. of 9 a.m. and 5 p.m. Mondays to Fridays. Books are Annali di Neurologia e Psichiatria. issued to borrowers during these hours. Archives of General Psychiatry. The Hon. Librarian will endeavour to obtain, as Archives of Neurology. far as possible, any books on psychiatry and allied Archivio di Psicologia, Neurologia, e Psichiatria. subjects required by members. Arquivos do Departamento de Assistência a Psicopatas do Estado de Sâo Paulo. Library Lending Department Regulations Arquivos de Neuro-Psiquiatria. 1. Books shall be lent to members within the Australia and New Zealand Journal of Psychiatry. United Kingdom and Eire who are not in arrears Bethlem-Maudsley Hospital Gazette. with their subscriptions. Bibliographia Neuropsychiatrica. 2. No member may borrow from the Library more Brain. than three volumes at one time. British Hospital and Social Services Journal. British Journal of Addiction. 3. 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