Abstract
JANICE WILSON
For the second year I write this letter for the February issue in early January, and in the middle of the holiday period. Holidays are a time of reflection and taking stock, as well as hopefully a time of recuperation. Last January I had just begun to play golf rather tentatively. This January, I finally joined a Golf Club rather than playing on the public courses, and I can hit the ball approximately 70% of the time instead of just 30%. I think that is reasonable progress for a busy person! At least as my father would say, ‘It is progress in the right direction!’
So a year on, have we made reasonable progress as a College and is it in the right direction?
The major focus of my presidency has been to strengthen the ‘core business’ of our College, so that we are as well prepared as possible for ongoing changes to health service delivery and funding models. We have made slow progress (like my golf and slower than I would like) on a number of projects:
the review of education and training has completed its first phase;
contracts are being developed for six clinical practice guidelines;
a scoping paper on clinical care pathways was completed in December and is being forwarded to the Commonwealth Government in Australia who funded this;
the first steps of the leadership and management training project are complete;
despite frustrations, considerable leadership is given to SPGPPS (Strategic Planning Group on Private Psychiatric Services) with a data definition dictionary complete;
most Australian States and Territories have a College office base as well as the New Zealand National Office in Wellington, which has facilitated, I believe, better communication with Fellows and better coordination of College activity in the Australian Branches and New Zealand, including advocacy to Governments;
communication has improved, I believe, but is not yet ‘perfect’ and, to this end, we have introduced a monthly electronic newsletter to those of you who have registered e-mail addresses with the College to receive it.
Of course all the regular business of the College carries on with scores of you working hard in training and education, professional standards, professional practice, research issues and relationships with community, professional, government and regional groups. As planned, there has been and continues to be, a considerable increase in College activity reflected by the progress made on a number of fronts and which, as you all know, is now reflected also in the increase in the membership fee for 1999.
In taking stock, one needs to ask: is all this activity necessary and to what purpose and, more importantly, is this progress in the right direction?
I am writing this newsletter on the way back from representing the College at a World Psychiatric Association meeting of Presidents of Societies in the Asia Pacific region. I was there with Dr Noel Wilton, former College President (1993–95) who is the WPA zonal representative for the eastern of the Pacific region. One of the major issues facing all countries in Asia and Pacific, and indeed world-wide, is providing psychiatric leadership within the development of mental health services, and more importantly within the whole socioeconomic development of a country. This focus is very important for us also in Australia and New Zealand, and is one that we have been working on for several years now and is well embodied in the College's strategic plan.
In both our countries we have a long tradition of professional self regulation as one of the major medical colleges, and of taking a prime role in education, training, and developing and maintaining professional standards. This outlines our ‘core business’ and builds the foundation from which we can provide leadership. This self regulation gives us a unique position of control and perceived power which is increasingly being questioned by others, particularly funders, but also other professional groups, consumers and carers. Our continual purpose or goal in having such ‘control’ is to ensure that the best mental health services are available for people with mental illness. This purpose must continue to have primacy.
However we also need to be responsive to the changes in our environment within this, adapt to the increasing diversity and complexity we find ourselves in, but always maintaining our sight on this prime purpose and goal. Thus all our activity and work has been aimed at strengthening the knowledge, skills and attitudes we need to have in order to continue to give leadership within the changing environment. We are continually going to be challenged, I believe, about what is the role of psychiatrists within an integrated approach to mental health service delivery, and about how we use our skills in the most cost effective way.
In looking back on 1998, it has been a particularly hard year in many respects, and we have a lot of work yet to go in the direction that we have set ourselves. Is this the right direction? Is our progress too slow? I believe it is the right direction and it is important not to get side tracked from strengthening the foundations from which we can continue to grow and be stronger leaders.
Although in every country mental illness is considerably stigmatised, and we suffer within that stigma, we have a foundation in Australia and New Zealand that is stronger than in many of our neighbouring countries. I believe we also need to give more attention to how we can support fellow psychiatrists nearby in similar struggles to our own, but ones that are much more difficult, lonely and challenging.
As we look forward to this year, we need to be both outward looking as well as focused on strengthening our own foundations.
