Sir John, ladies and gentlemen and fellow medical colleagues,
For some reason this evening, I feel a little bit older than I actually am and also deeply honoured and extremely touched that any of you should even consider electing me, and I shan't ask whether it was unanimously or not, to the position of President of the British Medical Association. I can't thank you enough. I don't believe for one minute that I am worthy of the particular position albeit during the 150th year of your existence, but I can assure you that I shall do my best and my utmost to carry out this great office in the way that you would I hope like me to do so. If you don't like it you can always let me know.
Ladies and gentlemen, I am here this evening by gracious permission of my small son, William.
In an extract from last month's journal of the Royal Society of Medicine it said that the Annual Representative Meeting of the BMA will be held in London "where it is hoped that HRH The Prince of Wales will be installed as president of the Association at the Royal Festival Hall on the evening of 7th July". I presume that the inclusion of the verb "to hope" in this context meant that the medical profession appreciated only too well that the duration of pregnancy is 40 weeks and not necessarily 9 months and therefore there was always the possibility of something happening on this particular date.
However, with a display of astonishing tact and sensitivity our son made an appearance at a most suitable moment (which, incidentally, was astrologically highly auspicious, according to the large number of letters we received!). He thereby successfully avoided causing any confusion or controversy - ideal qualifications, you might say, for future Presidency of the BMA?! And talking of Presidency of the BMA, The Times tells me that on this occasion I shall be surrounded by "respectable men in dark suits, who will be preening themselves, armed with the power of modern medicine and quietly proud that they are now the shock troops of the middle classes". My God - what have I let myself in for?...
One thing I do seem to have let myself in for is a certain amount of controversy. Last year I had a letter from a member of the medical profession who said his fellow members were pleased I was honouring them by accepting Presidency of the BMA despite the risk of my public image becoming tarnished when I am seen to be taking on active interest in the Association's affairs. He went on to say that he was concerned it would only serve to alienate me from the majority of doctors within my own age group and confirm the worst fears of my critics of all ages. He ended by reminding me that the initials BMA stand for BIGOTED MORIBUND and APATHETIC! Although I shall watch my step as carefully as I can, I have a sneaking suspicion that the author of that letter will one day probably become a revered and staid professor of medicine!
Although there is inevitably bound to be a strong element of controversy, criticism and disagreement within a body as democratic as the BMA, there is still, I think, cause for considerable celebration and gratitude on the occasion of the Association's 150th anniversary. The BMA has done so much to draw people's attention to areas of crying neglect and, what is more, actively campaign for a decade or more to have the situation changed or improved. A classic case was when the place of medicine in the armed services attracted the BMA's attention, following the appallingly inadequate provision of medical care for the wounded during the Crimean War. As a result the Association played a major part in the formation of the Royal Army Medical Corps in 1898 - and by some strange quirk of fate I am going tomorrow evening to a large reception given by the RAMC to celebrate the 150th anniversary.
The sleepless task performed by the BMA Services' Medical teams in the South Atlantic campaign can never be stressed too often. Having spoken to a considerable number of wounded men in various military hospitals in this country, all of them attest to the wonderful way in which they were calmly treated by the doctors, surgeons and medical assistants in appallingly difficult circumstances. One man told me how a doctor would come and sit by his bed when an air raid was taking place in order to reassure him - totally oblivious to his own safety and with unexploded bombs still lying nearby. That great progress has taken place during this century is, I believe, shown by the fact that during the First World War they expected to be able to save some 25% of casualties. In the Second War it was in the region of 80% (but I may be wrong...) and today I am told it is just about 100%. This really is an astonishing achievement and one for which the medical profession deserves the highest praise. People talk about the horrors of modern warfare, but there can surely be no doubt that the horrors have been immeasurably reduced by medical science and advances in battlefield first aid techniques, which can be taught to the majority of private soldiers.
The medical teams who served in the South Atlantic are indeed heroes and displayed that extraordinary brand of dedication which non-medical people tend to take for granted. All this was bought home to me again recently when I took my wife into hospital to have her baby. Although people may say that we have a different impression of things from what happens normally, it is still heart-warming to see the devotion to duty and the incredibly long hours that so many members of the medical profession put into their work. Without such people as yourselves being prepared to operate in this way the quality of our lives would be greatly reduced. Without those who are prepared and enabled become involved in academic medicine, which helps to keep alive that essential research-based outlook and, above all, an openness of mind, our acknowledged strength in this field will be eroded - with a consequent loss of reputation and also hard economic benefits. There are many in the profession who are concerned at the way in which the high reputation of British medicine is already in danger of being prejudiced through lack of adequate resources. The sad point being, of course, that once certain standards begin to be eroded, it is so very difficult to re-establish them again in the future.
Ladies and gentleman, you have, for some unaccountable reason, elected me as your President for one year. You may, for all I know, wish to get rid of me after six months, but might I ask you to consider two particular subjects during my term of office? The first is the very real problems faced by some religious sects amongst the immigrant communities who have made their homes in this country. One particular example is the Sikhs, who come originally from the Punjab and now number between 300-500,000 people in this country. The report of a study group commissioned by the London Health Planning Consortium into primary healthcare in inner London (in 1981) mentioned the problems faced by ethnic minorities in terms of medical care. As far as Sikhs are concerned they face special difficulties because Sikh women cannot go to men doctors and there are no Sikh women doctors. Going into hospital is a nightmare for them. Interpreters frequently cannot be found and there have been instances of men discharging their wives from hospital and taking very sick women home simply because a male doctor has looked at them. Apparently in Southall there is one woman GP who is prepared to get up in the middle of the night to attend to Sikh women who understandably take their religious duties extremely seriously. Such cultural differences in our present-day society in Britain produce considerable problems, but at the same time I believe that we should not expect people to have to alter their lives drastically in order to be able to fit into the system that happens to exist. There must surely be room for some degree of flexibility to enable a religious sect of this kind to exist in this country without unnecessary hardship. I would suggest that, if it has not already happened, some further attention ought to be paid to trying to find reasonable ways of meeting these problems.
The second point I wanted to raise concerns those people who are handicapped or disabled in some way or other. Having served as Patron in the UK of the IYDP I am most anxious that the great strides ahead, which were achieved last year in terms of making so many more people aware of the particular needs and problems of disabled people, should not shrivel up into nothing through lack of any further interest or activity on their behalf. Having talked to many disabled people - and those who represent them in the numerous organisations that exist - there is clearly a feeling that they endure a considerable degree of discrimination in various aspects of life - particularly in terms of housing, transport and places of entertainment. It is essential that disabled people have some way of getting their anxieties and their grievances heard and dealt with and this is something that needs careful attention. Bearing in mind the close involvement the medical profession has with disabled people, it would be splendid to feel that I could turn to the BMA for advice or help on this matter.
Having made these points you are now perfectly at liberty, being a thoroughly democratic body, to un-elect me - but if you decide to give me the benefit of the doubt but I can assure you that I am proud to be associated in this manner with the medical profession and look forward to my year of office.