My video statement
I'm standing for College President because I believe we need change.
First and foremost, we can't carry on being asked to do more and more for less and less. Pressure on services and referral rates are increasing to unprecedented levels, yet mental health services still only receive less than 8% of the NHS budget.
Calling this out loudly at a national level, as unacceptable - and demonstrating the clear human cost of the under-resourced nature of our services has to be the first priority for the College.
When we make the case for more funding, though, there is one aspect of the picture that we often miss out. The reason we need more funding, more psychiatrists and more capacity is because our job as psychiatrists is not just about prescribing. It's also about cultivating relationships. Decades of research in this area - including several studies I've published myself as an academic - show the powerful difference therapeutic relationships make. Yet it has been consistently underplayed in policy development and service design.
I have seen this in the nearly 20 years I've worked as a Consultant across the system in Crisis Teams, in-patient services, PICUs, addictions services and a Community Recovery Team where I currently work in North East London. And I've argued it during my years of engagement across a range of executive committees of the College - The General Adult Faculty, London Region, Spirituality SiG, The Academic Faculty and, until recently, College Council.
Many of us find that increasingly our patients are being treated like products on an assembly line - moved from one service to another, with relationship just an afterthought. And I have seen this trend grow in every speciality from Intellectual Disabilities to Forensic Services to CAMHS to Perinatal and older adult services.
So, yes, we need investment but investment with a purpose. Not to meet yet more new targets or open even more new services but to improve capacity in our existing services so that we can do what we are doing now only with more time and attention to our patients.
We need to learn from the four nations and the different ways in which services are funded and organised in each, highlighting what works best; on both structural and clinical levels.
And we need to couple this with an attack on the rising administrative burden. Yes we need to record notes and input key information but with all the mounting KPIs and reporting requirements its just gone too far. We need to put patients before paperwork and conduct a Bonfire of the bureaucracy. If its not really essential to patient care then it needs to go.
And finally, we need to support each other. The struggles against racism, gender inequality and for LGBTQ+ rights are all of our struggles, and the College's support system needs to be enhanced as part of a widespread expansion of the wellbeing provision for all colleagues.
Personal development needs to become a part of professional development for it is only by building resilience in ourselves that we can do the same for others.
And that is where I ultimately want to take us as a College.
Becoming a more compassionate, connected, community so that we can then help lead and reform services to be the same for our patients.
Rwy'n sefyll dros Lywydd y Coleg oherwydd rwy'n credu ein bod angen newid.
Yn bennaf oll, allwn ni ddim cario 'mlaen i gael ein gofyn i wneud mwy a mwy am lai a llai. Mae'r pwysau ar wasanaethau a chyfraddau atgyfeirio yn cynyddu i lefelau na welwyd eu tebyg o'r blaen, ond eto mae gwasanaethau iechyd meddwl yn dal i gael llai nag 8% o gyllideb y GIG.
Mae galw hyn allan yn uchel ar lefel genedlaethol, fel annerbyniol - ac yn dangos cost ddynol glir natur tanbaid ein gwasanaethau yn gorfod bod yn flaenoriaeth gyntaf i'r Coleg.
Ond pan fyddwn yn dadlau dros fwy o gyllid, mae un agwedd o'r darlun yr ydym yn aml yn ei golli allan. Y rheswm y mae angen mwy o gyllid, mwy o seiciatryddion a mwy o gapasiti yw oherwydd nad yw ein swydd fel seiciatryddion yn ymwneud â rhagnodi yn unig. Mae hefyd yn ymwneud â meithrin perthynas. Mae degawdau o ymchwil yn y maes hwn - gan gynnwys sawl astudiaeth rydw i wedi'u cyhoeddi fy hun fel academydd - yn dangos y gwahaniaeth pwerus mae perthnasoedd therapiwtig yn ei wneud. Eto i gyd, mae wedi cael ei danchwarae'n gyson wrth ddatblygu polisi a dylunio gwasanaethau.
Rwyf wedi gweld hyn yn yr bron i 20 mlynedd rwyf wedi gweithio fel Ymgynghorydd ar draws y system mewn Timau Argyfwng, gwasanaethau cleifion mewnol, PICUs, gwasanaethau dibyniaeth a Thîm Adfer Cymunedol lle rwy'n gweithio yng Ngogledd Ddwyrain Llundain ar hyn o bryd. Ac rwyf wedi dadlau hynny yn ystod fy mlynyddoedd o ymgysylltu ar draws ystod o bwyllgorau gweithredol y Coleg - Cyfadran Oedolion Cyffredinol, Rhanbarth Llundain, Spirituality SiG, Y Gyfadran Academaidd a, tan yn ddiweddar, Cyngor y Coleg.
Mae llawer ohonom yn gweld bod mwy a mwy o'n cleifion yn cael eu trin fel cynnyrch ar linell gydosod - wedi'u symud o un gwasanaeth i'r llall, gyda pherthynas dim ond ôl-ystyriaeth. Ac rwyf wedi gweld y duedd hon yn tyfu ym mhob arbenigedd o Anableddau Deallusol i Wasanaethau Fforensig i CAMHS i Wasanaethau Perinatal a gwasanaethau oedolion hŷn.
Felly, oes, mae angen buddsoddiad ond buddsoddi gyda phwrpas. Peidio cyrraedd targedau mwy newydd eto nac agor hyd yn oed mwy o wasanaethau newydd ond i wella capasiti yn ein gwasanaethau presennol fel y gallwn wneud yr hyn rydym yn ei wneud nawr dim ond gyda mwy o amser a sylw i'n cleifion.
Mae angen i ni ddysgu o'r pedair cenedl a'r gwahanol ffyrdd y caiff gwasanaethau eu hariannu a'u trefnu ym mhob un, gan dynnu sylw at yr hyn sy'n gweithio orau; ar lefelau strwythurol a chlinigol.
Ac mae angen i ni gyplysu hyn gydag ymosodiad ar y baich gweinyddol cynyddol. Oes mae angen i ni gofnodi nodiadau a mewnbynnu gwybodaeth allweddol ond gyda'r holl ofynion mowntio KPIs ac adrodd gofynion ei newydd fynd yn rhy bell. Mae angen i ni roi cleifion cyn gwaith papur a chynnal Coelcerth o'r fiwrocratiaeth. Os nad yw'n hanfodol iawn i ofal cleifion yna mae angen iddo fynd.
Ac yn olaf, mae angen i ni gefnogi ein gilydd. Mae'r trafferthion yn erbyn hiliaeth, anghydraddoldeb rhwng y rhywiau ac ar gyfer hawliau LHDTC+ i gyd yn ein trafferthion, ac mae angen gwella system gymorth y Coleg fel rhan o ehangu'r ddarpariaeth lles ar gyfer pob cydweithiwr yn eang.
Mae angen i ddatblygiad personol ddod yn rhan o ddatblygiad proffesiynol ar ei gyfer dim ond drwy feithrin gwytnwch yn ein hunain y gallwn wneud yr un peth i eraill.
A dyna lle rydw i yn y pen draw eisiau mynd â ni fel Coleg.
Dod yn gymuned fwy tosturiol, cysylltiedig, fel y gallwn wedyn helpu i arwain a diwygio gwasanaethau i fod yr un fath i'n cleifion.
My statement in full
You can also read this statement in Welsh.
I am standing for President because I sincerely believe we need change. The role of Psychiatrist has been gradually reduced to a tick-box exercise with our remit narrowing to a slither of what it once was. Despite this, the responsibilities we carry are higher than ever and too many colleagues are burning out and leaving early.
Relationships are at the heart of what we do as psychiatrists. There is a large body of evidence showing its importance in patient outcomes. Yet our services have been so thinned that we are left unable to spend enough time with patients. Indeed, the mounting bureaucracy means that we often spend more time with computers.
I came into psychiatry to forge meaningful relationships with the people I care for. I have worked in several Consultant roles in nearly 20 years including In-Patient, PICU, Crisis, Community, and I currently work as both a clinician and academic. The focus of my research has been on integrative and relational ways of working; unearthing the skills that help us deepen therapeutic relationships and improve outcomes.
Our services have, however, evolved in the opposite direction, becoming increasingly disjointed with patients treated more like products on an assembly line. Reforming our system has therefore been a focus of my engagement on a range of College Executives in recent years including College Council as well as London Regional, Spirituality SIG, General Adult Faculty and Academic Faculty Executives.
Increased investment is crucial to the improvements we need but previously this has always come with increased demands - for new services, new targets etc. What we need, however, is more resources to do what we do now, only with more time and more attention for our patients. This is equally important for CAMHS, Older Adult, Liaison, Forensic, Addictions and Intellectual Disabilities. We therefore need a broad-based campaign, backed by solid research in each field.
Reconnecting the College to the nations and regions of the UK – with regular Councils and engagement linked to them - will be vital too. Only this way can we appreciate where our priorities need to lie when it comes to redressing imbalances.
Sustainability and our carbon footprint needs to be another core issue within each region as we build on the excellent work the College is currently doing around this.
The College has produced a strong equalities action plan, which I support too. Racism, gender inequality and LGBTQ+ prejudice exist across our system and are experienced by professionals of all disciplines. Continuing the College’s important work therefore - seeing the recommendations through - will be vital going forward. Improving our wellbeing offer and support for all members would be a further important step towards making ours a more relational College, where personal development becomes a form of professional development too.
All of these areas work hand in hand. They form a synergy that, together, will help us forge a more person-centred, compassionate College, which I believe is essential to helping us build and lead more person-centred, compassionate services.