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Above: Geoff Garnett

Ladies and gentlemen, it hardly seems credible that it is now 53 weeks since I stood before you in Harrogate and was installed as National President of the British Dental Association.

Pat and I have had a busy year and I think we both agree that while receptions and dinners in London are quite fascinating and splendid, and visiting foreign dental associations is intensely interesting, the real pleasure of this high office still lies in visiting our own branches, sections and groups. The hospitality, kindness and general friendliness with which we have been greeted has been truly outstanding. Obviously we cannot name names, but nevertheless Pat joins me in recording our thanks to everyone who has received us so graciously over the past year.

I believe we should try to eliminate the geographical constraints imposed on us by boundaries determined in a previous century.

On completing the year as President I feel it may be an appropriate moment to make some comments on the situation facing our Association and our profession. While the central structure of the Association is currently being reformed and devolution is taking place, perhaps now is the time to re-assess the role of the sections and branches. In this matter there is no uniformity. In some areas sections flourish and branches are almost defunct, in others the reverse is the case. However, as we enter the next century with new means of communication and headquarters within electronic reach of every member, I believe we should try to eliminate the geographical constraints imposed on us by boundaries determined in a previous century. In my own Branch this boundary follows the track of a railway line torn up by Dr Beeching thirty-odd years ago. I rest my case.

I believe our executive is already applying itself to this problem. However, with the growth of continuing professional education, vocational training and specialisation, it seems to me that the social network and mentoring that can be offered at local BDA Section level is needed as never before. A problem shared is a problem halved and informal discussion at our local meetings is not something to be under-valued.

Reform and change in the way dental care is provided is of significant concern and challenge to our membership. We are told that dentistry is now a team activity, that specialist practice is the route to the high level of care demanded by our patients, and that the DH insists that access and care must be available for all. Doubtless some will consider my views pre-historic, but the paradigm that has served us well over the past 50 years is of the family practice where each dentist provides the care he or she considers appropriate for about 2000 regularly attending patients. Patients who over the years become friends. Care is also provided for about another 2000 patients who attend when they choose and who usually instruct the dentist what treatment they have decided they need, what treatment they are prepared to have and what treatment they are prepared to pay for. It is this latter group which is now causing the problem of access to NHS dentistry. Known in BASCD circles as the irregular attender the DH now seems to favour emergency clinics and 'drop-in' centres for this category of patient. Investing in Dentistry money is also targeted at this group. It is my experience that this group contains the most serious pathology and exhibits the most phobic attitudes to dentists and dentistry. Generally they are the most difficult patients to deal with in terms of consent, broken appointments, payment and of course complaints. Professions Complementary to Dentistry beware, for after forty years in practice I still struggle with the new patient who has attended neither me nor anyone else in the previous five or ten years. If, as I said earlier, the old paradigm of the family dentist is to be replaced, I make a plea that it should be a gradual and evolutionary process.

I cite as an example of sudden change the edicts issuing recently from the GDC on the matter of the provision of general anaesthesia in dentistry. I am sure the profession agreed with the views of the GDC in the long term, but found the overnight changes very disruptive and not in the best interest of many of our patients. Education, gradualism and evolution are surely the way to take a caring profession forward into the future.

Speaking of the future, my final task as President is to hand on this jewel of office to my good friend Stuart Robson. If I can't hand it on to a Lancastrian I suppose a Yorkshireman is the next best thing.

Stuart qualified in Newcastle, in spite of his passion for cricket, and for some time worked for the Grenfell Mission in Canada. However, general dental practice beckoned and since then our careers have run very much on parallel tracks. BDA Section, Local Dental Committee, Representative Board, GDSC — committees far too numerous to mention. We have become firm personal friends and I can tell you all that his wife Lalage cooks a very fine breakfast. Nobody cares more for his profession than Stuart and his knowledge of dental affairs is profound. I am sure he will be a worthy President and I have absolute confidence in his devotion and integrity when the dentists of the BDA and dentistry are involved.

Ladies and gentleman — farewell and thanks for the great privilege you have bestowed upon me, but please welcome your new President, Dr Stuart Robson.