Professor Fitzgerald is worried about the serious recruitment crisis in psychiatry. His answer is to advise psychiatrists to abandon their specialty and ‘return home to neurology’. In his opinion, a merger of the two professions would encourage clinicians to focus on careful clinical analysis and diagnosis, reduce professional isolation and stigma, enhance status and so improve recruitment. This may or may not be true, but I wonder about the attitude of neurologists to his proposal. The working life of a general adult psychiatrist is not easy and I think neurologists are likely to resist his advances. I don't know many who would be willing to regularly attend community-based mental health act assessments in inconvenient circumstances, subject themselves to cross-examination by enthusiastic lawyers in front of their patients at mental health tribunals, defend their practice at critical legalistic external inquiries, or subject themselves to the restrictions imposed by ‘new ways of working’. Psychiatric practice certainly needs to be reformed but a more practical analysis of our problems is urgently required. In my opinion, our College must lead on these issues. If it continues to equivocate it will quickly become an irrelevance.
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