In these remarks I want to concentrate on services for mentally ill people, though many of my comments are relevant to the other two parts of that unhappy triumvirate of neglected services, mental handicap and old age. Though finances appear even more ‘restrained’ now, with the latest expenditure White Paper projecting a real drop of 2 per cent in personal social services spending between 1985 and 1988, we should avoid an excess of political emotion over reason. There has been progress over the last ten years in promoting mental health. What the figures I will quote show, however, is how painfully slow and erratic these developments have been.

During the third quarter of the 19th century it became clear that the problem of pauper lunacy was not being contained by the county asylums. Despite much new building, accommodation in asylums was over-crowded; the patient population had become increasingly heterogeneous and therapeutic optimism was waning. The proportion of curable patients in county asylums declined steadily—for example, from 1844 to 1870 the proportion fell from 15 per cent to 7 per cent. The prospect of large-scale institutional confinement, however, did not go unnoticed and alarm was expressed by many contemporary writers. J. T. Arlidge, formerly of St Luke's Hospital, for example, observed that: ‘Many asylums have grown to such a magnitude, that their general management is unwieldy, and their due medical and moral care and supervision an impossibility … in a colossal refuge for the insane, a patient may be said to lose his individuality, and to become a member of a machine … In all cases admitting of recovery, or a material amelioration, a gigantic asylum is a gigantic evil, and, figuratively speaking, a manufactory of chronic insanity.’

General professional training in psychiatry under the eye of the College has changed rapidly over the past twenty years providing benefit, as well as upheaval, for trainee and trainer alike. Along with the increased structure of training has come a change in trainees' career planning—as in all branches of medicine, perhaps—so that less sampling of different specialties and earlier commitment to a final career specialty is now taking place. This, together with the more formalized and structured training stipulations, has led to the development of so-called integrated training schemes in many centres. In Avon it has been felt that such a scheme would be neither practical nor in the trainees' best interests; but a persistent call by a proportion of trainees has fuelled continuing debate over several years.

‘Have you thought about the questions you will be asked by the selection committee?’ asked a friendly consultant colleague shortly before I attended my first interview for a senior registrar post. My application had been deeply considered, I thought, and I felt myself to be well prepared for success. My failure to get the job was an unexpected blow, but also one from which I subsequently learned some important lessons. Retiring to commiserate with the successful candidate over a cup of coffee, I was lucky enough to obtain by chance some helpful feedback on my sorry performance that afternoon. I had, I learned, conveyed an impression of ambivalence about wanting the job, and worse, uncertainty about the direction of my future career. I was amazed. However, subsequent conversations with a nonmedical friend who was the veteran of many such encounters (from both sides of the interviewing table) soon revealed the many ways in which I had doomed myself to failure. I determined to do better next time, and set out to gather as much expertise as I could. I present the fruit of these researches here, in the hope that they will prove useful to others in a similar position.

The magic lantern was first demonstrated in 1660 by Christian Huygens, a Dutch physicist, and by the 18th century ‘moving’ slides were being shown, as in Robertson's ‘Phantasmagoria’ in 1798. At the same time dissolving slides, using more than one lantern, and optical toys, based on persistence of vision, were being displayed. The resynthesis of motion recorded as photographic images was first carried out by Eudweard J. Muybridge in 1879, using twenty-four cameras and trip wires to photograph a moving horse. The development of flexible light-sensitive film, in association with an intermittent movement and shutter, anticipated the inauguration of the public cinema in 1896.