I am delighted to contribute to theParliamentary Health magazine; a delight only tempered by a certain hesitancy about what to emphasise at this present critical time. Mental health maintenance and equitable services for those with mental illness is impressively on Parliament's agenda in both Houses. The government must maintain mental health services as an NHS priority.

The Royal College of Psychiatrists has its origins in a meeting convened in 1841 by Dr Hitch in Gloucester who brought together other directors of lunatic asylums. The purpose of this meeting was to exchange information and collection of "statistics" to improve the treatment of the "insane". The college and its predecessor, The Royal Medico Psychological Association, continued to lobby governments - especially on the drafting of the Mental Health Act legislation - but primarily the college is a standard setting/education organisation. College Officers are elected by the entire membership (10,000); my three-year term concludes in June this year. Michael Shooter, College Registrar - known for his work in public education and mental health law - then takes on the presidential mantle.

These are fast moving and important times for the medical profession and royal colleges. My term began shortly after the Bristol Enquiry commenced its work, in the aftermath of Harold Shipman's serial killings and the Michael Stone convictions. Since then all has changed - and all is changing.

Medical practice and the work of mental health professionals is influenced by this socio-political climate; the determinants of mental disorder are linked to the nature of family support, and to exclusion and poverty. There has been a "cultural revolution" - forms of social support from family, peers and professional workers are changing rapidly. Never before in my working experience have these principles led to such forthright commitment to provide equitable service for black and ethnic minorities. Never before have health policy documents placed the patient, the service user, at the centre of health care delivery. This perspective, which has humanistic, philosophical and religious roots - is of profound importance and a cause for real hope. The re-negotiation of boundaries between the medical profession, the public and the government has occurred and there is a new consensus. Users and carer representatives, and black and ethnic minority users, are more central to college thinking.

It will be possible for governments to marginalise doctors and the royal colleges if convenient to do so; it is more difficult for governments to marginalise considered public opinion for improved mental health services. The college has always had an innovative and radical element within its core structure and function - many of the movers and shakers of "new" mental health service are Fellows. What is different is that structures such as the Mental Health Taskforce and the Mental Health Alliance have brought us together with the public, and better able to find common mind with government. We have no fears about greater accountability: the more external bodies - who scrutinise our standard setting, examining hospital visiting and regulatory structures - the better.

Two vitally important new college structures are now in place - an International Board and Ethnic Issues Committee. Other developments during my three year term include strenuous efforts to drive forward the Changing Minds Campaign to combat stigma attached to mental disorder, and the Millennial Celebration of Psychiatry, the Mind and the Arts, a 2001 Mind Odyssey. These public statements have changed the image of the college and helped to de-stigmatise mental disorder and those who provide mental health services.

We now await the draft Mental Health Bill and remain very concerned that the resources necessary to implement the bill - especially to staff the tribunals - are presently totally lacking. The broad definition of mental disorder, without new community services in place and without adequate definition of "best interests", is a fundamental flaw to the proposed legislation. The white paper, drafted when public concern about the perceived dangerousness of patients with personality disorder was prominent, led to the stigmatising category DSPD ("dangerous severe” personality disorder). It should be encouraging new community based care in the least restrictive environment. We look to parliamentarians for support if the bill comes for debate.

The college is working closely with the Department of Health to develop new initiatives to solve our recruitment and retention problems. It is helpful when MPs are able to commend the work of psychiatrists who often work in impoverished circumstances, and with disadvantaged sections of society. The college, working with the Academy of Medical Royal Colleges, has much welcomed the informed debate in the House of Lords on the NHS Reform Bill - and in particular the proposed powers of "direction" of the Council for Health Care Regulators. The professionalism of doctors can be assailed both from inside and from outside; yet it is a core safeguard for the optimum treatment of ill patients. Although expectations are high both amongst the public - for improved mental health services - and psychiatrists - to deliver an evidence based service - the financial and human resources are not present. I believe fundamentally that both the public, the profession and the government need to be realistic about the timescale of changes in the delivery of a National Health Service and that improvements in the recruitment of psychiatrists will only occur with a year on year increase in expenditure and when the learning, not blaming, culture becomes cemented into the fabric of our thinking. We shall remain vigorous in our search for lost monies and in our public advocacy on behalf of those disadvantaged by mental disorder and lacking mental health. We wish to work with MPs to that end.