ACPGBI doi:10.1111/j.1463-1318.2012.03068.x

President’s report

My presidential time must be nearly up, as here I am

writing my report for 2011–2012. The year started in

Australia with the Tripartite and took in the usual

London meetings. I conducted the ACPGBI council in

Edinburgh and Dublin and went to local meetings in

Preston, Coventry, Leeds, Liverpool, Newcastle and

north-west Thames, to name a few. A communication

innovation to note is the development of Executive

meetings on-line by Webex, which may well be the

future for much of the Association’s business. And like

any good band the Executive needs to take a bow:

Jonathan Reynolds and Peter Dawson for handling the

money, including the Euro, VAT issues and charitable

trust matters, Brendan Moran for steering the very

successful Low Rectal Cancer National Development

Programme (LOREC), David Jayne and Asha Senapati

for BDRF, which funded seven research projects to a

total cost of £294 593, and John Hartley who steered

us through video simulation, unit recognitions and the

prospect of extending educational initiatives to the

Multidisciplinary Team (MDT). All were shepherded

along by Adam Scott and Anne O’Mara.

So to the highs and lows with some pointers for the

future.

Up there is the ACPGBI’s interaction with the Bowel

Awareness Campaign and the National Cancer Action

Team (NCAT). In a series of three meetings with Mike

Richards, Graham Williams and I have been closely

involved in the introduction of this initiative nationally.

The aim of the NCAT is very simple, to drive up

colonoscopy numbers year on year by 15% for at least the

next 3 years. Colonoscopy and its much wider use is seen

as a key cancer detection and cancer prevention tech-

nique; it is crucial that colorectal surgeons remain an

important component of this activity.

Outcomes are king, and the National Bowel Cancer

Audit Programme (NBOCAP) and our participation in

national audit is a fundamental plank of our credibility.

Emergency colorectal cancer presentation and surgery are

associated with a high 30-day mortality rate; no news to

the clinician but now an issue recognized by the

Department of Health. As I write, Karen Nugent

(president-in-waiting) is meeting Department of Health

ministers to emphasize the reality of frontline challenges,

including access to imaging, interventional radiology for

stenting, rapid access to emergency operating theatres

and a lack of critical care resources for preoperative

resuscitation and postoperative care. The Association is

nothing if not active, clinicians advocating patients’

interests.

The website is our public face and is in for a very

substantial facelift. After a careful tendering process Mixd

is our website design partner. A new buzz of creative

energy started by Mike Saunders has exploded into the

process through Mark Coleman and Chris Macklin.

Whistles, bells, fireworks are all being attached and the

fuse paper lit. Dublin is the place for the live launch. Your

website needs your content.

Disappointment of the year? That would be the

decision of the General Surgery Specialist Advisory

Committee (SAC) to retreat from the offer of General

Medical Council subspecialty recognition for the second

time in a year; on–off, on again and now off. The old

chestnut of the general GI surgeon has been resurrected

by the Association of Surgeons of Great Britain and

Ireland (ASGBI) and the General Surgery SAC. The

ACPGBI rejects this concept as not being in patients’

interests. It is a reductionist proposal that flies in the face

of the evidence base of benefit to patients from surgeons’

specialization in disease management of bread and butter

colorectal disorders, including published outcomes for

primary colorectal cancer resections. This is a matter of

direct patient interest as NHS managers are still able

simply to redirect colorectal referrals to any surgeon

(including upper GI surgeons who have lost a specialist

practice) with the implication that all will do bowel cancer

surgery.

Now we need to talk about the ASGBI. When does an

umbrella organization become a cloaking device for

subspecialty associations that are then effectively hidden

from wider surgical debate? Answer, when the ACPGBI

has a very different view of the world from that presented

by the ASGBI. We do not need an umbrella. Indeed the

ACPGBI was founded in 1991 against the opposition of

some, including the ASGBI. Twenty plus years later the

ACPGBI has led in colorectal education, laparoscopic

surgery, colonoscopy standards, cancer trials, position

statements, cancer audit, IBD management, proctology

and functional bowel disease treatment, produced a

world-class journal, a substantial research foundation

and played a major role in European coloproctology. The

ASGBI got it wrong in 1991, and by obstructing

subspecialty development within surgical training today

it is still getting it very wrong. The ASGBI has a valid role

� 2012 The Authors

900 Colorectal Disease � 2012 The Association of Coloproctology of Great Britain and Ireland. 14, 900–901

in many generic areas such as revalidation, design of

emergency infrastructure and terms and conditions of

service. The ASGBI has no role in speaking for or trying

to shape subspecialty colorectal practice.

Finally we go to Dublin. To paraphrase James Joyce,

we are today what we established yesterday or some

previous day. Phillip Schofield, Bryan Warren and Keith

Leiper shaped this day for us and our patients. All three

are missed by the Association.

Nigel Scott

President of the ACPGBI

E-mail: nigel.scott11@btinternet.com

ACPGBI

� 2012 The Authors

Colorectal Disease � 2012 The Association of Coloproctology of Great Britain and Ireland. 14, 900–901 901