The responsibilities of a Consultant Psychiatrist are similar to those of other consultants within the National Health Service. The few differences arise from the special circumstances within the specialty, particularly relationships with other disciplines. The ability of Consultants to accept medical responsibility rests on their training, qualifications and statutory responsibility. Medical qualifications carry professional, ethical and legal responsibilities. These responsibilities are exercised towards and given by the public; are aimed at the cure or alleviation of human suffering; are independent of remuneration; and follow the medical practitioner wherever he may be, even within his private life.

The object of this paper is to set out some of the difficulties experienced in early training in Psychotherapy.

Undergraduate teaching tends to present the student with a view of the patient as a machine with a faulty part rather than as a person. This is reinforced during his period as a houseman. In order to function efficiently, he learns from his senior colleagues how to detach himself from patients so that he can cope with the dying or with investigations which are painful and frightening, or with patients who are chronically sick.

The views I express in this paper are my personal views and not those of either the Department of Health and Social Security or the National Development Group, but they are, nevertheless, based on established services and views expressed to me by colleagues in various parts of the country.