I have been asked to explain the structural changes that are taking place in UKSCP and to describe how these will lead to the formation of a register of psychotherapists early in 1993. I shall briefly survey the present balanced structure, describe the most recent changes and show how they will work in practice.

In 1945 general psychiatric care in France was still mainly centred on large public and private institutions built, for the most part, in the 19th century and which had embodied, as their basic philosophy, the isolation and detention of the mentally ill.

As a psychiatric trainee I have often been intrigued by the respect that is accorded to pregnant women, deservingly or not, by the general public. People give up their seats on crowded trains and buses, they open doors, refuse to allow any heavy lifting and generally pamper the pregnant woman. As the months pass and the woman is transformed into a potential mother, attitudes towards her adjust, and she begins to be viewed in a different light. Certainly such was the case for me during my pregnancy and it was fascinating to observe the way in which the doctor-patient relationship changed as a result of my pregnant state.

An experiment in community care, training Omanis with bachelor degrees in social work, psychology and education to act as psychiatric care givers in the community, is currently being developed in the Sultanate of Oman. This experiment is based on the Alma-Ata declaration to achieve Health For All by the Year 2000 (WHO, 1978) and WHO aspirations to move psychiatric care back into the community (WHO, 1990), and the fact that in many developing countries psychiatric care has remained on the fringe due to lack of resources and manpower.