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Paul Gordon (PG): Perhaps to start you could say what the main changes have been in psychotherapy and the health service since you first started working in the National Health Service.
Jonathan Pedder (JP): I started in 1965 in psychiatry at the Maudsley. I think there's been a slow, steady advance in psychotherapy, if you take a broader view. The run-down of the mental hospitals, the move from the mental hospitals to district general hospitals, the movement from hospitals into the community, which is all in fashion at the moment—I like to think there's been a slow, steady advance although never as far as you would like. If you actually count up the number of consultant psychotherapists in Britain it's still a long way below what it should be, never as far as enthusiasts want but it's a slow, steady advance.
Robert M. Young (RMY): How many consultant psychotherapists are there today?
JP: There are now over one hundred consultant psychotherapists in the U.K. If you follow the Royal College of Psychiatrists norms which I mention in the paper (pp. 14-27), there ought to be one per hundred thousand but I think there are only a quarter of that number, so there is still some way to go. But there's been slow, steady expansion.
RMY: And how many psychiatrists?
JP: There are about five thousand members of the Royal College of Psychiatrists and something like a thousand general adult psychiatrists. So there's one psychotherapist to ten psychiatrists; it ought to be about two or three to ten.
RMY: How do we compare with other countries?
JP: In terms of numbers of psychiatrists of any kind per hundred thousand of the population we're way down, nothing like
as many as in North America or Australasia or in other European countries.
RMY: How would you account for that?