In his Presidential Address, Stuart Johnston looked to his term as an opportunity to thank the British Dental Association for all that it has given him. He pledged that the year would have his full commitment and he would be a strong advocate for all to join the Association and be active for the profession. Ladies and gentlemen, I can testify that Stuart has surpassed all his own goals and has been a tireless leader, travelling the country, visiting practices, dental schools and attending meetings. His already strong international reputation with such matters as the Minamata Treaty has ensured that he has been welcomed in many countries where he has represented the Association. Thank you Stuart for all that you have achieved; I can only hope that I can emulate what you have done in some small way to repay the huge honour bestowed upon me by the Association.

Sixty years ago, the BDA Conference was held in Newcastle, the venue at that time following the home city of the President. In 1957, Harry Davis, a general dental practitioner, was inaugurated as President and started his address by saying 'It is now nearly fifty years since I was a first-year dental student, and since that time I have witnessed many important and exciting changes and developments about which I could well speak'. He went on to say 'it is not my purpose to discuss their future development, but rather to assess from my experience the trends of current thought, and consider the changes in professional life that may perhaps take place during the experience of some present-day dental students'.

We should not feel frightened to report a mistake...

Now you may well ask why I have chosen to look at the Address from sixty years ago. The reason is that I too will be celebrating that particular anniversary in a few weeks' time and because that will coincide with my retirement from fulltime clinical practice. It is therefore an opportunity to reflect, as our President did then, on those changes that have happened since I started studying dentistry in the late seventies and how current views are affecting us all, but importantly the younger members of our profession. There was also another reason for looking back through the annals of the British Dental Journal for that year. It was of course only a few months after the Dentists Act 1956 had received the Royal Assent and the General Dental Council had met, electing Sir Wilfred Fish as its President. It is worthwhile reminding ourselves that during their first meeting, the GDC received a telegram from the President and members of the BDA sending greetings on the' historic day which marked the commencement of autonomy for the dental profession'. It is also worthwhile recalling that the BDA had submitted 18 amendments to the bill, 11 of which were incorporated or accepted by the Minister for redrafting and presentation later. In other words, then, as now, the BDA was standing up for our profession and influencing decisions at the highest level.

Perhaps a final reflection from Harry Davis should be considered. He said 'It has long been accepted that, though the foundations of the profession are the schools, it is true that an association and a journal are necessary parts of its structure. Unfortunately we so often take the foundations for granted, but if we, or our successors, ever take any of these three for granted it will be a sad day for the future of the profession'. It is to this theme that I will return later.

I have long thought that being a member of a profession is a complex matter and probably everyone in the hall today would have their own definition and view about that. I believe that it starts even before we get to dental school perhaps by talking to and watching our own dental practitioner. There follows the arrival of the university prospectus, the preliminary look round, the interview and offer of a place. It continues once we have started the course, with shared experiences in lectures, examinations and graduation. The relationships made at dental school create friends and colleagues for life. As I sat down to prepare notes for this address I soon realised how much I owe to the lecturers and part-time clinical teachers at my alma mater, the Royal Dental Hospital in Leicester Square. It didn't end there because throughout my career I have been lucky to have the advice and guidance from so many inspirational clinicians and I often will hear their words in the middle of a consultation or procedure. One comment made to me by Graham Roberts, who went on to become a professor of paedodontics, has particularly stayed with me. He said 'listen to the patients, they are telling you what is wrong with them'. I have often repeated this to students and younger colleagues demonstrating how just a few words can influence thoughts and behaviours probably in ways that we can't even imagine. This, I think, is just one aspect of belonging to a profession.

I have been fortunate to have a fulfilling career in oral and maxillofacial surgery and was lucky to return to my home area of Morecambe Bay. As a sixth former, I had watched the consultant Eric Cooper (who had been the dentist in Colditz, as a prisoner of war) carrying out surgical procedures and was inspired to follow in his footsteps. Parallel to my clinical duties, I became our trust medical director and more recently, the responsible officer for appraisal and revalidation.

My main clinical interests are trauma and the treatment of dento-facial anomalies and I am therefore delighted that Professor Lars Rasmusson from the University of Gothenburg has accepted our invitation to speak at this Conference about orthognathic surgery. I do encourage you to go and listen to this renowned expert in his field.

The BDA has been a constant factor in my professional life starting as a dental student and running like a thread throughout my career. Whilst on the executive of the British Dental Students' Association (BDSA), with the support of Diana Scarrott from the BDA Secretariat, we persuaded British Rail to extend the use of the Railcard for dental students who had rather longer academic terms than other students. In another, rather more political arena, the BDSA successfully stopped a move by the National Union of Students which would have led to its abolition. Later we worked with the BDA to create the Student Committee. I am encouraged that both the BDSA and BDA Student Committee are thriving because our students are our future.

As a dental student representing the UK at the International Association of Dental Student Congresses and then as the FDI-IADS Liaison Officer, chairing the IADS Annual General Meetings, I not only made lasting friendships but learned to understand the views of our international colleagues. Some of the issues we discussed then as students are still pertinent now and it remains important that the Association is fully involved in these.

The BDA represents all aspects of dentistry whether it is general practice, the community, academia, the armed forces or the hospitals. However our status as a profession is coming under threat as never before, and we as an Association need to recognise this and adapt to ensure that we and future generations of dentists are represented and supported. We cannot ignore the changes taking place in our professional lives and the BDA is, and will continue to be, the voice for dentistry, helping to develop the future leaders of the profession. It is therefore with pleasure that we welcome Peter Lees, a neurosurgeon and chief executive of the UK Faculty of Medical Leadership and Management, and who incidentally has a dentist for a brother-in-law, to give the Presidential Lecture at this Conference. Peter has over twenty years' experience in senior roles in operational management and leadership development combined with his clinical career. I would encourage everyone to attend this lecture from someone with a huge wealth of experience in global health matters and who understands the challenges facing us all and particularly the younger members of our profession.

A few years ago we were shocked to read about a series of medical scandals starting in Bristol with the paediatric cardiac unit. As a result, the medical profession came under intense scrutiny amid accusations that the General Medical Council was not regulating doctors properly. A huge rethink was necessary and this led to, amongst other developments, the introduction of appraisal and revalidation. The GMC accepted that there were deficiencies in its regulatory methods and adapted by changing significantly. It did this by a full and detailed consultation with its registrants, which is still on-going, responding to feedback, making further changes and then testing these. The GMC is now a very different organisation from ten years ago. It is reflective and responds to concerns appropriately but is still willing to change. It has regained the confidence of patients and the profession and throughout all of this, kept a doctor at the helm as President. I do think that this approach has been one of the reasons for the balanced way in which the GMC now regulates the medical profession.

As the responsible officer, I have regular meetings with a GMC liaison officer who can be relied upon to offer sound advice and who recognises that we can all make mistakes but that on each occasion this is a learning opportunity. Now surely this is the environment in which we would all like to work? We should not feel frightened to report a mistake, because if we are, there can be no understanding of why it happened in the first place. A chance to learn, for the individual and the profession as a whole, is suppressed. We know from the airline industry that pilots are encouraged to report their mistakes without fear of retribution. How different that must feel from our own experiences where failure is still frowned upon and can lead to serious professional consequences for the dentist.

It is against this backdrop that I think the BDA, acting as one of the foundations of our profession, can stand up and argue for a type of regulation in which both our patients and we feel confident. This might include, for example, an appropriate appraisal system which can help the individual grow as a professional. It should also include, I believe, a regulator once again led by a dentist.

Finally, I return to the words of Harry Davis at this meeting 60 years ago. Yes, the dental schools have an enormous influence upon us as a profession, laying the ground work for our careers. Undoubtedly, the world-renowned British Dental Journal is a jewel in our crown. It is, however, the BDA which is the face of dentistry, which binds us together through Section and Branch meetings where there is always a guaranteed sense of belonging. The Association will, with your support, continue to campaign for the profession.

May I thank the conference organising team for all their hard work in bringing this superb event to you, year after year. I know that you will find plenty to see and that you will leave the conference filled with a new enthusiasm for your work and profession. I would also like to thank the BDA Secretariat for their commitment to the Association.

I am deeply honoured to have been elected as your President and am grateful to the North West Branch for their nomination. I am also thankful to my wife, Vicky, and the family for keeping my feet firmly planted on the ground. Past Presidents have set a standard which I intend to keep and I will devote my time in the coming year by representing the Association to the best of my ability. I look forward to visiting as many areas of the country and meeting as many of you as possible. Thank you.