The Mental Health Task Force was set up by the Secretary of State for Health under the leadership of David King to assist in the process of the closure of the large mental hospitals and to ensure adequate provision was made to replace their services. Its strategic objectives, to be accomplished by the end of 1994, were to map the replacement of the remaining large institutions by good quality services, ensuring that this happened effectively; to identify what makes a service good and find ways of ensuring that services possessed these qualities; and to develop a vision of the shape of the mental health market in years to come. To assist in this a wide support group of about 20 people was set up. This included representatives of the Department of Health, Research and Development in Psychiatry, carer organisations, users, social services, general practice, nursing and the Royal College of Psychiatrists. The authors represented the College.

The General Medical Council have agreed that part of a letter which they wrote to a member of the College containing their current policy on confidentiality can be published in the Psychiatric Bulletin. This letter was written in response to a specific enquiry.

There are only 130 psychiatrists in Pakistan for a population of 95 million and they are stationed at major cities where only 15% of the population of the country resides. The foreign trained psychiatrists, mostly in the UK, are attached to the departments of psychiatry of medical schools in major cities and are not willing to go to rural areas where 85% of the population lives. Thus there is an acute shortage of psychiatrists at district headquarter hospitals (DHQ) in rural areas.

I would like to raise Issues about tape-recorded interviews by way of describing the recent admission to hospital of a man who began recording staff and patients.

Rwanda was the most densely populated country in Africa. It is two-thirds the size of Switzerland but contained a larger population (9 million people), growing by almost 40% every two years. Few square inches are left uncultivated. The Tutsi people (never more than 14% of the population) are said to have arrived in the 14th century ad, bringing with them a feudal and totalitarian system of government. There was significant intermarriage with the result that today the Hutu and Tutsi people share the same language, cultural beliefs and religions (predominantly Catholic). In reality the terms Hutu and Tutsi now more accurately describe caste than ethnicity (Delcros, 1994).