Honorary Fellowship of the Royal College of Psychiatrists.

Psychiatric Bulletin (2003) 27: 471-472
© 2003 The Royal College of Psychiatrists 

The College

Dr Pearl D. J. Hettiaratchy

(Introduced by Professor Susan Benbow)

Dr Pearl Hettiaratchy is a distinguished clinician, doctor, psychiatrist and old age psychiatrist, who has contributed to the National Health Service (NHS) over a period of more than 30 years. She qualified in Sri Lanka, one of three family members who took up medicine: her brother was a physician and her sister Port Health Officer in Colombo.

She came to the United Kingdom in 1968 for a clinical attachment at St James Hospital, Portsmouth, where she later commenced her first consultant appointment in 1975 after completing her training. Here, together with a nurse manager colleague, she pioneered the development of old age psychiatry services, setting up the first travelling day hospital for older people in the UK.

She has enthused colleagues of all disciplines, and educated people from many backgrounds to reflect on and improve their practice. For 5 years from 1983 to 1987, she single-handedly ran the Region’s Day Release Courses in the Psychiatry of Old Age, and educated 400-500 key professionals, who are now leading old age psychiatry services regionally and nationally. She moved to Winchester in 1984, where she continued to teach and develop services.

Pearl has worked for the Royal College of Psychiatrists on committees concerning later life, nursing, ethnic issues and unethical practices, and has also served as Vice President. She has been an important role model for younger people coming into the specialty. She was featured as one of five psychiatrists giving their views on why psychiatry is a rewarding career to choose, in the College’s career information pack produced in 1990, and again in 1994. What she wrote here is typical of Pearl’s approach to her work:

‘the field of psychiatry fascinates me. It takes time, patience and diligence to unravel the workings of the human mind and one can never fully understand its intricacies. Every patient I see, even after 23 years’experience is still a diagnostic puzzle and a therapeutic challenge. So there can never be any burnout or boredom.’

And further:

‘At the core of psychiatry is the ability to empathise, understand and give something of yourself to the patient within thetherapeuticrelationship....’

Pearl has been determined and devoted to her work: her humanity and compassion are shown by her willingness to take unpopular stances when in the interests of her patients. Her advice wasoverruled during a ward closure in 1994 and eight elderly patients died shortly after moving from long-term hospital care into private nursing homes, against medical advice. The ensuing scandalled to guidance on long-term care, an ombudsman’s enquiry and a Select Committee hearing. Pearl was quoted in the press as saying:

‘the care team becomes the family of the patient. They are faces in their failing memories.’

She has worked tirelessly on behalf of older people in need of long-term care, unafraid of making her views known.

Pearl was elected to the General Medical Council (GMC)in 1994, and reelected in 1999. Her election was a great event in Sri Lanka, as she was the first Sri Lankan to serve on the GMC. Her reelection was reported in Island International on July 21 1999: the report noted that Pearl had participated in the discussions the GMC had with Sri Lanka’s Minister of Health in 1998 on holding the Professional and Linguistic Assessments Board test (part 1) in Sri Lanka. This was a landmark achievement and she has continued to work to support the development of services in Sri Lanka. With the GMC she has served on the Racial Equality Group, the Steering Group for Performance, the Professional Conduct Committee, the Standards Committee, and the Working Group on withholding and withdrawing life-prolonging treatment. She became Medical Screener for Conduct and Performance in 1997 and regularly investigates complaints against doctors.

She retired from clinical practice on 4 February 2002, after 34 years’ continuous service in the NHS, but later that year on 23 October, her work was recognised and honoured when she was invested OBE by Her Majesty the Queen at Buckingham Palace for services to old age psychiatry.

Pearl continues to be active in voluntary work, medico-legal work and medical politics. She is actively involved in national and local fora in influencing policy and decision making in the NHS, and her advice is respected on a range of subjects including the ethics of heath care, the support of doctors in difficulty and issues in multi-ethnic populations. Following the inquiry into the death of Stephen Lawrence, she has become involved in work with the Chief Medical Officer on racism in medicine, and is about to become an official role model for ethnic minority doctors. For many of us, she has been an unofficial role model for a number of years. One of the pleasures of her retirement is to be able to spend more time with her family, especially her six grandchildren.

Pearl is a valued, loved and respected psychiatrist and old age psychiatrist. I am delighted to present her for the Honorary Fellowship of the Royal College of Psychiatrists.