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    Professor John Newsom-Davis

    I shall now attempt to summarise the discussions. As always in meetings of this kind, we have identified many problems and rather few solutions.

    The first factor to consider is the influence of demographic change and the aging of the population, with the resulting impact on the incidence and prevalence of neurological disease. This will have implications for our specialty. We need to develop stronger links with gerontologists. Some neurological disorders may begin to move out of our orbit and into theirs.

    Next, the paper by Charles Wolfe and colleagues showed that the opportunities for prevention of neurological disease other than stroke are fewer than we would like to think.

    We are agreed that there is a woeful lack of data about neurological disease services and their outcome. It is also clear that young neurologists do not seem at present to be keen to garner such useful data. That may change, if academic units take on board the need to carry out not only laboratory based or molecular research, but also health service research. Once there is an emphasis of that sort within an academic centre, then we will find bright young people who will be keen to do it.

    One issue to emerge today is that there is a real need for neurologists to communicate and cooperate with those in all the specialties with which we interact. These include general practitioners and gerontologists as well as those professionals who presently work with us (clinical neurophysiologists, neurosurgeons, nurses, and physiotherapists). But we should seek more help from voluntary organisations and patient support groups.

    The question of demand versus need has not been resolved. In the end there will have to be a compromise, because some patients will always demand interventions, even though neurologists may tell them that they are likely …

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