The creation of the BPPA was one that began as a matter of importance, particularly when British Pakistani psychiatrists began to feel to lose their identity and their say on issues important to their future and working lives. Surviving in a society that accords massive opportunities and challenges, survival can be stressful especially with dignity and parity. There is a constant need for everyone to be part of a larger, vocal, support network, like a union, a spokes-body for one’s aspirations, protection and assistance. That was why the trade union movement started. That was why human beings chose to live in groups and had alliances with each other. British Pakistani psychiatrists needed to have such alliances and representation. However, there was the desire but there was neither time nor resources to build this support network. Of course some attempts were made but those collapsed due to internal conflicts and divisions. Yet, there were always opportunities to meet at various conferences and forums, periodically, which gave us- British Pakistani psychiatrists, a sense of camaraderie and support.

Subsequently, it was at a gathering in Coventry 2000 that the first idea of creating an association for Pakistani psychiatrists was debated with a clear message of asserting our British identity. Consequently, the name of the association as it stands today was chosen to project that we are British first. We no longer wanted to remain alienated by remaining a minority. So indirectly, the purpose of this association was to mingle and subsume itself in the mainstream as without mainstream involvement we the British Pakistani psychiatrists would have struggled to have been recognized and valued on an equal par to others. From the 19 British Pakistani psychiatrists present at this gathering, the name and core principles were agreed and the motion to set up an association/forum was initiated. These were the founder members of BPPA.

Then a discussion about entry ensued and again there were multiple and varied thoughts. Another purpose of formation of such an association was to overcome the obstructionist nature of the concept of nationality. Should only Pakistanis join this group? Which Pakistanis? Those who had migrated to Britain and had Pakistani nationality before or those who never had Pakistani nationality but were children of Pakistani nationals living in Britain. Would they consider themselves as much Pakistani as the first generation or would this association have any meaning for them? What would happen after three generations? Would there be or should there be such an association? These were daunting issues.

The group decided a strange way forward. It was decided that there would be no convenor or co-coordinator of this group, at that time, although Dr Akmal Makhdum proposed that Afzal Javed to fulfill this role, being a senior psychiatrist. Afzal declined and insisted that Akmal should continue this work as Akmal had proposed the concept and was gathering people for that purpose. Afzal assured his complete support.

Consequently, it was decided that a constitution would be drafted by this small group and would be motioned in the next meeting. Akmal drafted the document and shared it by post to all those who were present in the first meeting.
In Coventry’s transcultural research group meeting held in 2001, when many ethnic psychiatrists gathered, the same group met again. This time, there were three more members who joined in. At this gathering the constitution was agreed. Few members of the group still insisted on remaining a group without an administrative structure and without clarity of roles. This was becoming a hindrance as in the constitution there were distinct positions required to do certain tasks, in accordance with the law of the land. It was envisaged that the association would be registered as a charity and all charities needed to have prescribed structures, by UK law. Prof Arshed Husain from USA attended that group as an observer and guided the discussion towards developing a set up which was universal and recognizable by all, rather than a rudderless vague shape with no clear direction. He felt that this would be a recipe for disaster, like all previous attempts.

It was decided that there should be elections and an office bearer should be elected, there and then, to move this on. This was more of a consensual agreement rather than a formal election, but election by choice; it was, by those who gathered there to launch the association. It was also agreed that there would be a formal election the following year, when the first BPPA conference was agreed to be launched.

The following were elected: Akmal Makhdum, Chair, Mateen Durrani, Secretary, Anjum Bashir, Treasurer. It was proposed that royal college regions should be followed as BPPA regions and executives elected from these. The following executives were elected: Khalid Saeed, to represent east, Asaf Khan, to represent midlands, and so forth.

At this same gathering, Asaf Khan offered to arrange the first BPPA conference and was appointed coordinator/organizer of this inaugural event. With his effective links with sponsors, he arranged a grand conference in Birmingham’s Hilton metropole NEC. Against all expectations, 134 delegates attended and became members of the association. BPPA constitution also dealt with mental health professionals joining in and associate membership was accorded to psychologists, community nurses and other allied professionals working in mental health in the UK. Australia and Irish regions were created and approved by the membership.

Before anything else, the executive and office bearers were put for a vote of confidence in the general meeting. They were confirmed by the gathering unanimously, in accordance with the constitution. A strong constitutional framework and process was launched, to ensure transparency, effectiveness and durability.

Subsequent years saw BPPA grow from 134 to 315 members (current strength in 2005), with about 39 associate members and two fellows , elected by the association, Dr Mike Shooter, past president of the royal college of psychiatrists and Dr Akhter Ahsen, pioneering psychotherapist from USA.

First Secretary of BPPA, Mateen Durrani, with his excellent organizational abilities, especially in computer database building, created an effective and responsive communication channel with members.

The executive team gelled in developing new ideas and initiatives. For instance, BPPA:

* Pioneered the idea of joint working with Indian, Sri Lankan and Arab psychiatrists and proposed setting up a joint committee.
* Pioneered in setting up an umbrella organization of all British Pakistani physicians in Britain, called BPPA.
* It started to liaise with BAPIO and other organizations; especially the royal college to pursue it aims objectives of forwarding the interests of the BPPA membership.
* It proposed various strategies to the college to deal with the issue of SAS and locum doctors.
* It proposed a clearing house system to the chief executive of the NHS, in dealing with the PLAB doctors.
* The BPPA is a dynamo of ideas, responsive and reactive, pre-empting and principled, all in one. When 7/7 terrorist atrocity occurred, BPPA membership was key in organizing a vigil for peace in London, covered by numerous international media sources.
* It is the only recognized and representative association recognized by the government of Pakistan and the royal college of psychiatrists.
* It is also the representative group on the ethnic psychiatrists committee and on the ABPPA’s standing committee.
* It has held four major national conferences and collaborated in arranging the largest ever gathering of psychiatrists in the UK, titled ‘ a great partnership’, in 2004.
* Amongst publications, it regularly prints its news letter, now called BPPAnama.
* It has close links with Family physicians association of Pakistan and is cooperating in the organization of its 2005 conference.
* It is planning to collaborate in arranging the next conference of Pakistan psychiatric society in Lahore, in 2006.
* It is seeking closer working relationship with psychiatrists in the USA and APPNA, amongst many of its other initiatives, in the UK and in Pakistan.

In summary, BPPA has three major areas of work:

* Peer support and representing British Pakistani psychiatrists;
* Influencing UK health policy and process so British- Pakistani psychiatrists are not excluded, becoming a pressure group;
* Uniting in action, with other associations so we are not split and lose out, as had happened historically.

Other purposes are to work closely with the royal college and other bodies like GMC and PMETB, the NHS and department of Health; work closely with the Pakistan High Commission, to make matters easier for its members in particular and all others in general.

It has proposed various ideas to the government of Pakistan, the health planners in Pakistan, to show another side of the picture, with an international view in mind. It is in communication with Pakistani medical institutions to develop international faculty.

It is a new association, but has come far in this short time. It has pioneered many constructive initiatives, nationally and internationally. It is proud of its tradition of proactive engagement with the wider society and to make our living experience better, in the country of our choice, our adopted country: Britain, while trying to improve life in Pakistan.