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A national survey of "psychogeriatricians" showed that of a "core group" of 106, 39 were working full-time with the elderly, 52 more than half-time, and a further 15 were running clearly defined psychogeriatric services. Adding late responders, non-responders about whom firm information was available, and people taking up new posts, it is estimated that at the end of 1980 at least 120 consultant psychiatrists were providing special psychiatric services for the elderly. The "core" psychiatrists were working in 87 "major services," 64 singlehanded and 23 joint. More than half the respondents had started this work only in the past five years. This is thus a very new major development in the NHS and in British psychiatry. Proper training, planning, allocation of resources, and monitoring of performance, all of which are still deficient, might be facilitated by formal definition of a new sub-speciality in psychiatry; at the very least, local and national data should be routinely collected in a way that ensures adequate monitoring.

A study was designed to evaluate provision of services, process of medical care, and outcome in four general-practitioner obstetric units in isolated areas (Berwick, Whitby, Guernsey, and Brecon). All units were equipped to induce labour; to perform instrumental vaginal delivery and selected breech deliveries; and to remove placentas manually. All had some fetal monitoring equipment. Caesarean sections could not be performed at Berwick and Whitby. Proportions of normal deliveries during 1976-7 varied from 75% to 93%. Perinatal mortality was acceptably low, as were transfer rates for neonates and mothers in labour. With specialist help and particular attention to training and broadening local doctors' experience of abnormal obstetrics, such units should be able to provide an excellent obstetric service.