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All prescriptions for anticonvulsants written over a four month period for patients in the Wellington area were identified. Of 1479 patients receiving anticonvulsants, 139 were suspected of receiving medication for conditions other than epilepsy. The prevalence of treated epilepsy in Wellington is 4.1 per 1000 population. Thirty-eight percent of patients were on multiple anticonvulsants, which compares favourably with reports of excessive polypharmacy in Europe. However, there was excessive reliance on standard anticonvulsant doses, given at frequent intervals regardless of probable rates of metabolism. Failure of compliance, as assessed by the time intervals between collection of drugs, was shown by 21 percent of patients.

Rates of mortality were determined in patients attending an alcoholic assessment centre. The study group comprised 1068 patients, studied for a mean of 1.5 years after referral. A total of 50 deaths occurred, being four times the expected death rate in the general population. Significantly increased mortality rates were found for deaths from cirrhosis, other digestive disease, cardiovascular disease, neoplasms, trauma and alcoholism. In 15 patients death was due to definite alcohol-related causes.

A survey was made of driving habits of 103 epileptic patients who, having suffered a seizure, were picked up by the Wellington Free Ambulance Service. It was found that 21 (20%) subjects were driving a motor vehicle--for nine this was necessary for their employment; 57% of drivers with epilepsy reported that the Ministry of Transport had not been informed of their epilepsy. For three subjects a driving accident was a direct result of their seizure. Forty-three percent of subjects in this study claimed never to have had any professional advice about driving. Of the 21 subjects who continued to drive, 13 were receiving inadequate drug therapy at the time of seizure. Advice and drug therapy for epileptic patients therefore required regular review. We consider that the Ministry of Transport should issue a simple statement about epilepsy and driving which should explain the law, risks, precipitating factors for epilepsy, and the need for good drug control. This should be issued to doctors and also be available for those applying for a driving licence.

A study of the incapacity and socioeconomic scales in 120 patients with multiple sclerosis (MS) living in Wellington, New Zealand, is described. The questionnaire has been compared by different health professionals. There was good correlation between the observations of different professionals on incapacity analysis and this may be improved by reducing the questions to six. The findings on the socioeconomic scale, however, cannot be predicted accurately from the incapacity scale. The socioeconomic survey revealed major improvement in patient support in New Zealand during the last decade. We consider that our New Zealand findings indicate the value of field officers concerned with co-ordination of services and provision of information for patients with MS. Future research should be directed towards assessment of support systems.

The place of team work in health care is emphasised. Reasons for caution among members of the medical profession are defined. The importance of medical students being aware of the input of other health care professionals together with association with them in their training years and integration in activities where possible has been proposed previously, but largely neglected. A number of schemes for improving the education of other professional groups in association with the Wellington Clinical School of Medicine are described. Better teamwork in health care depends upon people learning to work together by association during their training years.