The way in which doctors practise medically undoubtedly has effects on the ways in which other staff, the nurse, occupational therapist, physiotherapist etc. are able to practise, just as their style affects the doctor. But all share the common aim of providing the best possible care for their patients. Changing service provisions have affected mental handicap services more than most. It is crucial at a time of great change within health service systems that good medical practices evolved over many years experience are not lost or neglected by changing philosophies or care models. Medical aspects of care of the mentally handicapped person which evolved in hospitals should be flexible enough to be used in the settings used by any district. Medical standards of care must be maintained and improved despite changes to the service.