The APIT (1) report and that of the DHSS-sponsored conference (2) on the provision of a district psychiatric service are both concerned with a hospital-based psychiatric sickness service. Nowhere can one find any clear statement on the possibility or even desirability of a comprehensive community care service. We could define such a service as providing individualized, comprehensive, continuous, efficient, effective and flexible care, including the identification and treatment of psychiatric disorder, the avoidance or reduction of secondary and tertiary disability with integration or reintegration of the individual into the community, and the provision of appropriate support to his family during this process. There are some who would argue that even this as yet unattained goal is insufficient, and community care must also embrace primary prevention programmes and the alleviation of distress or disability not due to illness.