Over the past 20 years the Department of Psychological Medicine at King's College Hospital has gradually taken responsibility for the provision of psychiatric services to the East Lambeth sector of the Camberwell Health District. A small District General Hospital (DGH) in-patient unit was opened in 1972, and since then it has been the aim of the Department to provide a comprehensive locally based psychiatric service. Slow progress has been made compared with the developments that have taken place in the South Southwark sector of the District, which have been fostered by the Maudsley Hospital. With the impending closure of Cane Hill Hospital, on which the District has historically relied, the object of a completely local service is rapidly becoming a reality. Releasing the resources hitherto tied to the large institution presents an unparallelled opportunity for change.