The legacy of the workhouse origin of services for older people in the United Kingdom remains in the memory of patients and practitioners and is still a reality for some. In the area in which we work, geriatric medicine services are still provided in Victorian Poor Law buildings, although, we hope, not for much longer. The disadvantage that this causes to patients in terms of access to modern services and investigations is quite clear and the importance given to the ‘routing of age discrimination’ in the National Service Framework for Older People has in general been welcomed. In a parallel document, the Department of Health has stressed the importance of a robust policy for medicines management based on the twin principles of appropriate prescribing. Firstly, all older people should receive all the medication from which they would benefit. Secondly, steps should be taken to reduce the risk of adverse effects, the frequency of which rise with age. The prescribing principles outlined in these two documents, together with the other National Service Frameworks, form a powerful basis to improve the health of older people.