When the medical authorities in Indiana issued police officers with automatic external defribrillators, they hoped survival would improve for people having cardiac arrests out of hospital. It didn't. A before and after study showed that if the police arrived before the paramedics, they carried out defibrillations flawlessly. Unfortunately they arrived first in only 6.7% of cases (Academic Emergency Medicine 2001;8:324-30). The rest of the time, the police were too busy or too far away to make it in time.

During dangerous floods in early 1997, the residents of Yuba County, California, were advised to evacuate their homes for higher ground. Four fifths of them left, but the remaining fifth stayed behind—often because they didn't want to abandon their pets (American Journal of Epidemiology 2001;153:659-65). A survey six months later found a dose-response relation between the number of pets in a household and the likelihood of their owners refusing to leave.

Earlier this month Alan Milburn, the UK's minister for health, endorsed a report by the NHS Confederation calling for a major restructuring of the health service and an end to hospital outpatient clinics (Health Services Journal 5 April). The plan to site specialist services in the community came about after suggestions that …