In view of mounting concern about the level of preservation of medical records, the King's Fund Centre agreed to provide facilities for a one day conference. The morning session was devoted to papers outlining the major aspects of the problems of preservation of medical records. The afternoon session discussed four topics in syndicate groups: the legal and administrative framework; the preservation and care of medical records pre-1834; hospital records post-1834; local authority health records. It was felt that the meeting had demonstrated that the threat to medical records was, if anything, more serious than had previously been assumed. Destruction was not confined to modern records, but those dated pre-1858, often of historical importance, were not secure. There was continuing erosion of records which in theory were protected under present legislation. Material had been lost following health service and local government reorganisations. The conference considered it essential that interest groups, acting in partnership at a local level should ensure that records were preserved, and should introduce schemes for their retrieval, safe deposit, accessibility to scholars and medical workers.