There has been considerable concern over disturbances to the public-private equilibrium in local health care provision. We investigated the situation among mental patients. Only 11.5% of new patients presenting to a public general hospital psychiatric unit had consulted a private sector psychiatrist previously. Of these, 60% had moved to the public sector for financial reasons and the same proportion had had their last contact with private care within the previous three months. There were no dominant reasons for choosing the private sector initially. No particular privately practising psychiatrist's patients were more likely to seek public treatment subsequently. The results are analysed and the implications discussed.