Hospital closures

BMJ 1994; 309 doi: (Published 15 October 1994) Cite this as: BMJ 1994;309:973
  1. H Karcher,
  2. D Spurgeon,
  3. C Essex,
  4. F B Charatan,
  5. B Christie,
  6. M Dolley,
  7. A Murdoch,
  8. G Nandan,
  9. A Dorozynski

    Throughout the developed world, numbers of hospital beds are declining. Some of this decline is occurring naturally, but in many places the pace is being forced by governments anxious to contain costs. The problems of hospitals being too small, in the wrong place, and with fragmented services have long troubled older cities like London: and the solutions (closures, mergers, and improved community and primary care services) often cause controversy and public protests. In this round up our correspondents outline the pressures and solutions in their own countries. Often the arguments revolve around whether reduction in beds means reduction in services; many doctors in Britain fear that hospitals will not be able to cope with fewer beds, whereas the Canadians maintain that all the necessary services can still be provided even if the beds aren't there. In contrast to the Western world, in India the problem is one of too few beds rather than too many. But even there, the cities are subject to the familiar complaint of taking more than their fair share of medical resources.

    Germany: Patients stay in hospital for shorter periods

    In Germany the overall number of hospital beds has decreased from over 700 000 to about 650 000 over the past 20 years. This has been due mainly to patients staying in hospital for shorter periods. In addition, hospitals in the former German Democratic Republic had an overcapacity of about a quarter in the number of hospital beds, which was cut in recent years to meet standards in western Germany.

    The German Hospital Association estimates that the number of hospital beds will diminish by 4000 to 6000 a year in the near future with the advent of a community care scheme for elderly people, which would remove from hospitals those patients who do not really need hospital care but have nowhere else where they …

    View Full Text

    Log in

    Log in through your institution


    * For online subscription