Intended for healthcare professionals

Feature Data Briefing

Do we have too many hospitals?

BMJ 2014; 348 doi: (Published 13 February 2014) Cite this as: BMJ 2014;348:g1374
  1. John Appleby, chief economist
  1. 1King’s Fund, London, UK
  1. j.appleby{at}

The NHS is under repeated pressure to close beds and hospitals. John Appleby investigates the true extent of provision and how it compares with that in other countries

London’s health services have been subject to major reviews—around one every decade since 1890.1 Nearly all have suggested that London needed fewer hospital beds and indeed fewer hospitals. A 1980 report reviewing London’s health services suggested the capital should lose the equivalent of a 500 bed acute hospital each year for 10 years to get into line with population needs.2 The Tomlinson inquiry report in 1992 and a King’s Fund review in the same year both, among other things, recommended reductions in hospital beds and by implication reductions in the number of hospitals in London. 3 4 Health Care for London is the most recent review of the capital’s health system, and like its many predecessors recommended fewer hospital beds and fewer hospitals through reorganisation of care into polyclinics and people’s own homes.5 Similar …

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