London’s health services have been subject to major reviews – around one every decade since 1890. 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. The Tomlinson inquiry report in 1992 and a review by The King's Fund in the same year both, among other things, recommended reductions in hospital beds and by implication reductions in the number of hospitals in London. 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. Similar assessments have been made in other conurbations, and the trend seems to be to indicate a move to fewer hospitals.
But how many hospitals are there? How big are they? Indeed, what actually defines a 'hospital' and do we really know how many are needed?