In what's likely to prompt a very hot debate, Dr Gill Morgan, head of Britain's NHS managers, has said that the health service could actually do with fewer hospital beds, not more, writes Jo Revill, health editor.
Even though the NHS has lost many thousands of beds from its hospitals over the past two decades, she points out that the number of patients being treated has risen much more, and that most of the patient surveys suggest that there are high levels of satisfaction with the service.
Why would she want to see fewer beds? Because she believes that hospitals need to redesign their services, to keep fewer people in for long stays, to do more day case surgery, and to push forward the initiatives to treat many chronically ill patients nearer to home - or actually in the home itself.
Her vision for the future is one where an army of community nurses, supported by specialist doctors, GPs and therapists can provide care far more in the community, so that you only go into hospital when you are very seriously ill.
This is what many people would like to see, but the question, of course, is how you get there. Morgan, who trained as a doctor before moving over into management, admits that they are in a Catch-22 situation, where no one can close beds until the alternative services are provided in the community, and nothing can be developed in the community until money is freed up from hospitals.
Closing hospital beds can spell disaster for local politicians, as people equate beds with care. The headlines of local ward closures produce a lot of fear, particularly among elderly people who see a lifeline disappearing.
Many doctors and some economists would argue that good community care is not necessarily cheaper than hospital care - and recent studies which look at specialist GP clinics offering, for example, dermatology services, suggest that it is not much cheaper than the equivalent clinic in a hospital.
There are many elderly patients who have multiple illnesses who simply need to be in a hospital ward because their care is complex, and they need to be seen by several different specialists in order to get their medication right, and to be looked after safely.
But it is also true that many patients with chronic conditions could be far better cared for in a community setting than by being constantly propelled in and out of hospital.
It is very admirable, I think, that Morgan has prompted a debate on this, which is fully outlined in the report the NHS Confederation is publishing on Monday.
What do you think - more beds or fewer?
