Cuts to the number of NHS hospital beds should be seen as evidence of a more efficient health service, not one that is struggling to cope, hospital managers insist today.
A new report from the NHS Confederation says that although the number of hospital beds has fallen by 31 per cent in the last 20 years, the health service is actually doing more than ever before.
It says the reduction in hospital beds from 211,617 in 1984 to 145,218 in 2004 has been caused by moving more and more services into the community, specialist hospitals and people's homes - something that most patients prefer.
In 2004, more than 90 per cent of NHS patients rated their care as excellent, very good, or good - and the NHS Confederation says this must be taken into account when discussing the state of the health service.
"We need to move away from this fixation with bricks and mortar. The world is changing, patients' needs are changing and the NHS is adapting to meet those needs," said chief executive Gill Morgan.
"It's not surprising that people believe that more beds mean better patient care - this has been the assumption for many years.
"We must start judging the NHS by the number of people we make better and keep well, not by the amount of beds which are, after all, only hospital furniture."
The report cites the fact that treatments such as intravenous antibiotics and chemotherapy can be administered in people's homes as one reason why less hospital beds are needed, and most patients prefer this kind of service.
The increasing use of keyhole surgery also means patients can spend less time in hospital recovering from their operation, it says, while the improved management of chronic diseases such as asthma and diabetes means less people are being admitted to A&E.
"Developments in technology and changes in the way treatment is delivered mean we simply need fewer beds," Dr Morgan said, and called for an "informed debate" about whether NHS investment should go into beds or improved services.
The report is likely to be welcomed by the Department of Health, which has been fighting off claims that despite a doubling of investment into the health services, its reforms have failed to bring any major improvements in the NHS.
However, public sector union Unison warned the study was too narrowly focused, saying that many of the bed closures in the 1980s were due to the closing of mental health services and disability learning services.
"A lot of patients were kicked out of institutions and ended up in bed and breakfast or homeless," said head of health Karen Jennings.
"We are left with a situation where we have 150 per cent bed occupancy rates in mental health care - this is hidden in the debate that is being raised."