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For this purpose the optimum number of beds seems to lie between 250 and 500.' Above this figure the human and personal aspects of patient care become progressively harder to maintain, and the loss of human values has to be weighed against the economic and technical advantages if any larger size is proposed. The figure which the Ministry put forward for the district general hospital was 600 to 800; but in the 1964 edition of the ten-year plan2 there were at least ten general hospitals of over 1,000 beds envisaged. Professor McKeown has already put forward proposals for a teaching hospital complex of 2,120 beds at Birmingham.3 Let us regard this as an experiment, and at least wait until we have assured ourselves that so large an institution can be staffed,4 and can really cure more illness than it creates.-I am, etc., Birmingham.