DECLINE OF THE HOSPITAL - RECONSTRUCTING INSTITUTIONAL DANGERS

The number of hospital beds in Britain rose to a peak about 35 years a go but has since rapidly declined. This dramatic change was preceded b y a number of independent technical critiques of two core assumptions of hospital care, that the hospital was a place of safety, and bed res t was in itself therapeutic. The result was the end of the old hospita l and a search for an alternative that stressed restricted bed usage a nd more ambulatory services. These changes may themselves be manifesta tions of an even more fundamental realignment in the relationship betw een health and illness.