The government is facing growing demands for the publication of its much-vaunted national beds inquiry, billed as a flagship review to determine the 'future number, mix and use of NHS beds' at last year's Labour Party conference.
An 'ideal model' for the future of acute services was presented by doctors this week in a draft report from the Joint Consultants Committee of the British Medical Association. It suggests hospitals serving populations of about 500,000 people would be 'ideal' in terms of training specialists, providing round-the-clock cover and specialist care for emergencies.
But the Department of Health admitted that its own inquiry, due out this spring, may not emerge until the end of the year.
Questions are being asked about the value of what has turned out to be an internal inquiry, headed by DoH chief economist Clive Smee.
Dr Steve Swindells, executive committee member of the Hospital Consultants and Specialists Association, said he had 'personal' suspicions about the DoH's failure to involve experts from the field. 'An internal inquiry is likely to find the conclusions it wants,' he said.
Health secretary Frank Dobson told the House of Commons in January that work by the Audit Commission and the Intensive Care Society would feed into providing 'a sound basis on which to plan for better services'.
But sources said the Audit Commission report does not include bed numbers. And the Intensive Care Society said its part in the study was limited to encouraging members to provide information requested.
The JCC draft report, which builds on a 1998 report from the royal medical colleges, and uses 1996-97 figures, says more than half of England's 198,958 beds are for acute care.
Despite its support for the concept of 'superhospitals', it concedes that district general hospitals serving populations of 200,000-300,000 will continue to be the 'backbone of NHS acute hospital provision for the forseeable future'.
NHS Confederation policy director Nigel Edwards accused doctors of 'concentrating on training standards' at the expense of 'other criteria which define what a hospital is for - such as treating patients'.
Of the colleges, pressure for centralisation is believed to have come largely from the Royal College of Paediatrics and Child Health and the Royal College of Obstetricians and Gynaecologists.
A DoH spokesperson said Mr Dobson had not yet seen the report.