IN OPPOSITION, David Cameron was adamant: Chase Farm hospital in Enfield, north London should be spared “reconfiguration�—NHS jargon for merging or closing failing or supernumerary hospitals. He pledged a “bare-knuckle fight� to save it and others. Things look different now. Chase Farm is to be absorbed into another big hospital, its accident and emergency (A&E) service reduced and a maternity ward lost. Others face similar measures: not far away in Ilford, for example, the King George hospital will be closed or shrunk.The recent row over the commissioning of hospital care drowned out another big issue in health-care reform: how many hospitals England really needs. Sir David Nicholson, the NHS’s chief executive, has long argued for a big reduction in their numbers, in part because £20 billion needs to be saved in the health budget by 2014.But thrift is not the only argument. The King’s Fund, a health-care think-tank, believes that services ranging from A&E to neonatal and heart specialisms are best concentrated on fewer sites. The British Medical Association, which represents doctors, and the NHS Confederation, representing hospital managers, agree that cities, in particular, have too many hospitals, with London the most over-endowed.That means weaning the public off the idea that most local hospitals should offer most services—and dealing with worries about...