NHS England chief executive Simon Stevens told the Telegraph:
A number of other countries have found it possible to run viable local hospitals serving smaller communities than sometimes we think are sustainable in the NHS.
Most of western Europe has hospitals which are able to serve their local communities, without everything having to be centralised.
He warned the complex care systems outside of hospitals must change and investment is needed in community services for the elderly to stop spiralling numbers ending up in hospital.
You cannot have a modern health service that is not treating older patients with dignity and compassion, supporting them at home and ensuring targeted prevention [of ill health].
There is a big opportunity to reorganise that so it meets the needs of those at home. At the moment it is too complicated and too fragmented.
If you were starting from scratch you would not design community services like that.
More top news
Here's my best go at explaining how George Osborne magicked away his tax credits headache.
A baby boy was found abandoned in a church's nativity manger with his umbilical cord still attached.
At least 30 people, mainly patients, were killed when US forces began firing at the facility "mistakenly" thinking it was a Taliban base.