Between 1877 and 1903 something extraordinary in the history of health services happened in a small north Kent town. The number of hospital beds in Dartford increased a staggering 60-fold to reach almost 10,000, this in a local population of just over 20,000. The earlier history of the town offers no clues as to why this happened. Tracing the developments of the 11 hospitals over the 26-year period reveals the role of three powerful bodies establishing facilities to meet the needs of Londoners: the City of London Corporation, the Metropolitan Asylums Board and London County Council. It is also apparent that there was no careful strategic plan but a series of opportunistic and pragmatic decisions, facilitated by the lack of any effective local opposition as occurred within London. The staggering increase in hospital beds in Dartford in the late 19th century is just an exceptional example of the way health services so often develop.