The Netherlands is strongly leaning towards treating cancer patients at a limited number of hospitals. This approach has been poorly investigated and there is little evidence that the quality of care and the outcome of treatment in the Dutch system are related to the size of the institute. Oncological care is getting more and more complicated and requires a certain scale, but the formation of networks offers more possibilities than centralisation. Technical developments may offer alternatives to centralisation. In addition, care given closer to home to an increasingly older patient population is very valuable. Comorbidity is another reason to provide care at a general hospital in close cooperation with general practitioners. Strong ties with a university clinic is an important requirement for such a network to work well.