On the other hand, the numbers of rayon and tertiary level facilities have remained stable, while the number of secondary multi-profile centres has slightly increased. By contrast, the sizes of hospitals have not changed substantially, with the average number of beds by type of facility remaining virtually unchanged over the years, implying that the decrease in the number of beds and hospitals has been driven primarily by the closure of facilities rather than the reorganisation of existing ones. The average number of beds in secondary multiprofile and tertiary hospitals (less than 200 beds in both cases) is very low given their role and scope of services, and there would appear to be significant potential to benefit from greater concentration and economies of scale. In recent years a strong policy of investment in the public sector has also contributed to upgrading buildings and equipment in Kazakhstan.