BACKGROUND. Reports in the national press suggest that general practitioners in London are experiencing difficulties in securing hospital admission for their acutely ill patients. AIM. A study was undertaken to investigate the problems encountered by general practitioners in one family health services authority in south east London in arranging acute admissions to hospital. METHOD. A self-report questionnaire was completed by a sample of general practitioners every time an acute hospital admission was attempted. RESULTS. A total of 493 questionnaires were completed by 111 general practitioners over the 47-day study period. Problems during the hospital admission procedure were experienced in 171 (35%) of the cases reported, with 115 of the 537 telephone calls to a hospital (21%) resulting in a refusal to admit the patient to that particular hospital. The main problem reported was that of 'no beds available', an obstacle to admission that was more likely to be encountered if the patient was aged 75 years or over than if the patient was younger. CONCLUSION. In the light of the problems reported, possible changes to the current method of arranging acute admissions to hospital in London are discussed.