Leaked minutes of a dinner at the Royal Society of Medicine have revealed that senior doctors accept two out of six leading London hospitals in the North London Central district will have to close or merge.

The doctors also accepted that they would have to undertake a damage limitation exercise.

Brian Sedgemore, Labour MP for Hackney South and Shoreditch, said the new plans, spread over three to five years, involve: a new 400-bed hospital for University College; the closure of two hospitals; directing purchasers to specific hospitals; the creation of a super trust to cover the area; getting medical appointments in the purchasing authorities to enable the trust to take control of the purchasers.

'Although the minutes of the dinner contain no names, it is thought that the Whittingdon Hospital and Royal Free Hospital could be at risk.

The document, a copy of which has been obtained by the Independent, records the conversation by the clinical and academic staff from University College Hospital (UCH), the Whittington, Royal Free, Great Ormond Street, the National Hospital for Nervous Diseases and the Royal National Ear Nose and Throat hospitals. Those present included deans of the medical schools, medical directors of the trusts in the area and members of the London Implementation Group, which is looking into the future of London's health services.

The London Implementation Group, which is responsible for examining the rationalisation of London hospitals as recommended in the Tomlinson report, is now working in consultation with senior hospital staff to bring in the changes.

To opponents of the Tomlinson recommendations - they include many hospital staff and much of the Labour Party, who feel that essential services are being put at risk - the talk at the dinner smacks of betrayal.

'Those not at the dinner have expressed astonishment after receiving the minutes that major changes in London's health service could be made in this way, said Mr Sedgemore.

''The staff who took part should be ashamed - they should be fighting back.

University College Hospitals, the newly created trust covering UCH and the Middlesex, already plans to merge all its services on the one UCH site eventually in order to cut down overheads.

But Dr Anthony Goldstone, medical director of that trust, admitted there would have to be an even bigger shake up in the longer term among the six hospitals represented at the meeting, with two of the sites facing possible closure.

The leaked minutes of the meeting make it clear the decision will not be an easy one.

'Courage would be needed when suggesting departments come together as undoubtedly there would be some 'fall out', which some will describe as damage and others try to depict as destruction.

Dr Goldstone denies any particular hospital was earmarked at the meeting, though 'there was no specific discussion in relation to any hospital site during that conversation'.

Clinicians and academics at the dinner saw UCH as the North London Central district's shared academic focus and attached great importance to the presence of a 400-bed hospital immediately adjacent to the college site.

The minutes said they would be reporting their findings to Virginia Bottomley, the Secretary of State for Health, after consulting colleagues.

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