Blair intervention saves Barts from closure

Yesterday's decision to save St Bartholomew's hospital, Britain's oldest, was hailed as a triumph by some and an act of political cowardice by others. Jeremy Laurance and Anthony Bevins chart the bitter disagreements that lay behind the move.

The decision to save Barts was taken by Tony Blair in the face of opposition from the Treasury and some of his personal advisers, it emerged yesterday.

The Prime Minister, whose three children were born at the hospital, pledged shortly after he took over as Labour leader that the facilities at Barts should be "preserved forever".

Ignoring protests that running two teaching hospitals in one of the most deprived areas of the country would swallow resources needed for GP and community care, he answered an appeal from Frank Dobson, Secretary of State for Health, that in the 50th anniversary year of the NHS a Labour government could not close one of the world's best-known hospitals.

Mr Dobson announced in the Commons yesterday that Barts would continue providing its current range of specialist services for seven to eight years while a new 900-bed hospital is built on the Whitechapel site of the Royal London hospital.

It would then become a specialist centre for heart and cancer patients similar to the Royal Marsden and Royal Brompton hospitals in west London. The decision is in line with recommendations in the review of London's health services, commissioned by the Government last June and published yesterday.

Consultants and patients at Barts were delighted that the five-year campaign to save it had succeeded, but GPs warned that it could spell disaster for the local community.

Mike Besser, professor of medicine at the hospital who spearheaded the campaign in its early stages, celebrated yesterday with Brian Sedgemore, the local MP. "It is a great day. Barts will be here forever," he said.

The hospital, founded in 1123, has survived an attempt by Henry VIII to sell it off, German bombs during the war, and now the 1993 decision of the previous government to axe it following the Tomlinson review of London's health services. The accident and emergency department was closed in 1995.

The Tomlinson review concluded that London had too many hospital beds compared with the rest of the country and recommended 2,500 should close. Because of Barts' location, between Guys to the south, the Royal London to the east and University College to the west, it became the target.

The new review, chaired by Sir Leslie Turnberg, former president of the Royal College of Physicians, has concluded that London is no longer overbedded. Mr Dobson told the Commons: "The Government has therefore abandoned the presumption we inherited from our predecessors that London is overprovided with acute hospital beds. As a result any future changes in bed numbers will be in line with those in the rest of the country."

The saving of Barts is, however, the second-best of two options put forward in the review. The first option, which the review panel describe as "the favoured solution clinically" would involve closing Barts and centralising its facilities in a new 1,200-bed hospital on the Whitechapel site. However, the panel members feared that a new hospital of that size, which would have been the largest to be built in Europe for 20 years, was unrealistic. They feared that, if it were scaled down and Barts was still closed, that would be the "worst possible outcome".

To avoid this they proposed the two-site solution, retaining Barts as a specialist hospital. But they warn: "The key question is how much more expensive would it be to run a two-site versus a one-site operation?"

No figures were forthcoming from ministers, yesterday, but a spokeswoman for the Royal Hospitals Trust, which favoured closing Barts, said it had been estimated at an extra pounds 26m a year.