Hospital closures could be shelved

FEARS are growing among National Health Service managers that the Government may shelve crucial decisions to close or merge several London teaching hospitals after the independent inquiry into the capital's health services reports to ministers next week.

The Department of Health did not deny suggestions yesterday that it could be many months before ministers decide how they respond to Sir Bernard Tomlinson's report.

He is expected to recommend the phased closure or merger of at least three teaching hospitals to counter what the Government considers to be over-capacity of London's acute hospital beds in the internal NHS market.

However, some senior managers believe it will be well into next year before ministers are ready to 'bite the bullet' and name the hospitals that will shut. 'Such is the political and economic turmoil in Government now, it is doubtful whether ministers have the bottle to risk any further unpopularity in the near future,' one said.

Sir Bernard is likely to press the Government to plough the savings made from contracting the hospital sector into improving London's GP and community health services. Virginia Bottomley, Secretary of State for Health, will be anxious to protect the likely savings yield from the Treasury's public spending axe for reinvestment in primary health care.

A spokesman for the Department of Health said ministers would need time to consult on Sir Bernard's recommendations, and meet hospital managers before coming to final decisions. 'We are looking at some time in the New Year for a detailed reponse from the Government to Sir Bernard's report,' he said.

David Blunkett, Labour's health spokesman, said the Government had got itself into a 'terrible tangle' over the future of London's health care.

'Without the promise of necessary resources, there is a real danger of a period of chaos engulfing the capital's health care,' he said.

'We not only need decisions from the Secretary of State, but to know she is battling for additional resources to facilitate the changes needed.'

Earlier, the manager of one of London's threatened teaching hospitals announced his intention to resign. Dr Ken Grant, chief executive of St Bartholomew's Hospital, in the heart of the City, would not comment on his decision yesterday, although he has been an outspoken critic of the progress of the Tomlinson inquiry, and the reliability of the statistics being submitted to it.

In an interview with the the Independent on 10 August, Mr Grant said the changes flowing from the Government's new managed market in NHS care had failed to live up to ministers' promises that money would follow patients. 'We are getting the patients, but they are not bringing the money with them,' he said.

It also emerged yesterday that another of the threatened hospitals, St Thomas', had allocated pounds 160,000 to 'improve the image' of the hospital in the run-up to the Tomlinson report. An internal document leaked to the BBC showed it had engaged the services of Sir Tim Bell, former public relations adviser to the Conservative party, and Ernst and Young management consultants to help fend off moves to close the hospital.

Tim Matthews, chief exeutive of St Thomas' said the money had come from the hospital's independent trustees, not patient care budgets, to ensure that decision about its future were based on 'proper information'.