How Bart's was unsaved: Judy Jones reports on the false hopes leading to its loss of independence

THE 'REPRIEVE' granted to St Bartholomew's Hospital, in the City of London, last Tuesday was not what its staff and supporters had in mind. What emerged was not so much an official pardon, nor even parole; it looked much more like the promise of only a few extra months for the prisoner to put his affairs in order before something painful happened.

Closure of the hospital, founded in 1123, was urged in the report of Sir Bernard Tomlinson last October, as part of a programme to concentrate the capital's acute hospital services on fewer sites.

Virginia Bottomley, the Secretary of State for Health, had made little secret, among colleagues, of her desire to implement it.

So the hospital was to be closed, then it was to be saved and finally came the 'reprieve'.

The seeds of the confusion were sown last month after a senior official at the Corporation of London, the authority that represents City interests, phoned John Major's office.

The Corporation had earlier written to Mrs Bottomley, asking her to receive a deputation headed by the Lord Mayor. It wanted to impress upon her its view that Bart's should be retained for the good of residents and commuters and to maintain the City's attractiveness to overseas investors.

The Corporation had become anxious at the absence of a swift or positive response. One source said: 'Basically we asked Downing Street for assistance'.

A few days later, Mrs Bottomley was summoned to Downing Street. Mr Major pressed her to proceed cautiously with the closure programe.

The first sprinkling of newspaper reports suggesting that she was preparing to compromise over planned closures of London hospitals came on 17 January.

'Bottomley backs off from axing Bart's' (Sunday Telegraph) was the most bullish of the crop, saying that Bart's 'is to be saved' after a 'last-minute retreat'.

The Government's response to the Tomlinson blueprint for London was pencilled in for discussion at the Cabinet meeting of

4 February, but it was put off for a week. It went for approval to the full Cabinet on 11 February. That day, the London Evening Standard, which had campaigned to save Bart's, led its front page with 'Bart's set to be saved today'.

Hours after the Cabinet meeting, ITN was leading its early evening news bulletin with a 'Bart's reprieved' story.

The Department of Health was deluged with telephone calls from journalists all afternoon trying to find out the what exactly had been agreed.

One source said: 'What we were trying to get over was that something or other of Bart's would probably survive on the site. I told people 'Yes, it is likely there will continue to be something there, a much-truncated hospital would survive'.'

Friday's newspapers carried broadly similar stories of a reprieve. Professor Michael Besser, Bart's chief executive, was himself convinced that the Government had finally stepped back from the brink of closure, and that a smaller, specialist hospital would survive.

To him, the only substantial remaining area of doubt appeared to concern the future of the accident and emergency department - as was reported two days later in the Independent on Sunday.

In the event, the Government decided that two other options for Bart's - in addition to the closure proposal - should be included in its formal response. These were merger with the Royal London, or continuing independence as a much smaller, specialist hospital.

The day after the Government announcement, Bart's acknowledged that the third option was hopelessly unrealistic, and decided its only chance was to merge with the Royal London. Negotiations begin on Tuesday.

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