St Bartholomew's reprieved in NHS study compromise

THE CABINET endorsed the reprieve of the core of St Bartholomew's hospital yesterday as part of a compromise plan for the reorganisation of London's health care and the closure of some world-famous teaching hospitals.

Following the Prime Minister's intervention, Virginia Bottomley, the Secretary of State for Health, secured the agreement of a Cabinet committee for a revised package to avoid the closures and mergers pitching the Government into a new crisis like the pit closure announcements.

The Cabinet, in effect, rubber-stamped the package yesterday. It will mark a compromise over the Tomlinson report on health care in London, which recommended the closure or merger of 15 of the capital's 40 hospitals.

Sir Bernard Tomlinson found that many of the old and outdated teaching hospitals, although containing centres of excellence, were no longer properly serving patients, who were being treated in hospitals nearer their homes in the Home Counties.

Ministers intend to ease the impact of the closures by announcing a programme to improve family doctor services in the capital to deal with many of the patients who have been resorting to hospitals rather than GPs.

Ministers say they will be able to match the demand by Professor Tomlinson for about pounds 140m to be invested in primary care, but this would be spread over several years. The statement, due next Tuesday, will be followed by long consultations with staff and patients before any changes are made. Labour will oppose the plans, and its spokesmen are ready to support protests by staff in the hospitals.

Mrs Bottomley will require short-term savings and cuts. 'She has got to make savings and she can't wait too long for that to happen,' one ministerial source said.

Bart's attracted attention because of its high-profile international campaign to be saved, which was supported by many celebrities. The Tomlinson report proposed that Bart's should be merged with the Royal London Hospital, but bowing to pressure, most of the care on the site will be retained.

Health ministers have been preparing the ground with local GPs to take the strain over the expected closure of the accident and emergency unit at Bart's.

The closure list is expected to include the Charing Cross Hospital, while the new 600-bed Chelsea Hospital, which is regarded by ministers as a white elephant, is kept open.

The trusts responsible for Guy's and St Thomas's - the hospital which serves the House of Commons - were to be forced to merge on one site. But Mrs Bottomley is expected to announce a further compromise on that.

Some Tory right-wingers have complained that Mrs Bottomley has 'gone soft' on the closure or merger of the 15 hospitals cited in the Tomlinson report.

Mrs Bottomley had been pressed to impose a time-limit of five years for Bart's to prove itself or face closure.

One Tory backbencher said: 'It should show that it can attract patients and if it fails, it should close.'