Leading article: A closure that will test the commitment to NHS reform

Share
Related Topics

The hospital is the modern cathedral, a place of sanctuary and succour and an object of intense interest to the surrounding community. Any government questioning the life of a local hospital does so at its peril, and for the Tories, who have a fraught history with the NHS, hospital closures potentially are an even more toxic issue. Which is why the news we report today of the threat to one of London's oldest and most prestigious hospitals, St Mary's in Paddington, is bound to test Coalition nerves to the limit. Founded in 1845, it was where Alexander Fleming discovered penicillin. The strength of the outcry can be imagined if plans to sell off the site for conversion into 3,000 luxury flats get a go-ahead.

The background to the crisis behind St Mary's is a microcosm of the dilemmas facing the NHS as a whole as the Health Secretary, Andrew Lansley, struggles to reconcile the need for financial retrenchment with the demand for modernisation. The debts of the Imperial College Healthcare Trust, which runs five hospitals in London, have spiralled, now total £100m, and, as St Mary's stands on a prime site, the trust could save millions by selling the land and focusing activities on Hammersmith Hospital, which occupies a far less sought-after site in west London, near Wormwood Scrubs prison.

There is no easy answer to the question mark hanging over this and other, less well known hospitals. As Richard Taylor discovered in 2001, when he won the seat for Kidderminster in the general election on the single issue of keeping open his local hospital, this is a cause that can mobilise communities. That result was a warning to every MP: never underestimate the passions that hospitals can arouse. No wonder that MPs of all parties have been assiduous since then in pledging to fight to keep their constituency hospitals, or that Mr Lansley announced a moratorium on hospital closures last year.

The threat to St Mary's is a reminder that the issue of closures hasn't gone away, and that strong pressures tend in the opposite direction, not all of which are financial. Medically, there is an argument for concentrating the provision of services in centres of excellence, which means that some hospitals must go in order for others to attain the highest standards. The argument is stronger still in London, which is better endowed with hospitals than other parts of the country.

The Tomlinson report recommended closure of four in London back in 1992. Only one, the Middlesex, has closed since, principally because shutting a hospital in the capital, under Parliament's nose, is even more politically risky than trying to close one in somewhere like Kidderminster. In practice, in the absence of hospital closures, practices are changing on the ground. Emergency services are increasingly geared towards taking people past their local A&E to the nearest centre of excellence, on the grounds that the sacrifice involved in subjecting patients to longer journeying times to hospitals is more compensated for by the provision of bettercare.

St Mary's august history and high profile may gain it a reprieve from closure, but this won't substantially change the contours of the debate over the future of hospitals in the rest of the country.

React Now

Latest stories from i100
iJobs Job Widget
iJobs General

Recruitment Genius: Online Media Sales Trainee

£15000 - £30000 per annum: Recruitment Genius: Now our rapidly expanding and A...

Recruitment Genius: Public House Manager / Management Couples

£15000 - £20000 per annum: Recruitment Genius: Are you passionate about great ...

Recruitment Genius: Production Planner

£20000 - £30000 per annum: Recruitment Genius: This fast growing reinforcing s...

Recruitment Genius: General Factory Operatives

£18000 - £35000 per annum: Recruitment Genius: This fast growing reinforcing s...

Day In a Page

Read Next
 

If I were Prime Minister: Every privatised corner of the NHS would be taken back into public ownership

Philip Pullman
 

Errors & Omissions: Magna Carta, sexing bishops and ministerial aides

John Rentoul
As in 1942, Germany must show restraint over Greece

As in 1942, Germany must show restraint over Greece

Mussolini tried to warn his ally of the danger of bringing the country to its knees. So should we, says Patrick Cockburn
Britain's widening poverty gap should be causing outrage at the start of the election campaign

The short stroll that should be our walk of shame

Courting the global elite has failed to benefit Britain, as the vast disparity in wealth on display in the capital shows
Homeless Veterans appeal: The rise of the working poor: when having a job cannot prevent poverty

Homeless Veterans appeal

The rise of the working poor: when having a job cannot prevent poverty
Prince Charles the saviour of the nation? A new book highlights concerns about how political he will be when he eventually becomes king

Prince Charles the saviour of the nation?

A new book highlights concerns about how political he will be when he eventually becomes king
How books can defeat Isis: Patrick Cockburn was able to update his agenda-setting 'The Rise of Islamic State' while under attack in Baghdad

How books can defeat Isis

Patrick Cockburn was able to update his agenda-setting 'The Rise of Islamic State' while under attack in Baghdad
Judith Hackitt: The myths of elf 'n' safety

Judith Hackitt: The myths of elf 'n' safety

She may be in charge of minimising our risks of injury, but the chair of the Health and Safety Executive still wants children to be able to hurt themselves
The open loathing between Barack Obama and Benjamin Netanyahu just got worse

The open loathing between Obama and Netanyahu just got worse

The Israeli PM's relationship with the Obama has always been chilly, but going over the President's head on Iran will do him no favours, says Rupert Cornwell
French chefs get 'le huff' as nation slips down global cuisine rankings

French chefs get 'le huff' as nation slips down global cuisine rankings

Fury at British best restaurants survey sees French magazine produce a rival list
Star choreographer Matthew Bourne gives young carers a chance to perform at Sadler's Wells

Young carers to make dance debut

What happened when superstar choreographer Matthew Bourne encouraged 27 teenage carers to think about themselves for once?
Design Council's 70th anniversary: Four of the most intriguing prototypes from Ones to Watch

Design Council's 70th anniversary

Four of the most intriguing prototypes from Ones to Watch
Dame Harriet Walter: The actress on learning what it is to age, plastic surgery, and her unease at being honoured by the establishment

Dame Harriet Walter interview

The actress on learning what it is to age, plastic surgery, and her unease at being honoured by the establishment
Art should not be a slave to the ideas driving it

Art should not be a slave to the ideas driving it

Critics of Tom Stoppard's new play seem to agree that cerebral can never trump character, says DJ Taylor
Bill Granger recipes: Our chef's winter salads will make you feel energised through February

Bill Granger's winter salads

Salads aren't just a bit on the side, says our chef - their crunch, colour and natural goodness are perfect for a midwinter pick-me-up
England vs Wales: Cool head George Ford ready to put out dragon fire

George Ford: Cool head ready to put out dragon fire

No 10’s calmness under pressure will be key for England in Cardiff
Michael Calvin: Time for Old Firm to put aside bigotry and forge new links

Michael Calvin's Last Word

Time for Old Firm to put aside bigotry and forge new links