Letter: 'Slow death' of St Bartholomew's: tragic or beneficial?

Sir: I welcome your balanced treatment ('Bart's faces slow death in hospital reforms', 16 December) of Virgina Bottomley's statement on 15 December. I have serious doubts about health service 'reform', with its purchaser-provider marketplace emphasis, if only because I see little evidence for the necessary management competence on the purchaser side of that relationship. However, in the context of London medicine I believe that the reforms advocated by Tomlinson, and taken forward by the London Implementation Group, are necessary and ultimately beneficial.

In particular, I believe that great credit is due to the Secretary of State for making decisions which run counter to orchestrated public relations campaigns but which do take full account of the position of University College London hospitals 'as a world centre of medical teaching and research' - and for that reason 'ensures that UCLH have a secure future'.

Under questioning, Mrs Bottomley said 'a managed market has always been the intention of the National Health Service changes'.

That should be good news for all - not just London.

Yours sincerely,

D. H. ROBERTS

Provost

University College London

London, WC1