Letter: Tomlinson's effect on casualties, mental health and community care

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Sir: In Friday's Commons statement, Virginia Bottomley, the Secretary of State for Health, stated that the Government accepted the thrust of the Tomlinson findings, although they were only advisory and would be subject to consultation. However, a grave hidden danger exists within the findings in failing to recognise sufficiently that central London's accident and emergency needs are generally served only by the excellent casualty departments at the remaining teaching hospitals.

Today, major incidents in the capital's heart are served by St Bartholomew's, Guy's, St Thomas' and Westminster hospitals, with Westminster already about to close next spring. History has recently demonstrated that major incidents such as the sinking of the Marchioness, the Clapham Junction rail disaster, the poll tax riot, Cannon Street, and the Victoria station and City bombings, require at least two major receiving hospitals' casualty or trauma departments in the close vicinity if the victims are to be helped properly. London's traffic cannot be ignored when ambulance speed is essential.

Should the Health Secretary, after meaningful consultations, decide that only Guy's or St Thomas' should remain to service London's central casualty needs, future victims will be deprived of essential facilities and no improvement in their treatment will have been secured. In many cases, lives may be imperilled.

Unless adequate and strategically located local or community hospitals are provided with sufficient accident and emergency facilities, manned by fully trained, expert casualty doctors, implementation of the Tomlinson closure proposals would almost certainly be unlawful - and contrary to the Health Secretary's statutory duties and responsibilities.

Yours faithfully,



Westminster Hospitals

Development Fund

London, SW1

26 October