So long Guy's, last word in health

IN 1861, the trustees of Guy's Hospital purchased one of the alcoves that formed part of the original London Bridge. The graceful stone edifice cost them 10 guineas but was viewed as a fine investment for convalescing patients. They would sit in the alcove - incorporated into the hospital's boundary wall - protected from the weather but exposed to the bustle of life which, it was reasoned, would speed recovery.

More than 120 years later similar concerns motivated the trustees approving plans for a new development at Guy's. A state-of-the-art hospital building was needed, but one that would provide an environment conducive to health.

Philip Harris House, at a cost of pounds 140m, was the result and is due to open in September. Work is still going on at the seven-storey building, which has airy walkways and plant- filled atria. It is the most advanced NHS development in Britain - but in the end may shelter fewer patients than the mossy alcove nearby.

For Guy's staff, patients and supporters, the unthinkable has happened. Their hospital, which until a year ago was the 'flagship trust' of the Government's NHS reforms, is to be run down, leaving a medical school, day surgery, research and outpatient facilities on the 273-year- old site. World-famous departments are to be shunted up river to St Thomas's Hospital in Lambeth, Guy's partner in a merged trust and the hospital that has emerged as victor in the bloody re-organisation of the capital's health care.

'It will be like fitting a quart into a pint pot, damned near impossible. Of course we are going to lose the brightest and the best,' said one professor. The five acute wards, a 100- bed mental health unit, numerous outpatient clinics and laboratories planned for Philip Harris House may never be used for the purposes envisaged by the trustees, private donors, medical charities and thousands of individual fund-raisers.

The atmosphere at Guy's Hospital is one of fear and loathing; fear for the future - or lack of it - and loathing of a government that appears to have defied all logic in its decision to dismantle the hospital.

It is, Guy's folk believe, a political decision, influenced by the proximity of St Thomas's to Westminster and Whitehall, by the lobbying of MPs, the Foreign Office and the Metropolitan Police, which they claim have long-standing connections at St Thomas's. Some hint at Freemason involvement: 'It was always said that you couldn't get a consultant's job at St Thomas's unless you were a mason,' said one senior physician. Others point to family links. The father of Virginia Bottomley, the Secretary of State for Health, was chairman of West Lambeth Health Authority. The notices on cheerful blue and yellow stationery put up by the trust board welcoming last week's announcement by Mrs Bottomley were the final straw. On Monday evening medical and dental staff met to form a 'war cabinet' and launch one more 'Save our hospital' campaign in London. 'Pinning that statement up everywhere was an insult, a gratuitous insult to everyone here,' said Dr Chisholm Ogg, the 'Magnus Pyke' of renal medicine, whose frustration and anger manifest themselves in a machine-gun-like delivery and perpetual motion of the limbs. He said he 'smelt a rat' months ago and warned Guy's Kidney Patients' Association to hang on to the pounds 1m it had raised for Philip Harris House.

Alec Schwartz, former chairman of the association, said: 'We'd be so disappointed if we had handed it over. It is staying put until we know what will happen. What I think of the decision is unprintable.' His wife, Betty, was a patient at Guy's from 1977 until she died in 1980, since when he has devoted his time to the hospital. Other donors, such as the Imperial Cancer Research Fund and the Arthritis and Rheumatism Research Council, wait to hear if the facilities their money was provided for will be available at St Thomas's. If not, they want it back.

There are others who have no financial commitment to the hospital but who are equally devastated. John Stride, 67, sits behind a table in the Accident and Emergency Department, on the look-out for anyone who is lost. He travels from Blackheath two days a week to work as a volunteer. 'It stinks,' he said. 'It is a bit old-fashioned and spaced-out but it is a brilliant hospital. They just want to junk it.'

Janet is one of the thousands of middle-class women of a certain age who are 'Friends' - voluntary helpers - at hospitals. She hauls her trolley of snacks and sundries from the radiotherapy department to casualty, around the waiting- room and then up the five-floor tower block. 'I am so angry. It is the wrong decision and Philip Harris House is a terrible waste of public funds. You don't need that calibre of building for a day surgery.'

Dr Bob Knight, a consultant physician at Guy's who is co-

ordinating opposition to the Government's plans, knows they are coming to the fight late, but is hopeful. A judicial review of Mrs Bottomley's decision is on the cards, and the Commons Public Accounts Committee is to consider the use of pounds 100m of public money for Philip Harris House. An independent review of the evidence for the best site for the trust hospital is also under way. 'All we wanted and expected was a fair decision based on the facts. If Thomas's was the better site, then we would accept that. But there was nothing fair about it.

'Virginia Bottomley has said that she wants to have done something for health care that will be remembered in 20 years' time. Well, she is dismantling one of the best hospitals in London. That is something to be remembered for.'

(Photograph omitted)