Decisions on closures of hospitals to be postponed

MINISTERS are to postpone decisions on which London hospitals should close until early in the New Year, it emerged yesterday, the day before the Tomlinson report on the future of the capital's health care was expected to land on their desks.

The report, which is understood to recommend closure of St Bartholomew's, either St Thomas's or Guy's, and widespread rationalisations and closures elsewhere, is intended to be published before the end of the month, and possibly next week.

But Virginia Bottomley, Secretary of State for Health, plans no announcements on decisions, leaving the report for consultation until the end of the year. Decisions on hospital closures are not expected until about January .

Even then, another period of consultation on each proposed closure is required by law before firm decisions can be taken.

With many London hospitals and the British Medical Association having accepted the need for change, and with some London hospitals and health authorities already proposing defensive rationalisations, ministers hope the delay will help to promote acceptance of deeply unpopular decisions affecting some of London's most famous medical names.

Brian Mawhinney, Minister for Health, said yesterday that a further 121 hospitals and units had expressed interest in becoming National Health Service trusts in 1994.

If all were to apply and be approved, 95 per cent of core hospital and community services will have become self-governing by that date, he said.

He maintained that the new applications were 'clearly based on the benefits (trust status) can bring to patients and NHS staff'.

Trusts, he argued, were 'an obvious return to first principles - decisions based on local needs, made by local managers with the full involvement of senior professional staff'. He said it was nonsense to believe that the competition they introduced meant the first priority of every manager was 'to engineer the downfall of all other hospitals'.