Leaked report outlines closure threat to hospitals: Loss of speciality services raises doubts over future. Rosie

SEVERAL top London hospitals, including three teaching hospitals, previously thought to have a secure future, face cuts and possibly closure under the Government's review of specialty services.

A leaked report warns ministers of the controversy that will follow the recommendations made in reports by the London Implementation Group (LIG) after conducting six reviews of specialty services. The reviews of cancer, cardiac, neurosciences, renal, plastics and burns and children's services are due to be presented to ministers soon and published this month.

A report on the consequences of the proposed rationalisation has been written by Bob Nicholls, executive director of LIG. It has been leaked to a health pressure group, London Health Emergency. His briefing to ministers gives a breakdown of the consequences of recommended cuts:

Kings College, the Royal Free and St Mary's teaching hospitals 'could see a significant withdrawal of specialist services as a result of the reviews' bringing 'difficulties of maintaining morale and retaining the high quality staff needed for teaching'.

At the Maudsley Hospital, 'if the proposed regional neurosciences centre is relocated to Guy's there will be knock-on effects for the viability of the significant psychiatric services and research also provided by the hospital, and to the proposed trust's viability'.

The Brook Hospital, Greenwich, would lose cardiac and neuroscience services to Guy's.

Oldchurch Hospital, Romford, 'would cease to provide neurosciences and cancer services. This would effectively make the remaining activities available at this hospital non-

viable.' The trust is also seeking to close its casualty unit.

Harefield Hospital, 'where relocation of all cardiac services to Northwick Park and Oxford is recommended in the medium term'.

St Helier Hospital would lose its renal services to St George's. 'This will be fiercely resisted by the trust.'

Queen Mary's Hospital, Roehampton, would lose its regional plastic surgery specialty.

John Lister, information director of London Health Emergency, said: 'There is a danger that when combined with cost pressures on London hospitals and their loss of other contract income as a result of the NHS internal market, the withdrawal of specialist services could easily trigger a serious financial collapse of some key hospitals.'

St Mary's, a trust hospital since April, has lobbied the LIG to keep its speciality cardiac and renal services but it is recommended renal services will be concentrated at the Royal Postgraduate Medical School at Hammersmith.