THE TOMLINSON report urges ministers to close St Bartholomew's teaching hospital in West Smithfield, one of the world's oldest and most prestigious, and merge teaching functions and some services with the Royal London hospital, in Whitechapel.
The Homerton hospital, in Hackney, should take most of the Hackney patients that are currently treated at Bart's. A new type of minor casualty centre for the 300,000 commuters into the City of London should open, perhaps on the Smithfield site.
The Middlesex site of the combined University College/Middlesex hospitals should close and its services relocated on the University College Hospital site. Both the London Hospital for Tropical Diseases, in King's Cross, and the Royal National Throat, Nose and Ear, at Gray's Inn Road, would shut under the plan, and move to the redeveloped University College Hospital in central London.
Guy's, next to London Bridge station, and St Thomas's, a mile away opposite the Palace of Westminster on the south bank of the Thames, should merge on one site under a joint management trust board.
St Mark's hospital, in Islington, which specialises in the treatment of bowel diseases, would become part of the Northwick Park district hospital complex in Harrow, Middlesex.
Charing Cross, in Hammersmith, which has the highest level of excess costs, must close. The Royal Brompton hospitals, dealing with heart and lung complaints, and the Royal Marsden cancer hospital should be brought together on the vacated Charing Cross site. If not, the site should be sold. St Mary's, Paddington, needs to reduce the number of its beds, Sir Bernard states, and Queen Charlotte's maternity hospital in Hammersmith should shut and its services moved to the Hammersmith.
Eight of the nine medical schools in London should merge into the four multi-faculty colleges of the University of London. The ninth, St George's, should consider a merger at a later date.
The capital's postgraduate research institutions should consider ways to concentrate the single specialty research institutes on fewer sites.
Sir Bernard estimated that cuts in acute services and rationalisation could yield pounds 54m a year.
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