Bookmarkers beware: Bookmarks to pages other than the home page may not work after we change our server in April Editor's Choice | This Week in BMJ | Press releases BMJ No 7130 Volume 316 News Saturday 14 February 1998 St Bartholomew's saved in London plan Britain's oldest hospital, St Bartholomew's in London, has been saved from closure by a Labour government, which has endorsed the latest review of health services in London and reversed the conclusions of the previous Conservative administration after the 1992 Tomlinson review. St Bartholomew's is to become a specialist unit for cardiac and oncology services, and its planned replacement, a new Royal London Hospital at Whitechapel, will be scaled down from 1,200 to 900 beds. The survival of Bart's is a rare example of government sentiment prevailing over savings after a period of Cabinet infighting. The symbolism and tradition of Bart's helped win its reprieve Photo: MARTIN ARGLES/GUARDIAN The Treasury opposed the reprieve on cost grounds but was overruled by the personal intervention of the prime minister, Tony Blair, who is on record as saying that services at the hospital should be "preserved for ever." He backed the health secretary, Frank Dobson - an inner London MP, - who had declared when he was appointed last May that he did not want a plaque on the wall of St Bartholomew's stating: "Founded by Rahere 1123, closed by Frank Dobson 1997." He initiated a review - there have been well over 20 in London's health care this century - under Professor Sir Leslie Turnberg, past president of the Royal College of Physicians, which duly recommended retaining St Bartholomew's. In accepting the report, Mr Dobson admitted to the House of Commons that the symbolism, history, and tradition of St Bartholomew's had influenced his decision. But although the immediate crisis has passed, doubts remain whether the hospital will reach its 10th century. The Turnberg report states that preserving it is the more expensive option, and will need to be kept under review. Critics say the reprieve will be at the expense of primary health, mental health, and community services, although Mr Dobson announced an extra £140m for this purpose. The 80 page Turnberg report describes health services in London as woeful and makes numerous recommendations for improvement, including an increase in the number of GPs. The key departure of the Turnberg review from the earlier Tomlinson report is to dispute that London has too many acute hospital beds, which was one reason for planning to close St Bartholomew's. The Turnberg report now says that London probably has fewer beds than the average, and further bed closures should not be planned. The switch of services from Guy's Hospital to St Thomas's Hospital will proceed, though on a more limited scale than was planned. New hospitals in the pipeline for Greenwich, Euston, and Oldchurch are approved, but Queen Mary's Hospital, Roehampton, will be downgraded to a community hospital. To ensure a London-wide strategy for health, the government accepts that there should be a single NHS regional office for the capital. Ray Pett, chief executive of the Royal Hospitals NHS Trust, which runs four hospitals including St Bartholomew's, welcomed the decision but warned that the long term problems of sustaining services both clinically and financially needed to be addressed. Jack Warden London Home | Current issue | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline