A £1bn (€1.5bn; $1.7bn) deal to redevelop two of London’s landmark hospitals, St Bartholomew’s and the Royal London, has been approved by health secretary Patricia Hewitt.
The decision comes more than two months after Ms Hewitt threw into doubt the future of the hospitals, which together make up the Royal Hospitals NHS Trust, by announcing plans to review the redevelopment plan just after the trust had reached an agreement with contractors (BMJ 2006;332:196, 28 Jan).
The new buildings will be run in partnership with construction firm Skanska Innisfree, the makers of Swiss Re’s “gherkin.” The new accommodation will provide 1248 beds across two sites, together with modern cancer and cardiac facilities. This is the largest such private finance initiative scheme in Britain.
But news that 250 beds—representing two floors at the new Royal London building and one at Barts—will be left empty until the hospital trust can prove to the government that there is sufficient demand, has angered some critics. Shadow health secretary Andrew Lansley said, “It amounts to taking a fifth of the project away for less than a tenth of the cost. The Department of Health has arbitrarily cut 250 beds to satisfy some affordability criteria of its own devising.”
Wendy Mead, from the Save Barts Campaign, added, “It all looks a bit like a face saving exercise from the Department of Health, who were hoping to close Bart’s, and they have not managed to do it.” Critics have estimated that the delays have so far cost about £35m.
Consultant cardiothoracic surgeon Rakesh Uppal, one of the trust’s 8000 staff, described the mood at the Whitechapel site as generally upbeat. “The last few months have been difficult for all of us and I think the important thing is that we’ve got a decision,” he said. “It has been difficult to attract staff with the future of the hospital hanging in the balance. It just shows what can be done when management and clinicians stand shoulder to shoulder to take action.”
In January, more than 1000 doctors from both hospitals wrote to the Times to protest against plans to scrap the revamp. “These hospitals serve Britain’s most ethnically diverse population. [Their loss] would be damaging to the health of this vulnerable population,” it argued.
The recent protests came after years of uncertainty over the future of Barts and the Royal London. Barts last faced closure in 1992, when an inquiry headed by Bernard Tomlinson recommended that it be scrapped. It was merged with the Royal London and the London Chest hospitals to form the Royal Hospitals NHS Trust in 1994.
Paul White, the chief executive of Barts and the London NHS Trust, said, “The future of our world renowned hospitals is now assured. The people of east London and our 8000 staff can now look forward to the world class new hospitals they deserve.”
“The new deal saves the NHS £650m over the life of the contract, more than enough to build another major new hospital,” Ms Hewitt said.
The project is predicted to be complete by 2015. Construction firm Skanska Innisfree will manage the buildings and services such as catering and cleaning for 35 years. There are 49 private finance initiative hospitals currently open or under construction in England.