St Bartholomew's may avoid closure

OPTIMISM was growing last night that St Bartholomew's may emerge completely unscathed from the planned programme of London teaching hospital closures and mergers due to be considered by Cabinet ministers next week.

Professor Michael Besser, chief executive of St Bartholomew's, said months of cost-cutting had enabled the hospital to bring a projected deficit of pounds 12m at the start of the year down to pounds 167,000. The hospital's budget was on target to be in balance by April.

The management consultants Coopers Lybrand assessed the costs both of closing St Bartholomew's in the City of London and implementing the hospital's plan for survival on a smaller scale before Christmas. But last week the management consultants were asked by the health department to make a third visit, to report on the feasibility of allowing the hospital to continue operating exactly as now.

St Bartholomew's also received funds from its special trustees last month that enabled it to clear pounds 4m of its deficit. Overall, the trustees have donated more than pounds 30m over the past five years. Moreover, if the St Bartholomew's Trust is dissolved, as proposed by Sir Bernard Tomlinson's inquiry into London's acute health services, plans for a new geriatric and psychiatric unit at its sister hospital in Hackney would almost certainly be abandoned. The special trustees believe they would be forced under charity law to withdraw their pounds 4m contribution towards the building costs because the Homerton Hospital, in Hackney, would no longer form part of the St Bartholomew's complex.

Mr Besser said last night the hospital's cash problems had been turned around by imposing 'firm financial discipline' and persuading health authority purchasers to pay for treatments over and above contracted levels.

'It's becoming increasingly clear that you cannot expect the City of London to go on being the business centre of Europe and rip out its medical heart,' he said.