Abstract

A Century of Hospital Planning in London: From the House of Lords' Enquiry to the Tomlinson Report MARTIN POWELL The London hospital system is undergoing fundamental change. It is claimed that the London hospital system has been frozen in time, and that the influences of population change, in particular population loss in the inner areas, and changing medical technology has made the existing system an anachronism. Thus, it is argued that London has too many beds, too many independent units and an over-concentration of facilities at the centre. It is further claimed that there has been a large measure of agreement over a period of the last century on both the nature of the problem and the solution, but little action has been taken. There is some validity in these claims, but an examination of the key reports from the House of Lords Committee of 18921 to the Tomlinson Report of 19922 - a century of hospital planning - shows that this conclusion is too simplistic. It is generally claimed that the roots of London's current problems are rooted in history. This claim is most clearly associated with the King's Fund. This voluntary organisation was set up in 1897