The chief executive of NHS London Ruth Carnall has told HSJ she regrets the “compromise” that created South London Healthcare Trust in its current form.

The multi-site hospital trust is predicted to deliver a £65m deficit for 2011-12 and was created from a merger of three south east London organisations in 2009. Chief executive Chris Streather left for a new job last week.

Dame Ruth spoke to HSJ after her speech to the NHS Confederation on reconfiguration in which she told delegates: “You can be placed under very, very intensive political pressure to change [your plans] and in some cases we have done that because we thought it was better to get something [than nothing].”

She added this could lead to a situation that was “at best ineffective and at worst unmanageable”.

Dame Ruth told HSJ the creation of South London Healthcare Trust was what she had been referring to.

“People were asking ‘why are you including Lewisham? Why are you including Lambeth?’” she said, “We knew there was a system wide problem and we decided to look at one part of it only.

“On reflection we should have stuck to looking at the whole of south east London We should have looked at the entire population but we focussed on outer south-east London.

“But people were very hostile to it. And it was early days for us. We were more susceptible to pressure, we wouldn’t be now.”

She added that the result of a simulation exercise NHS London had run in March had shown that a south-east London-wide solution was needed to the trust’s problems.

In her speech Dame Ruth said successful reconfiguration had given her credit with groups who were previously hostile, describing a meeting about London’s stroke network at which she presented a retrospective evaluation of the programme to a group in the House of Commons, who told her they had previously seen her as “Cruella de Ville” but were now prepared to listen.

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