It was not surprising that the chief executive of the UCH and Middlesex Hospitals trust was upset at the prospect of a rival redevelopment proposal in the form of a 'millennium hospital' on the King's Cross goods yard site. My surprise is that this trust is still pursuing the idea of rebuilding on land adjoining the constricted UCH site.

A few years ago, when I was a Department of Health architect involved in the option appraisal for this development, this seemed an awkward and piecemeal approach unlikely to produce a satisfactory major teaching hospital for the next century. I understand that a key element in the trust's present planning is a 13-storey tower on Tottenham Court Road. Quite apart from the visual effect of such a block, vertical hospitals have long been seen as inherently expensive and inflexible.

I should have thought that the King's Cross site offered much better scope: it is an ideal location for access by public transport, and is big enough to facilitate long-term growth and change. The 'millennium hospital' proposal, based on an accident and emergency department serving a much larger than usual catchment population, and with peripheral locality hospitals each with a minor accident unit, seems to accord better with the current policies of the royal colleges, and could become a model for future urban hospitals.

Tony Noakes,