Published: 02/06/2005, Volume II5, No. 5958 Page 3

Is London different - and, if so, how different? This has concerned planners of the capital's public services at national and local level for over a century.

It is a debate that irritates those working elswhere, many of whom believe London gets more than its fair share of attention. They also argue - looking in particular at the city's wealthy teaching trusts - that the NHS in London cannot complain about money.

Not so, say the five London strategic health authorities among others. The city's huge, transient, multi-ethnic population make it a special case both in organisational and funding terms. They also argue that, given the capital's impact on the nation's health, it is in everybody's interest to have a healthy London.

Now London's NHS organisations have launched a major review (news page 6).

The focus will be on centralising some pan-London functions - probably those concerned with strategic, capacity and workforce planning. It appears to fall short of the all-out SHA merger some were expecting following former health minister John Hutton's warning that 'we do not have a London voice for the NHS'.

Fearing the disruption merger would bring, most will welcome that. But it is now up to London's NHS to develop the answers to the unique health questions the capital's population poses - and to convince the rest of the country that it is not simply special pleading.