Health authorities are being asked to pay for a paediatric neurosurgery ward that has been standing empty for six months and may now never open.
King's Healthcare trust spent 500,000 building, equipping and staffing the ward after a consortium of South Thames HAs decided to transfer paediatric neurosurgery from Atkinson Morley Hospital to King's College Hospital in April 1997.
The transfer was 'deferred' by Merton, Sutton and Wandsworth HA in February, four weeks before it was due to go ahead, when solicitors threatened legal action over an alleged lack of consultation about the plans.
A new review group was set up and has now concluded 'there will be no immediate move to a single centre', although 'such a development cannot be ruled out' because an 'external adviser' will be asked to review its work.
In a statement, the group adds: 'As King's had already invested in the development of their neurosurgical unit, the HAs have agreed to meet the associated costs incurred.'
King's responded by saying it was 'very concerned' by the 'complete volte face' and 'remains a larger and better equipped unit'.
'We cannot understand the justification for leaving its new facilities unused at a major cost to the NHS,' said a spokesman.
Atkinson Morley Hospital is due to close. When it does, its services will transfer to St George's Hospital.
The original review found paediatric neurosurgery could transfer to St George's, but not until after the turn of the century.
Lesley Stuart, chief officer of Wandsworth community health council, said St George's Healthcare trust was now hoping to move its paediatric neurosurgery by Christmas, in advance of adult services.
'This is a victory for common sense,' she said. 'We wanted this review because there was no formal consultation. We got it because of local pressure.
'These decisions should be taken on the basis of what is right for patients, not individual units fighting for their own business.'
Merton, Sutton and Wandsworth HA told HSJ in February there was no need for statutory consultation because the changes to a regional service did not constitute a 'substantial change of service'.
No one at the HA was available to comment this week, although a spokeswoman stressed it did not 'act in isolation' from other South Thames HAs.
Lambeth, Southwark and Lewisham chief executive Martin Roberts, who chaired the new review group, said the cost of keeping both neurosurgery services open was 'relatively small'.
He argued that demand had increased since the original decision was taken, but acknowledged: 'We need to learn from this. We are now in an era when patients and service users want to be involved.'
The review group has recommended that there should be at least one neurosurgical centre in South Thames on stand-by for emergencies at all times.
Its says that 'if individually King's and St George's cannot meet this requirement, a joint rota should be established'.
King's said it would be 'concerned' about plans to share neurosurgeons which 'would see patients and doctors shuttling across south west London'.
The review says a clinical audit of both centres should be set up, costs at both centres should be reviewed and they should co-operate on staffing and training.