Competition and collaboration rules should not stand in the way of hospital trust mergers and acquisitions, two major acute trust chief executives have argued.

Imperial College Healthcare trust’s Stephen Smith said “There has got to be a degree of reality and that has got to come from the politicians. Thirty-two trusts, each with their own boards, often dealing with sums of money which are not even worth getting out of bed for, is frankly ridiculous”

University College London Hospitals foundation trust chief executive Sir Robert Naylor said:”We cannot continue with 31 primary care trusts and 32 hospitals. I think the recession is going to force us into a fundamental restructuring of the NHS in London.”We have to merge organisations and [in Imperial] we have one good example of how. That will be unstoppable, despite huge political questions about how that happens”

HSJ last week reported concerns that academic health science centre plans could be seen as “collusive” market sharing under draft co-operation and competition panel guidelines.