Published: 12/08/2004, Volume II4, No. 5918 Page 8 9

London mayor Ken Livingstone has warned that he is 'minded' to direct local authority planners to reject£1bn plans to redevelop the Royal London Hospital unless radical design changes are made.

Mr Livingstone made his comments about the biggest NHS private finance initiative scheme in the country after government architecture watchdogs the Commission for Architecture and the Built Environment attacked the proposals.

CABE said current plans to rebuild the 905-bed Royal London Hospital in Whitechapel, east London, attempt to cram too much into a small space.

The plans are so seriously flawed that they would be refused planning permission if they were an office project, it adds.

CABE said the proposed buildings were too tall and bulky, adding that the flaws in the design 'led us to seriously question the practice of developing major new hospitals on existing urban sites'.

Proposals for a new hospital on the 252-year-old site date back nearly 15-years, but have been dogged by political delays and service reviews that led to the hospital's amalgamation with Bart's Hospital. Architects have been given a tough brief to retain the listed facade, stay within a space bordered by narrow streets and neighbouring buildings and produce a design solution that keeps the hospital open throughout construction.

But CABE says that 'navigation around the buildings is likely to be confusing and lack the patientfriendly qualities proven to help people get better faster'.

Tower Hamlets council is the local authority with responsibility to grant or refuse planning permission. But the mayor has the power to direct the council to refuse permission, and if the council gives it the go-ahead, Mr Livingstone can over-rule it.

The mayor made his comments as the Greater London Authority handed a report on the designs to the trust. Mr Livingstone said:

'This hospital will dominate the local area and affect the lives of east Londoners well into the next century. They have every right to expect that their new hospital meets the highest possible standards. But the current proposals fall short.'

The case for the defence Barts and the London trust confirmed it had received a report from the Greater London Authority about the proposed designs. In a statement, it said: 'The trust will need time to digest it and reach a considered view, which we will discuss with the GLA at the earliest possible opportunity.'

Responding to CABE's criticisms, trust chief executive Paul White said the design was 'strongly supported'by staff and local people: 'We make no apology for requiring that clinical functionality of the hospital and patient care comes first.'

David Fison, chief executive of private finance initiative partner Skanska UK, said the plans have the support of English Heritage and provided the best architectural solution that reconciles the demands of a large hospital with the site's historic location.He said that concerns about navigation around the building would be solved as part of the 'fine-tuning process'.