Published: 16/12/2004, Volume II4, No. 5936 Page 6

The NHS in London could be heading for re-organisation, according to health minister John Hutton.

Speaking at an HSJ conference last week, he said: 'I think There is a problem with London. We do not have a London voice for the NHS.' He added: 'We do not have a structure that corresponds to the mayor's office and That is a problem for us.' HSJ understands there is a growing belief in the Department of Health that the unique nature and scale of health issues facing the capital require an organisation that could oversee development of services across the city. And there is concern about performance: the three north London strategic health authorities were the poorest performers in the 2004 star-ratings.

The re-organisation is most likely to result in one health authority for London, split into a number of sub-regions - perhaps along the lines of the existing SHAs. Primary care trusts would remain, though some could merge.