STRUCTURE: A London commissioning consortium has complained to the Co-operation and Competition Panel about a merger that would create the biggest provider organisation in England.

Barts and the London, Whipps Cross and Newham University Hospital trusts are working on becoming a combined organisation with a turnover in excess of £1bn.

City and Hackney East London Integrated Care wrote to the CCP, saying: “We are extremely concerned about the impact of the merger in creating a monopoly provider.”

The group, which represents 32 practices and serves a population of 220,000, asked the trust how it “would ensure the savings the merger should realise wouldn’t make admin systems – e.g. booking etc – worse than it already is”.

It also queried “what the building rationalisation plan would look like and how you would ensure the organisation wasn’t so big and unwieldy that this compromised clinical service delivery and it became in effect too large”.

The GPs also asked for the trusts to give “assurances that there are no plans to change the current clinical collaboration between the three hospitals with Homerton Hospital” – its likely main competitor in the area for general services if the merger goes ahead.

Dr Lucy Moore, integration director across the three trusts, and Whipps Cross chief executive, said: “This is a very new merger and we are talking to all stakeholders, which includes ongoing discussions with clinical commissioning groups [as consortia are set to become].

“The issues identified by this group of GPs are very helpful for the planning process and will be addressed in the full business case, which is due to be published later this year.”

The CCP is due to decide by 27 July whether it needs to open a more detailed investigation into whether the proposal breaches competition rules.

All three of the trusts face different financial problems.

Barts and the London has the biggest private finance initiative arrangement in the country and is due to start repaying £100m+ a year in unitary payments from 2012-13.

Whipps Cross still owes the Department of Health £33.5m from loans made to it over the past five years, £20.8m of which were made in 2010-11.

A recent NHS London document on “challenged trusts” said Whipps also owed £26m locally.

Newham University Hospital borrowed £5m from the DH in 2010-11 and owes another £1m, according to the same document.

The three organisations most recent turnovers were £686m, £244m and £164m respectively.

A plan for University College London Hospitals Foundation Trust to acquire the specialist heart and cancer facilities at Barts was abandoned last year.