Closing Barts: Community and Resistance in Contemporary UK Hospital Policy

Abstract

Debates concerning the nature and extent of hospital provision in London, England are longstanding. Reviews in the 1990s have focused on a perceived over-provision and recommended rationalisation. This paper explores the representations of place which emerged in the discourses surrounding the possible closure of St Bartholomew's Hospital (Barts), London. Through a discourse analysis of official and unofficial reports, Parliamentary debates, press releases, campaign material and coverage in the London Evening Standard and other newspapers, we assess resistance to closure and the construction of communities dedicated to the retention of Barts. Four different representations of Bart's are identified: as community resource, as a site of expertise, as a heritage symbol and as a site pertinent to the identities of Londoners. The effectiveness of these different strategies is considered and their positioning and use within the ‘Campaign for Barts’ is evaluated. We conclude that, notwithstanding the potential to present the (possibly temporary) retention of Barts as a recognition of its status as a locus of particular medical expertise, the potency of this health care facility as a symbol both of London and of medical tradition was the crucial factor in its reprieve.