A £5bn development programme of more than 150 healthcare projects in greater London could be undermined by funding and planning problems.
Grand Designs: The New London NHS, published this week by the confederation of London NHS trusts, reveals proposals for more than 10 hospitals, more than 60 primary care centres, seven walk-in centres and five treatment centres.

However, the report claims that the projects are threatened by changing funding regimes. It also claims that certain areas of London receive NHS funding below the government's agreed fair level.

The report states: "In north-east London, for example, there is a gap of £34m.

"Developments such as the Thames Gateway will create an even greater challenge."

It says that the problem can only be solved if more investment is found from partner agencies such as local authorities, voluntary agencies and private sector firms.

Another funding problem pointed out concerns nhs and primary care trusts that lease their hospitals and health centres from PFI consortiums and other private companies.

Starting in the next financial year, the Department of Health will disallow these public-sector trusts from spending any spare capital on buildings they do not own.

The report adds that "hospitals that need essential repairs" could be hit particularly hard.