The Department of Health has all but abandoned plans for a £1bn PFI hospital in Paddington, London, amid delays and escalating costs.

The plan had been to consolidate medical facilities at Harefield, the Royal Brompton, St Mary’s and Imperial College on a site next to Paddington Station. The plan ran into trouble when the value of its intended 3.2 acre site rose to £148m.

Now the Royal Brompton and Harefield NHS trust has vetoed changes to the business case, citing uncertainty about the land deal, an affordability gap and whether such a big hospital was needed.

Campaigner Jean Brett, who has been opposing the PFI hospital, was delighted that the NHS trust has had this change of heart.

She said: “It is extremely rare for this to happen as it’s usually a rubber-stamping exercise. It boils down to neither the land nor money for Paddington being available and its clinical efficiency is now being questioned.” The plan was praised in parliament before the election by Tony Blair.

The private developers behind the scheme pulled out last month and have already signed up US architect Perkins + Will to come up with another design for the Grand Union building.

The development team, which includes developer Pearcroft and Multiplex, is now undertaking a month-long “stock take” of their options.