Andrew Lansley: NHS services in London will change
The government has admitted for the first time that health services on the ground in London will have to change because of NHS reorganisation.
The coalition is turning every hospital in London into a foundation trust, with more control over its own spending.
Health Secretary Andrew Lansley has told BBC London this will inevitably mean changes to the way services are delivered.
A series of hospital mergers is already planned in the city.
Foundation trusts are still within the NHS - but have more freedom to make their own decisions and more freedom over how they spend their money.
In return they have to be more accountable to patients and hit tough clinical and financial targets.
Asked if it was possible for all London hospitals to reach foundation trust status without major change on the ground, Mr Lansley said: "We are not anticipating any hospital closures.
"Clearly there will be service changes in London, as across the country.
"We are moving towards a service designed around the needs of patients which will change, sometimes, where those services are delivered and by whom they are delivered."
Mr Lanlsey said that turning all hospitals into foundation trusts would help them increase choice for patients.
He added: "For some it will be very hard work - but it's necessary work."
Sue Slipman, from the Foundation Trust Network, the body that represents foundation trusts, said: "I think it is a very big challenge. I think if we don't live up to that challenge, London could end up in a much worse place.
"Taking preventative action and reconfiguring those services in time will be a better way to go."
Tim Smart, chief executive of King's College Hospital in south London, said: "The evidence is that foundation trusts deliver better care more cost effectively than hospitals that aren't foundation trusts.
"Why invent something else if you've got a model that works."