- This report is based on public discussion of the six specialty reviews for London that were set up by the Secretary of State for Health earlier in 1993. In July 1993 the King's Fund arranged six meetings to encourage public debate about the outcomes of the independent reviews of specialty services in London: renal, children, cancer, plastic surgery and burns, neurosciences and cardiac. These reviews made recommendations for changes to the structure and organisation of tertiary care in London. This report records the debates and contributions from all those involved; it also comments on the difficulties which need to be overcome during the process of moving towards more accessible and better quality specialist care in London. It is valuable reading for clinicians, providers, purchasers, patient groups and representatives. The debates and the emerging issues will also be of interest to health care professionals and the public in other cities in the United Kingdom where the same pressures are at work.