Question: There is a LOT of changes if you compare the film to the book, and most of them I understand, since you always have to make some changes. But why did they change such things as characters names and genders?
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Answer: The film makers changed the name of Amelia Sachs because it sounded too much like 'sex'. I have not been able to discover for certain why they made Thom into a woman, but possibly this had to do with Thom's homosexuality. It could be viewed as controversial that Rhyme's nurse is a gay man, and could possibly also bring Rhyme's own sexuality into question. To make the nurse female would avoid all such issues.
Twotall