THE KNIVES are out between rival hospital Trusts, as the battle for scarce NHS contract revenue gets seriously nasty.
in EAST ANGLIA, leaked documents have exposed the bitter struggle behind the scenes as the James Paget Hospital Trust in Great Yarmouth goes on the warpath against competitors in Norwich and ipswich.
Funding cut
With the market reforms set to reduce the lunas available for healthcare in East Anglia, one Trust can only grow at the expense of others. James Paget managers have their eves on increasing revenue by extending their catchment population.
"The James Paget Hospital has to grow - to achieve an optimal size supporting a larger population, and providing a broader range of clinical services. If our hospital does not grow it will die. This is the essential message.
Homing in Celebrating the abandonment of plans for a new general hospital in Norwich, and eagerly listing the 'publicly known' failings of its Norwich foe, the James Paget management home in for the kill, hoping to snatch extra contracts and revenue.
It sees in 'the current difficulties of the Norwich Acute Unit' what the document calls "a unique window of opportunity for the James Paget Hospital".
Similar ruthless logic is driving the competition in London between Charing Cross Hospital and the Royal Marsden Hospital, each of which is battlino for a share of the cancer market.
Charing Cross bosses were embarrassed to be caught redhanded when a leaked document revealed their plans to 'destabilise a competitor' by poaching a top Royal Marsden consultant to help run a new 'head and neck cancer unit in direct rivalry with the Marsden's, just three miles away.
Weakening
The appointment of reconstructive surgeon Mr Nicholas Breach would, said the draft Charing Cross business plan, "obviously enable Charing Cross to improve specialist cover, but would have the additional benefit of weakening one of our strongest competitors."
While these and other Trusts battle to break into each other's share of the market, the struggle for survival is leading some to put up new barriers to keep out expensive and unwanted patients.
Scandals have centred on Trusts in Brighton and London caught restricting services to patients deemed 'too old', while Sheffield's Jessop Hospital for women cites cash as the reason for banning treatment to save very premature babies.
Across the country, the pattern is the same: Trusts in turmoil are resorting to mergers, rationalisation, expansion of private medicine, closure of A&E and less lucrative NHS services, cuts in community and other services and attacks on staffing levels as they battle with the balance sheets.
Bottom line
But the bottom line remains the same: the market system operates at the expense of planning and proper patient care.
Until this crazy system is scrapped, patients and health workers will pay the price of its failure.
By Barry Gale BRITAIN is experiencing the world's worst-ever asthma epidemic as high temperatures smother big cities, especially London, in petrochemical smog and ozone.
The epidemic began after violent thunderstorms in southern and central England on June 24; at its height hospitals were inundated with people suffering breathing problems and ran out of the asthma-relieving drugs.
One doctor described the effect of the epidemic on medical services as "the equivalent of every major hospital having to cope with an aircrash".
The epidemic is similar, but on a much larger scale, to those which occurred once in Birmingham and twice in Melbourne during the 1980s.
As afternoon temperatures soared to over 30 degrees, high levels of ultra-violet radiation interacted with fumes from car exhausts to produce a Los Angeles-style smog, including poisonous ozone and benzene concentrations. The number of deaths directly attributable to the epidemic is not known, but is believed to be at least 200.
The asthma epidemic is just one incident in the sustained growth of respiratory diseases in Britain. One in seven British children now has asthma - the thousand joined march on July 5 the closure of Guy's Hospital only preventable disease advancing throughout the advanced countries.
Its development is associated not with pollution in general, but with the benzene and nitrogen dioxide emissions from cars in particular. Ninety-four per cent of benzene comes from car emissions, as does 75 per cent of nitrogen dioxide.
Road building The government's crazy roadbuilding and "great car economy" policy, allied with that of privatising and running down public transport, is directly contributing to the rise in respiratory diseases.
During the asthma epidemic the government Department of the Environment declared that air quality was "good" and the