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Education And Debate

Personal paper: The conflict in transferring a cystic fibrosis specialist service between two hospitals in Manchester

BMJ 1997; 315 doi: (Published 18 October 1997) Cite this as: BMJ 1997;315:1009
  1. A K Webb, consultant respiratory physiciana,
  2. S P Hanley, consultant general respiratory physicianb
  1. a Bradbury Cystic Fibrosis Unit, North West Lung Centre, Wythenshawe Hospital, Manchester M23 9LT
  2. b North Manchester Health Authority, Manchester M8 5RB
  1. Correspondence to: Dr Webb
  • Accepted 3 February 1997


Despite the best endeavours of doctors and managers when faced with a turbulent mixture of vested interests—local politics, competing trusts, university, and patients—there is still no easy path to tread when moving specialist services between NHS trusts. In 1993 a proposal to move the regional adult cystic fibrosis unit for the north west of England from within what is now the North Manchester Hospitals NHS Trust to one in the south of the city was opposed by the health authority in North Manchester. There was no effective arbitration process available to resolve the issue between the factions in the competitive climate promoted by the NHS reforms. In this “tale of two hospitals” we describe the tumultuous sequence of events that eventually culminated in the move.

Relocation of the adult cystic fibrosis unit

Summary points

In 1993 the regional adult cystic fibrosis centre for the north west of England was transferred from the Monsall hospital, part of the North Manchester Health Authority, to the Wythensahw Hospital, part of the South Manchester Health Authority

The move had been vigorously opposed by North Manchester, and the resulting conflict between hospitals had a seriously demoralising effect on both unit staff and patients

The regional health authority had no power, it seemed, and the purchasers were unable to organise themselves in order to resolve the issue

Despite the competitive climate promoted by the NHS reforms and the fact that this is not an isolated incident, the NHS has no effective process for arbitrating between opposing groups, except by resorting to judicial or ministerial review

During early 1992 it was proposed that the regional cystic fibrosis unit should be transferred from a small peripheral hospital to the district general hospital (North Manchester General). In mid-year, the new accommodation offered to the unit was withdrawn because of a funding shortfall of £200 000. Consequently, the unit's …

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