31.   But better patient care is the ultimate aim.

32.   Mr Wilkinson, patient care manager, will be presented with a leaving gift this afternoon.

33.   And hospital chiefs are confident the shops will turn in healthy profits that will be used to improve patient care.

34.   And it was not pretty, what with the multiple allegations of mismanagement, inferior patient care and retroactive denial of emergency care claims.

35.   And hospitals and nursing homes say it might force hospital closings and a decline in patient care, especially at poor institutions that depend heavily on Medicaid payments.

36.   And like many health care workers, he worries that the spread of managed care may be forcing the agency he works for to sacrifice patient care.

37.   And now, they say, patient care is suffering.

38.   And only expenses related to patient care qualify for such payments.

39.   And, mayoral aides argued, the quality of patient care would not be diminished, as they combined jobs and worked toward what they said were needed efficiencies.

40.   And they foresee improvements in patient care if unions can give them more authority over medical decisions.