A migrant worker in Chaozhou, Guangdong province, stabbed one doctor to death and seriously injured two other hospital personnel on Thursday, in yet another incident arising from strained doctor-patient relations.

Huang Shuijin, 32, from Jiangxi province, rushed into the Chaozhou Men's Hospital, where he had been treated for prostatitis, bearing three knives. He stabbed one of his doctors, inflicting serious injuries.

He then stabbed the vice-president of the hospital and another doctor, who tried to stop him. The vice-president was killed, while the second doctor was injured.

Huang had been treated by doctors at the hospital since October and had spent some 3,000 yuan ($473). He first tried to obtain a refund, claiming the treatment had been ineffective. After his demand was refused, he carried out the attack, he was cited by the Chaozhou police as saying.

He also told the police that before the hospital attack, he had killed the wife of his manager at a kitchenware parts plant.

A statement from the hospital said Huang's illness was relatively minor and curable. His situation had been improving as indicated by a recent test report. Huang had been cooperative in the treatment and had not complained to his doctors.

The hospital authority requested that Huang undergo psychological testing.

A man of few words, Huang was honest, one of his co-workers, surnamed Liao, was quoted by the News Express as saying. Because he could repair machines, he was relatively well-paid.

After the Spring Festival in February, Huang came back to the plant with a woman and the two lived and worked together at the plant.

The woman had disappeared from time to time without notice and did it again about a fortnight ago, after being scolded for lateness by the manager's wife.

Huang had not been at work until the night before the killing, when he told the manager that he would work again. Strained doctor-patient relations have many deep-seated causes, but the number one reason lies in the commercialization of hospitals, said Chen Anwei, a medical expert and a deputy to the Guangzhou people's congress.

The media also played a part, Chen said. For example, in a recent case in Shenzhen, the diagnosis of the hospital was correct but media reports raised doubts about the hospital, which planted the seeds of doctor-patient conflicts.

Years of reform involving pushing hospitals into the market and a lack of government funding for medical care had led to worsening doctor-patient relations, said Liao Xinbo, deputy director of the Guangdong provincial health department.

Further, the establishment of third-party medical appraisal and mediation bodies was important in dealing with medical disputes.