EXHIBIT 23.4

            CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

The Board of Directors
Vanguard Health Systems

We consent to the use of our report dated June 25, 2004, with respect to the
consolidated balance sheets of Tenet HealthSystem MW, Inc. and subsidiaries as
of December 31, 2002 and 2003, and the related consolidated statements of
operations, shareholder's equity (deficit), and cash flows for each of the years
in the three-year period ended December 31, 2003, included herein and to the
reference to our firm as experts under the heading "Independent Registered
Public Accounting Firms."

Our report refers to a change in Company's accounting for goodwill effective
June 1, 2002.

                                                /s/  KPMG LLP

                                                KPMG LLP

Dallas, Texas
December 17, 2004