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It is genuinely surprising that the Labour party is so adamantly opposed to what is a sensible devolution of management to the hospitals. It is also foolish of the union leaderships concerned to oppose these developments. We are already seeing in some trust hospitals a recognition that we have too many low-paid people in the NHS, which we have, and a search for greater and more flexible ways of dealing with pay, which is to the benefit of those very people. I suspect that we shall see that opposition crumbling too, at least from the grass roots, as the doctors' opposition has crumbled so far.