My hon. Friend has illustrated the consequences of the financial squeeze in the NHS. Ministers seem to think that they are running a different health service in which such things do not take place, and, as my hon. Friend has said, sometimes they do not seem in touch with what is happening on the ground.
The focus of today's debate is the work force, and the Council of Heads of Medical Schools has rightly criticised what is going on:
"Coherence is required—and this is sadly lacking at present—to the detriment of the entire nation."
It is talking about the Government's failure to ensure proper work force planning. Whenever I have asked written questions about that matter, I have been told, "That is the responsibility of trusts or health authorities." I sometimes think that this Government are the "Not me, guv" Government, because they always say that it is someone else's problem.
Where things need to be done strategically and nationally, the Government should be planning—I know that "planning" is a dirty word in new Labour—so that people who commit their lives to the NHS by undertaking three, five or seven years of training have a good prospect of obtaining a job when they complete their training. The Secretary of State has no answer to why 90 per cent. of recently graduated physiotherapists are unemployed. Is that acceptable? Has the right hon. Lady got anything to say on the subject? All she has said is, "We are trying to help. We will do what we can." The situation is totally unacceptable; it is the result of mismanagement; and the buck must stop on the Government Front Bench.
Some things in the NHS must be done nationally, strategically and with accountability to Parliament. However, as much as possible should be done locally by local people, who should be engaged early in the decision-making process to allow them to face the difficult choices, to express their priorities and to have those priorities respected, which is not happening in the NHS at the moment.
One important issue that has arisen in the debate is that of switching money from people with longer life expectancy to people with shorter life expectancy. There is the question whether enough money is going into the system in the south and whether too much money is going into the system in the north. How can the Conservative party run a "no cuts" campaign without promising to spend any extra money? It is difficult to work that one out, until one realises that, with one or two exceptions, it does not intend to win any seats north of the Watford gap. Conservative candidates in seats south of the Watford gap will say, "We will spend more money in this area." If, however, we were to have a parliamentary by-election north of the Watford gap, the Conservative candidate would not mention spending less in that area.