My hon. Friend is entirely right. He cites a perfect example of the trend about which I am talking, which exists throughout the health service. Resources are being taken out of the community services because they are an easy hit.
The second example of short-term crisis management is the difference between the rate of inflation of health care costs in the system and the change that the Government have made to the tariff charged by secondary care to PCTs and commissioners. We all know that health care costs are rising very quickly—my right hon. and learned Friend the Member for Rushcliffe referred to that—and the latest estimate from the Office for National Statistics, which was published in August, is that they are rising by 6 per cent. a year. Given that the costs are rising at such a rate and the tariff that the Government published on
The situation shows that Ministers are not facing up to the consequences of their actions. If costs are rising by 6 per cent., yet Ministers fund them to the tune of 1.5 per cent., Ministers are effectively hoping that all the people in the national health service will somehow cover up the 4.5 per cent. gap so that they can avoid political embarrassment. It is not surprising that those people find their morale undermined if Ministers apparently believe that they are employed to do such a job. Those people think that they are employed to deliver high-quality health care to patients, as they should be. However, their experience is one of being asked to cover up the consequences of ministerial unwillingness to face precisely the kind of tough decisions about which the Secretary of State talked.
The development of training policy in the NHS, which is my third example of the short-term responses, has already been referred to during the debate. I have previously welcomed in the House the fact that we now spend more on training doctors and nurses in medical and nursing schools than we did when I was Secretary of State. I have reminded Ministers on previous occasions that that has happened partly because of carrying through plans that started to be generated when I was Secretary of State, but the big increase is welcome. However, it is not welcome that people who leave medical schools, and especially nursing schools, find that they cannot be employed in the national health service because Ministers have not faced up to the need to improve the efficiency with which health care is delivered. Furthermore, not only do we have unemployed nurses and doctors coming out of the growing medical and nursing schools, but the operators of the schools anticipate a 10 per cent. cut in the budgets available for training future doctors and nurses for the national health service. The Government have created a growing training sector, but they are not employing the people whom it produces, and they are also preparing a substantial cut to the increased training budget for which they are claiming credit.