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Yes, predominantly. Nobody is suggesting that everything is perfect at local level, but I think that, on reflection, the hon. Gentleman will agree that the serious mismanagement comes from the top. The trusts are acting within a framework that is determined at the top. We welcome decent pay for nurses—we have all campaigned for that—but the environment within which trusts operate is centrally determined contracts for staff, centrally determined contracts for consultants, and central arrangements for practically everything that trusts do. However, when there is a shortfall in paying for overpriced PFI contracts—perhaps the hon. Gentleman will be more sympathetic to this point—and the sums do not add up because central Government have set the tariff, it is said that the fault is local.