But uppermost in our minds is the problem of finding extra money without making any cuts in the service, for if the Minister makes any further cuts in the service affecting young hospital doctors the Crisis in the Service is going to be very real indeed.

It was this sudden disruption which helped to create a sense of Crisis in the Service.

The Times said:In giving way to political pressures from non-medical staff it turned the whole economic and administrative Crisis of the Service to a political one.

The Crisis in the Service has been stimulated and provoked by legislation and the imposition of expenditure cuts on local authorities.

Most of my hon. Friends would agree that the west midlands may well have the worst Health 412 Service Crisis in Britain, and I must tell the Minister that, although I listened carefully to his speech, I do not think that he appreciates the scale and depth of today's crisis in the Health Service in Birmingham and the west midlands.

In view of the perpetual Crisis in the Service over recent months and the tragic cases that have been highlighted in the press, will she now recognise that many people throughout the country believe that she has blood on those hands?

In a note dated 2 February, Bolton said:A major initiative is required if a Service Crisis is to be avoided … people with profound handicaps, and challenging behaviour … are finding that services are grossly inadequate … Suitably skilled staff must be recruited so that we do not end up with an army of community carers unable to provide the skilled input required.

Time and again, the Opposition take individual cases, exploit them out of all recognition and paw upon personal detail to try to create a Crisis in the Service.

It is frustrating that it has taken a perceived Crisis in the Service in relation to recruitment and retention, not to mention morale, before action has been taken.

In the latter case, the Crisis in the Service happened in 1997, and the PAC reported in April 2001.

It is time for the Secretary of State to stop playing to the gallery, to start listening to the chief inspector and to deal properly with the Crisis in the Service.