I was particularly impressed by the tone and quality of the Minister's speech, particularly his starting point, namely, the need to show compassion to patients and maintain standards. We all want friends, relations and ourselves to be treated by the best people at the best time. While there will always be a tension at local level, let us please try to stop using terms such as "downgrading". We must stop thinking of the acute service as the only service people need. Let us examine how we improve the service within the resources available to us, which are financial and human – one cannot conjure staff out of the air.