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Despite it being mid-summer every medical (as compared with surgical) bed in the hospital was full, with most of the weekend still to run. Patients were in extra beds put up in rooms which lacked necessary safety equipment. Sir: You write: “Professionally, organisationally and morally, the health service is in remarkably fine fettle,” (leading article, 21 June). This is in contrast to the letter I received the same day from the President of the Royal College of Physicians. Better to start low rather than make mistakes.So there it is. The policy that helps people into work and saves taxpayers’ money in the long term could be the very one that the Conservatives claim will cost jobs: a minimum wage It’s almost shocking and unthinkable after all..

No one should envy the Labour government minister stuck with unenviable task of getting the level right. However, if the combination of technology and global competition mean wages at the bottom end of the labour market are just too low, the long-term answer may lie in subsidising wages rather than subsidising unemployment.The government has already embraced in-work benefits such as Family Credit; they encourage people to take low-wage jobs and at least get a foothold back in the labour market. But expanding them is an expensive proposition, especially when companies can simply cut the wages they pay knowing that the state will make up the difference. Without some kind of floor on wages, in-work benefits are just a blank cheque from the taxpayer to unscrupulous employers.

Yet a minimum wage set too high would indeed destroy the very jobs that many of the unemployed need as their first step back into employment. Often that will involve providing people with exactly the kinds of support, training and work experience that Labour has proposed. Tailoring the approach of the unemployment service to the circumstances of each individual is a worthwhile idea, and far more likely to help them swiftly to a job or retraining course that suits them. Moreover, as customer charters have revamped other parts of the public services to respect the consumer, it is about time someone did the same for the sections of the state which deal with the poor.Yes, it will mean a big shift in the culture of the employment service. Yes, it will require better trained, better motivated and more professional staff. The long term unemployed, the young, the unskilled, single women with children, and those whose partners are out of work too, all have particular trouble getting new jobs. Of course there are no cheap and easy answers, but there are certain things the state can do to help.So the climate is right The rhetoric is right.

But has Labour got the practical policies? Yesterday’s announcements sounded badly like tinkering at the margins, rather than radical overhaul.Many of Mr Smith’s proposals are welcome. And the unemployment problem in Britain has a plethora of tangible underlying causes itching to be dealt with.Defeatists tend to shrug their shoulders and assume unemployment is just a question of too many people chasing too few jobs Not so. Some people don’t get jobs whatever they do, and however fast the economy booms. Providing short-term palliatives for a problem is a waste, when you can start to tackle the underlying causes instead. It’s a classic case of old Labour values applied to the modern world. The party remains, so we are told, as concerned as ever about the plight of the poor and the underdog, but it no longer sees the solution as greater redistribution through the tax and benefit system.