Nursing a grievance on a wing and a prayer

It was what we call a tight night for space, and I wasn't keen. But you could see what was on his mind: Alan Milburn's latest burst of PFI hospital projects and the annual health authority allocations, not to mention more money for road repairs, beating Internet crime and child poverty.

As it happened, I'd had a call at a similar time of night a few days earlier, the day after the chancellor's pre-Budget report. Why hadn't my account in The Guardian spelled out the report's three useful cash boosts for disabled people and their carers, a caller/carer asked.

Because the paragraph was cut, I had to explain. But we sent her Alistair Darling's press release which contained all the detail she could want. Darling's Blairish display of well intentioned virtue - Al Gore with more style - pervaded the prime minister's latest 'choices for Britain' speech to the nurse managers' conference in Brighton.

Re-reading the text, you could feel him straining to persuade the angels he is on their side. As widely reported, he apologised for underfunding them from 1997-2000 - 'so you were working flat-out, and often still are, in an NHS that was underfunded'. But now that investment has started it will do so in a way that will last - honest, he says. Trust me.

To cement that trust, Mr Blair rattled off the stats ('the glass is half-full, not half empty') about growing numbers of doctors and nurses - nearly 5,000 medics and over 10,000 nurses in place compared with Year Zero, 1997.

There was also the vital admission that 'in an era of near full employment, public sector employers are in competition for skilled staff '.

Hence Mr Milburn's offer of the£500-£1,000 pay supplement for nurses struggling to live in high-cost areas. It won't go far in the Big Smoke's housing market.

But, like the new flexi-time arrangements for returnees, part-timers and casuals, it shows that ministers are trying to engage with market realities.

That, of course, brings us sharply into contact with other market realities: that nurses from the Philippines - not to mention the 5,000 they want from Spain - are keen to work for NHS salaries, as the latest Milburn recruitment drives underline. Since Big Al now has the cash, but not the staff, that makes sense from our standpoint, though the Tories were quick to point out that, as an old lefty, Frank Dobson was very sensitive to charges of ripping off the third world's fragile healthcare systems.

I know the Philippines. It was going to be the East Asian economic miracle of the 1950s, but instead fell into the hands of thieves like Ferdy and Imelda-the-shoe-lady Marcos. It now needs all the help it can get to catch up with the likes of Taiwan and Thailand. Ministers have been assured by Manila that it produces too many nurses and can safely export some. But it's also said that we are in danger of getting their best. A similar danger must exist over Spain, which was also held back by dictatorship but has modernised rapidly since Franco died in 1975.

To check the problem, I rang Dr Jenny Tonge, Lib Dem MP for Richmond Park, medic and international aid specialist. Did she worry? Yes, she'd asked Clare Short and been given official assurances. But in what Dr Tonge calls 'second world countries, rather than third', they still train nurses in 'the Nightingale mould with lots of practical caring experience, the sort of people you dream about who really care about people as opposed to high-tech geniuses with degrees'.

I think we get her drift. She hopes that her local hospital gets all the friendly Filipinos it can, Spaniards too, if possible. A few French nurses ('brilliant') would be nice. As we know, Dr Liam Fox wants them all to speak proper English like what he does. I can help here. Filipinos may have been under Spanish rule for 400 years, but they already speak English. Either that or their own languages, like Tagalog. You have been warned.