Thursday, December 17, 1998 Published at 19:46 GMT
NHS workers reject pay reform plan
Nurse leaders claim a big pay rise is needed next year
Government proposals to reform and improve pay NHS pay structures if next year's rises are "affordable" have provoked anger among doctors and nurses.
Health minister Alan Milburn has set out proposals for reform of NHS pay in letters to the two chairman of the independent pay review bodies which recommend annual increases for doctors, nurses and other NHS staff.
But he enraged NHS workers by insisting the government would only be able to undertake reform of their pay if the review bodies recommend rises that are "affordable as well as fair" for 1999-2000.
Mr Milburn also sparked controversy by spelling out his intention to change hospital consultants' contracts to tackle those who put their private practice before their NHS work.
The British Medical Association responded by penning its own letter to the review body, warning that hospital doctors were already struggling to cope with a heavy workload and long hours.
Dr Peter Hawker, chairman of the BMA's consultants' committee, said: "Hospital consultants are working more than 51 hours a week across the board for the NHS and the pressure of work is growing day by day.
"I completely reject any suggestion by Mr Milburn that the review body should hold back from making a fair award to hard pressed doctors this year simply because he wants to change our contracts in future."
Dr Hawker accused Mr Milburn of focusing on a minority of consultants who arguably were not giving a full commitment to the NHS.
He said: "The NHS gets an extremely good deal from its senior doctors."
Nurses issue warning
The Royal College of Nursing said it would explore details of the Government's plans for full-scale reform of NHS pay.
"Nurses need a proper pay boost now. The promise of jam tomorrow simply isn't enough," she said.
In his letters to the review bodies, Mr Milburn said nurses and other staff had to rely on a range of arcane allowances rather than a higher level of basic pay.
Many staff were given automatic pay increments until they reached the ceiling for their grades, irrespective of changes in their skills, responsibilities or performance.
These allowances were not only bad for staff, but inhibited flexible working and 24-hour service delivery.
The Government wanted to harmonise conditions of service and consolidate allowances into basic pay in order to remove barriers to modern, flexible working practices.
Mr Milburn proposed introducing a core set of national conditions with others to be determined locally.
But he stressed that the Government rejected the "muddle" of national and local pay bargaining introduced by the Tories as "confusing and divisive".
He said under the current, outdated system staff faced "glass walls" as well as glass ceilings because they were defined by their job label rather than what they did for patients.
The Government wanted to give higher pay to nurses and other NHS staff who took on extra responsibility and provided high-quality service to patients.
Nurses who could demonstrate their competence and performance should be able to progress more quickly and earn more money.
Mr Milburn said the Government would publish its reform proposals in the spring.
But he concluded his letters to the pay body review chairmen by saying: "All of our proposals will, of course, be conditional on our ability to finance change.
"We will carefully assess whether we can afford to proceed in the light of the recommendations you make for 1999-2000."