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Last Updated: Thursday, 19 April 2007, 08:21 GMT 09:21 UK
Why NHS nurses may back action
By Jane Dreaper
BBC News health correspondent

Nurse with doctor and patient

Just over a year ago, a seasoned commentator on social policy advised me not to get too excited about Patricia Hewitt addressing the nurses' annual gathering.

They're a deferential lot, he said. I believed him.

By then, I'd already attended the RCN Congress that took place a few weeks before the general election in 2005.

Delegates had listened patiently as politicians from the three main parties spoke at a hustings.

The gloom about deficits and job losses in some parts of the health service seems to have contributed to a collective feeling among nurses of insecurity

The main emotion during those few days came from a young nurse whose voice broke, as she talked about the violence she'd experienced from people attending her accident and emergency department.

Skip forward to 2006 - and those instincts that the Health Secretary's speech wouldn't be much of an event. How wrong we were.

Fierce rows were brewing about NHS deficits, and Patricia Hewitt's remark that it had been the best year ever for the health service was proving inflammatory.

Within a couple of minutes of her beginning to address delegates, it was clear that the mood in the hall was set for confrontation.

'Not megabucks, not peanuts'

The student nurses, who like to provide a lively presence at congress, were particularly vocal.

This year, the Royal College of Nursing didn't invite politicians to Harrogate.

A sensible move no doubt - although we journalists like the headlines, more productive exchanges are achieved in private meetings.

But the atmosphere was nonetheless very feisty - particularly during yesterday's debate on pay, which culminated in one nurse's roar as he shouted to the audience to back the prospect of industrial action.

"Wonderful stuff", a woman said to me afterwards.

It's hard for outsiders to understand this anger.

Spending on the NHS has rocketed in recent years, and the average nurse's salary is now 25,000 - not megabucks, but certainly not peanuts either.

But the delay to this year's pay award has caused anger, particularly as Scotland has decided to give nurses the full amount straight away.

Leader's challenge

The gloom about deficits and job losses in some parts of the health service seems to have contributed to a collective feeling among nurses of insecurity.

More than one delegate remarked to me that several decades into their career, they were feeling at their most vulnerable among - as they put it - colleagues who were all fighting for their jobs.

Let's be clear - I'm not saying the health service is in crisis. But the government admits there have been pressures on staff in the past year- and the staff are saying they're feeling it.

The challenge for the new leader of the UK's nurses, Dr Peter Carter, is how to take forward this strength of feeling - in a way that doesn't conflict with the RCN's declaration that it will do nothing to damage care for patients.

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