Nursing leaders dealt another blow to ministers yesterday by voting overwhelmingly to ballot for industrial action if the Government attempted to freeze their pay.

Delegates at the Royal College of Nursing (RCN) conference also voted massively in favour of a motion saying Health Secretary Andrew Lansley's reforms of the NHS would not benefit patient care.

Health minister Anne Milton infuriated nurses earlier in the week when she said an offer was still on the table for no compulsory redundancies in return for nurses accepting a two-year pay freeze when they move up pay bands.

The proposal, made by NHS Employers last year, was rejected by all major health unions including Unison, the British Medical Association and the RCN.

The RCN described the proposal as an "attack on hard-working nurses" and said NHS Employers had been unable to even guarantee that more than 100 trusts would stick to any agreement on compulsory redundancies.

But Ms Milton told nurses the proposal was still there, adding: "These are difficult times and we are walking a financial tightrope."

Speaking in favour of the motion for a possible ballot on strike action, nurse Tom Bolger, from Suffolk, said: "We've had enough of deception, of lies and bully-boy tactics."

The motion, which was passed 97 per cent in favour to 3 per cent against, said the RCN should ballot members on industrial action if there was any "imposition" of an incremental freeze or any other proposal which challenged nurses' national pay agreement.

RCN chief executive Dr Peter Carter said the vote was "a symptom of nurses feeling that the Government may be listening but they are not hearing". He added: "Nurses are not going to do anything that damages patient care."

A spokeswoman for the Department of Health said unions had rejected the deal but NHS Employers had left it on the table.

She added: "The Government has no intention of imposing any national freeze on increments for NHS staff.

"But many staff have told employers that they are more concerned about job security than pay. NHS Employers proposed a national framework that would allow each trust to decide with its staff whether to freeze increments for two years to protect jobs."

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