Nurses to be paid by results

DOCTORS, NURSES and midwives are to be paid by results in a sweeping reform of National Health Service salary structures which will put the Government on collision course with trade unions.

Frank Dobson, the Secretary of State for Health, will announce shortly that the Government intends to introduce performance-related pay for health professionals to "create greater flexibility" in their careers.

Doctors with a high operation success rate or who dedicate themselves to the NHS, and nurses who prove themselves to be high achievers, will rise through the ranks quickly, gaining large pay rises, under the proposals.

The radical shake-up of health service wages will fuel the controversy over the widely leaked review body recommendations on public sector pay increases, to be published tomorrow.

MPs, senior civil servants and judges will be the big losers this year, with rises in line with inflation of about 2.8 per cent. Most public sector workers are expected to get around 3.5 per cent.

Mr Dobson has already started discussions with the British Medical Association about changing consultants' contracts so that their pay is more "outcome driven", according to senior Whitehall sources.

The Department of Health has also met nursing unions to negotiate the introduction of a more results-driven pay structure which would allow the best nurses to get rapid promotion. Ministers have already announced that they want to create new "supernurses" able to take home significant salaries for increased responsibilities. They now want to enable the best more junior nurses to rise quickly through the ranks.

However, the proposals for the NHS, to be put forward in a consultation paper shortly, will infuriate the health unions. The Royal College of Nursing and the British Medical Association are likely to argue that it will be virtually impossible to assess performance in hospitals.

This week's announcement of the pay review body recommendations will prompt a furious row between the Government and the unions, already cross that only junior nurses and primary heads are getting large rises. John Edmonds, head of the GMB, said: "A lot of people voted Labour because they thought there would be a substantial change in the approach to public sector workers and people are discouraged that there hasn't been."