LEADING ARTICLE:When being cross is not enough

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Not many people prefer ministers to nurses. Given the choice between Baroness Cumberlege - whose very name suggests unwieldiness on the brink - and, say, Charlie Fairhead from Casualty, most sane Britons would opt for the downtrodden nurse. Consequently many people's reaction to yesterday's historic decision by the Royal College of Nursing to abandon its 79 year no-strike policy will be to blame the Government for pushing the angels too far.

Certainly nurses are very cross and sensible governments usually manage to avoid confrontation with them - if only for reasons of expediency. But being cross does not necessarily make them right. They are, for instance, wrong about local pay. It makes sense for hospitals and trusts in different parts of the country to pay what is necessary to attract the staff they need. Until they do they will not have the flexibility to offer the patient the best possible service.

True, any decent personnel manager could have advised the trusts and the Government that the introduction of local pay would be accomplished successfully only against the background of a generous overall settlement. If you are going to take something away from people that they value, you must give them something else in return. This has not happened - and stories of local stinginess have fuelled the nurses' resentment. But that does not make local pay undesirable.

Nurses are also wrong to suggest that there are forms of industrial action that they could take that would have no impact on patients. It sounds seductive when the RCN talks about a "bureaucratic blockade" - a kind of industrial neutron bomb, which will hurt managers and leave everything else unscathed. But somewhere along the line the important information will not reach its destination in time. No one will ever be able to prove that someone was left in pain, or suffered as a result of the action - but that is what will have happened. No, if nurses really want to target managers alone they would be better off letting down their tyres or spilling things on their suits.

This does not mean, as some on the right have suggested, that we need a statutory no-strike policy. There might just conceivably be circumstances in which it was justifiable to risk the lives of patients for the greater good. But it is virtually impossible to imagine what these might be. So although nurses, like anybody else, should be entitled to withdraw their labour, they would need to consult their consciences in a way that, for instance, miners would not. Next month, when nurses are balloted on industrial action, they should not fall for the "painless action" myth.

But perhaps the deepest frowns at the RCN conference in Harrogate should belong to the representatives of the Labour Party. So far they have ridden on the tide of Tory unpopularity in the health service. In a very short time, however, it could be the parsimonious Brown and the tough Blair who find themselves dealing with NHS discontent. After all, the last time that patients found themselves waking up from the anaesthetic to discover that their operations had been cancelled due to industrial action was when Barbara Castle was Health Secretary.