NHS employers clashed with prime minister Tony Blair over pay this week in the run-up to tomorrow's deadline for evidence to the pay review bodies.

The NHS Confederation says in its evidence, to be published tomorrow, that there should be no changes to the present structure pending the promised new pay system for the NHS. It also calls for an 'identical pay award for all staff grades'.

But Mr Blair announced on Tuesday that he was asking health secretary Frank Dobson to 'look at' introducing nurse consultant posts 'with the same status within nursing that medical consultants have within their profession'.

Andrew Foster, chair of the confederation's human resources committee, said Mr Blair's move was a 'bolt from the blue' and 'disconnected from the strategic discussions' taking place on a new human resource strategy and pay system for the NHS.

Malcolm Wing, Unison head of nursing, said most nurses would feel the idea 'missed the point'.

'The most persistent problems in the profession are low pay across the board and chronic staff shortages,' he said.

But Royal College of Nursing general secretary Christine Hancock said: 'Recognition that these nurses are effectively working like consultants is long overdue.'

The nurse consultant posts would be created on top of the new discretionary awards, due to be implemented this week, that will give nurses on grades F to I and senior professions allied to medicine up to 1,200 a year extra.

Mr Blair said the new posts would provide nurses with an 'alternative career path' to non-clinical management jobs.

The confederation's evidence was completed before there was any inkling of Mr Blair's intervention. It emphasises that much of the growth money awarded through the government's comprehensive spending review is earmarked for a variety of initiatives.

It also asserts that employers can afford only a 'pay award modestly higher than inflation' and then with difficulty.

But the British Medical Association announced yesterday that it was seeking a 10 per cent pay rise for doctors, while dentists want 5 per cent. Nursing unions are seeking a substantial increase to close the gap between private and public sector pay.

The confederation evidence says NHS employers strongly support an identical pay award for all staff groups unless there is a 'fully reasoned and explained justification for any differential'.

It says employers and staff are 'very dissatisfied' with the higher pay award for doctors this year, the third year in which a differential pay award has been made 'without explanation'. It accepts that there are real problems with doctors' workloads but says pay is not the way to address them.

McLoughlin wins election for chair

The NHS Confederation made a partial break with its past this week, electing Catherine McLoughlin as its first overall chair.

Ms McLoughlin has been joint chair with Marco Cereste since the organisation was set up last year, but as chair of a health authority was not thought to be a front-runner for the new post.

In the event, she beat off a challenge from Mr Cereste and former National Association of Health Authorities and Trusts chair Professor Michael Schofield.

She also beat Fiona Peel, chair of the NHS Confederation in Wales, and Dianne Jeffrey, chair of North Derbyshire Community Healthcare Services trust.

Ms McLoughlin, who chairs Bromley HA, said members wanted the confederation to be 'driving policy not a sounding board' and promised to help the organisation 'realise its influence'.