Putting paid to the past

l woke up this morning to the shock of Stephen Thornton on the radio,' health minister Alan Milburn told a conference on NHS pay last week.

'That always means I am in for a good day. Whenever he is on the radio I know it means trouble in the NHS.'

Mr Thornton, chief executive of the NHS Confederation, had been commenting on an earlier interview with Roger Kline, national secretary of the Manufacturing Science and Finance union.

He, in turn, had been discussing an MSF claim that NHS equal-pay claims could 'cost the taxpayer millions' unless fairer arrangements were put in place.

MSF is already preparing legal cases based on a 1994 European Court ruling that speech therapist Pam Enderby did work of equal value to (mainly male) clinical psychologists and pharmacists, and should be paid accordingly.

Its new claim was based on a legal opinion from Lord Lester QC on the implications of a more recent ruling. This said comparisons could be made 'within the same establishment or service' and not just 'the same employer', and Lord Lester argued the NHS was a 'service' in this context.

MSF says the implication is that if the work of one professional, such as a senior nurse, can be shown to be of equal value to that of another, such as a doctor, in another trust, then an equal-pay claim could be made.

'This throws into doubt all traditional grading structures and even the whole concept of local pay,' Mr Kline claimed.

Mr Thornton agreed, to the extent of saying the current pay system was 'a dog's breakfast' and a new system was needed. This, he added, would cost money - and the money should come from the Treasury, not the NHS.

Having proved he had been awake early enough to hear the debate, Mr Milburn did his best to ignore the specifics. Instead, he told human resources managers at the conference in Winchester organised by trading agency NHSP that it was time for them to make sure staff were 'motivated' and 'felt valued'.

He said pay was being considered as part of the government's comprehensive spending review, and a system was being developed which would combine 'a fair deal' on national pay with 'local flexibility'. This would link in to the 'new human resources agenda', tackling issues like racism and health and safety across the NHS.

The lack of detail meant unions attending the conference could only argue over what the new pay system should look like.

Michael Lowe, assistant secretary of the British Medical Association, argued the doctors' and dentists' review body should be left intact.

But Unison head of health Bob Abberley claimed the government was contemplating a single pay spine with harmonised conditions for NHS staff in which review bodies would have a modified role.

Mr Kline said it was important not to become bogged down in political arguments over the status of existing jobs.

'The real challenge is to find a system that will fit in new jobs, make the management of change easier, feel fair to staff and be equal-value proof.'

Mr Milburn used the conference to announce the membership of the government's taskforce on staff involvement.

It will be led by Hugh Taylor, NHS head of human resources, and include nurses, doctors, a hospital porter, managers and unions.

Hugh Stirk, personnel manager of Unilever, has also been invited to join.