There would appear to be little chance now of a new pay system for the NHS during the lifetime of the present parliament. It is true to say that even The New NHS white paper talks about restoring a national pay system only as a 'longer-term' objective, but last week's shambolic opening skirmish between management and staff sides has probably already put paid to the timetable set out in the draft document presented to the unions, and that in turn talked of agreeing the job evaluation system necessary for a shake-up of NHS pay only by April 2001 (see news, page 5).

So much for 'intensive' negotiations when one of the unions which has always been keenest on making good progress is unable even to confirm that its officials should be present, let alone reach agreement with its sister organisations on who should represent them in such talks.

The argument that there is nothing to be gained by hastening through a deal to which one or both sides are not committed is seductive. But the longer it all takes, the more difficult it will be to reach agreement of any kind.

Discontent in the British Medical Association over the consultant contract is already rumbling ominously around the NHS, while junior doctors are threatening industrial action over their, admittedly hard-to-defend, overtime payment system. The longer the national picture remains unclear, the more localised outbreaks of dissatisfaction there will be, and the greater the danger of more widespread discontent or worse.

The anger aroused by this year's award to nurses provides a warning of what happens when people are given false hope and then see it taken away. Expectations have been raised in the health service about what a Labour government can deliver, and staff not unreasonably want to see the results appear in their pay packet. Perhaps only managers have come to expect a continued clamp-down on their pay (see news focus, pages 9-11).

Meanwhile, as time goes on, and the more national talks get into specifics and have to be reported back by the unions to their members in detail, the more their expectations will grow, and the higher the price of implementing a deal will become. The consequence of allowing expectations to get out of hand may be a backlash among ordinary health service staff which engulfs both the government and union leaders in a tide of bitter recrimination.

The objective for both sides must surely be to act swiftly and decisively or face the consequences.