The only real solution to the nursing shortage is much better pay

The government's strategy for handling the NHS pay-round came into focus with the publication of its evidence to the review bodies. Its game plan is to ease recruitment problems by raising nurses' starting salaries, aid retention by dangling 'supernurse' status in front of those at senior level and keep the rest quiet by means of more 'family-friendly' working conditions - while telling the doctors they are already well off and it's the nurses' turn this year.

The NHS's recruitment and retention problems, and the review bodies' unwillingness to compromise their independence, make for an interesting back-drop against which the Department of Health's spending plans and the government's inflation target will be thrown into stark relief.

But trying to solve the nurse shortage on the cheap simply will not work. The government's efforts to improve nurses' working conditions are to be applauded as long overdue, but the only real and immediate solution would be a hefty pay increase for all nurses. Because they are such a large group, the government could not afford that without raising taxes - an unlikely scenario.

Three options will present themselves should the review bodies make an award higher than the level of inflation. The government could stage the award again - ruled out by health secretary Frank Dobson. The Treasury could find more money - ruled out by chancellor Gordon Brown. Or the service would be left to find the money itself by cutting services and staff. Which would you bet on?