Opinion  

In one corner the unions are arguing for an above-inflation rise to combat plummeting morale and the impact of this year's staged pay deal. In the other, the DoH is insisting costs need to be kept down and is pushing for a rise of just 2 per cent.

In primary care, a significant proportion of nurses are not covered by the recommendations of the independent NHS Pay Review Body. For many of them, the battle raging over GP pay will be just as significant. Last week, in its evidence to the Doctors' and Dentists Pay Review Body (DDRB), the DoH said it wanted to freeze GP pay in 2008/9 for the third successive year.

The effects of this freeze are already beginning to bite - although it may not be immediately obvious. Recent official figures showing that the average GP earned more than £110,000 in 2005/6 received widespread media coverage. However, figures from medical accountants suggest that practice profits fell by 7 per cent in 2006/7, the first year of the pay freeze. Further pay freezes could see profits fall further.

Falling profits have implications for the salaries of practice staff. Even if nurses employed by the NHS receive a pay rise, there is a chance some practice nurses might be subject to pay freezes in the future as practices seek to rationalise spending and protect their income.

Practices don't have a good record on pay. The DoH's evidence to the DDRB highlighted figures showing that the estimated basic salary of a practice nurse fell by 9.6 per cent between 2004/5 and 2005/6 (from £23,355 to £21,118). During the same period practices' income across the UK increased by £400 million, according to the DoH, largely because of practice nurses' work to achieve QOF targets. These figures hardly inspire confidence that nurses employed in practices will receive a fair deal in 2008/9.

Both of the pay review bodies have yet to make their decision, but we must hope that they will take into account the evidence from all sides. Anything less than a pay rise at the rate of inflation is effectively a pay cut. The DoH cannot expect individual health professionals to bear the brunt of its attempts to cut costs. It is grossly unfair and has the potential significantly to damage the future of the nursing profession.

Emma Bower, editor, Independent Nurse

emma.bower@haymarket.com