I understand fears of regional NHS pay

I CAN fully understand why those who work in the public services might feel hard pressed at the moment.

At a time when the Government is wrestling with a massive deficit, it is inevitable that public sector pay comes under pressure, as indeed it has done, with the current pay freeze for those on other than low pay.

What's more, the reforms to public sector pensions, while necessary, are hardly likely to be popular with those who have been used to a rather better deal than their private sector counterparts.

But those in the National Health Service in the South West have an additional concern, which I also understand. They are worried about an initiative taken over recent months by health service employers in the region, the various trusts, who have come together as a consortium to look at issues of pay and conditions for their staff.

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Not unreasonably, the staff concerned interpret that as looking at the possibility of introducing regional pay, which they think will mean that those in regions such as the West Country, where the average pay is lower, will see cuts in comparison with their colleagues in the South East.

I don't believe that's the right way to proceed. But let's first put the contrary point of view. Undoubtedly, health service managers have a difficult task. Despite the fact that resources for the NHS are going up, costs and demand on the service are constantly increasing, and the plans they signed up to a few years ago mean they need to find cash savings in order to stand still. And, of course, their single biggest cost is the payroll.

Also, the concept of regional pay is not entirely unfamiliar. London weighting has been with us for some time to reflect the added costs of working in the capital. The last Labour government went further, introducing regional pay structures into the civil service for the courts service.

But at the moment we have national negotiating for pay in the NHS and there is no sign that is going to change. I have taken up the issue locally with the chief executive of the Royal United Hospital Trust, and he has given me assurances that it is not their intention to cut pay for their staff or move to local pay rates. He insists what they are looking at is whether there is scope for local flexibility in conditions or in rewarding performance, but not, even were they to be accepted by the boards, regional pay structures.

There are very strong arguments, both in terms of recruiting and retaining the best staff and simply being fair to employees carrying out the same duties in what is supposed to be a national service, to reject regional pay. It is not the policy of the coalition Government, and I do not anticipate it becoming so. Although I'll listen to the arguments, I can't foresee what would persuade me it's in the interests of the health service in the South West.