Nurses vote for 12.5 per cent rise and pay revolution

The biggest shake-up of NHS pay in more than a decade has won overwhelming support from nurses and midwives.

The Royal College of Nursing announced yesterday that 88 per cent of nurses had voted in a secret ballot to accept the Agenda for Change proposals, which will give a basic 12.5 per cent rise over three years, with more than twice that for some staff. The Royal College of Midwives also backed the reforms with 93.1 per cent of those who took part in the ballot voting in favour. Such positive votes were greeted with relief by ministers whose efforts to reform doctors' pay have been met with scepticism and disbelief by GPs and outright rejection by consultants.

In a pointed rebuff to the British Medical Association, whose leadership has been strongly criticised, the Health minister John Hutton praised the RCN and its general secretary, Beverley Malone, for the nurses' response. "It is a tribute to the leadership and courage of the Royal College that they have secured this support from their members," Mr Hutton said.

He said Agenda for Change was a "something-for-something deal based on the more you do the more you get".

The new deal covers all NHS staff except doctors and dentists and will sweep away the labyrinthine system of pay and allowances covering the 17 staff groups and replace them with a single pay ladder with eight pay bands. All staff will be subject to a job evaluation scheme which will rank them on the scale according to their skills and responsibilities.

The proposals took three years to negotiate and will give staff the opportunity to earn extra pay for taking on extra responsibilities or acquiring new skills. About 8 per cent are expected to lose pay under the deal unless they retrain.

The RCN was initially doubtful about the deal but eventually decided to back it last January and campaigned for a "yes" vote. Other unions have been more cautious, with Unison and the Transport and General Workers Union saying they will delay a ballot of members until the results of pilot schemes are known next year. Unison agreed to back the pilot schemes to be run at a dozen sites earlier this month.

The RCN said 110,000 ballot papers were returned, a 32 per cent turn-out, which was one of the highest in the college's history. Ms Malone said: "Council, activists and staff have worked very hard to deliver an informed choice to members and they have responded with a very clear message in favour of the proposals."

The decisions are the first positive result for ministers in their efforts to reform outdated working practices in the NHS and deliver the shorter waiting lists and improved quality pledged in the NHS plan.

But the support of doctors, has yet to be won. Consultants remain in a bitter dispute over their deadlocked contract negotiations after they rejected a deal worth 15 per cent over three years because of fears over excessive management control.

GPs are considering their new contract, worth an extra 33 per cent over three years, but remain sceptical because half of practices could lose under the deal. A hastily negotiated minimum practice income guarantee had to be inserted to ensure no practice lost out, but the confidence of many doctors has been damaged and a "no" vote is feared when the ballot takes place in May.