The comprehensive management guidance which has been issued to health authorities makes it clear that, where this is possible, posts should be graded on the basis of existing duties and responsibilities.
The Minister gave a commitment to fund the award fully, but there are disturbing stories that, because of the cash limits placed on health authorities, managers are trying to squeeze the award down to the money available. Does the right hon. Gentleman agree that that would be a shortsighted policy, which could only cause problems in future years and lead to a sense of betrayal among nurses?
The Government have made the funds available to the health authorities to meet the costs of the award on the best available estimates. We have issued guidance to assist that process. I have every intention of ensuring that it is carried out in good faith.
I welcome my right hon. Friend's statement and efforts on nurses' pay, but what fills many of us in the Conservative party with dread and foreboding is allowing regions to dole out the money to the districts, particularly regions such as North East Thames, which do not seem to have the management expertise to do so efficiently or properly.
I note my hon. Friend's views on the North East Thames regional health authority, which I share with him, but the sensible way to proceed is in the normal way that we seek to allocate funds in the Health Service.
Is it not now clear that the sum that the Government have set aside will not fund fully the nurses' pay award? The Government must give an unequivocal commitment to fund in full the results of the clinical grading review, otherwise managers will have to choose between downgrading nurses to meet the cash limits and cutting services to meet the pay award. Which is it to be?