Is the Minister aware that, of the 23 trusts in Wales, only six have made any offer to nurses for their annual pay award, and two of those—South Gwent community and Bridgend—offered less than the 3 per cent. that they were supposed to have offered under the pay review agreement? Is he aware that representatives of nurses and doctors feel that local pay and performance-related pay will only set trust against trust, nurse against nurse and doctor against doctor? If we are to have a national health service that takes account of the needs of recruitment, particularly in peripheral trusts in Wales, do we not need a national health service with a national pay policy?
I do not agree that local determination of pay will set trust against trust or nurse against nurse. It will give local trusts the opportunity to be flexible and to reward staff according to local needs and local pay provision. Six trusts have already declared what they intend to do about nurses' pay and I hope that the other trusts in Wales will soon come up with their own proposals for their staff.
Will the Minister confirm that, under the local pay arrangements about which he is so keen, there will be yet another expensive tier of management, and that even more funds will be diverted from essential nursing services to inessential management activities? Does he realise that, in many cases, the bureaucrats are considering tying the nurses' 3 per cent. pay award to their acceptance of contracts with the trusts? For example, in one Welsh trust, nurses are being asked to forgo premium payments for night and weekend work, while in another trust sick pay and overtime have been targeted. Is it any surprise that the Government are neither believed nor trusted when they say that they believe in a truly national health service?
Local trusts will discuss the matter with local employees and decide what their remuneration will be. Unlike the Labour party, we do not believe in interfering at a local level. We believe in devolution of the right kind.
I remind the hon. Gentleman that, since 1979, nurses' pay has increased in real terms by 53 per cent., after allowing for inflation. When the Labour party was in government from 1974 to 1979, nurses' pay fell by 3 per cent. in real terms, after allowing for inflation.