Cuts by Brown add to crisis in NHS

GORDON BROWN is planning to put further pressure on the NHS, struggling to cope with an influenza outbreak, by demanding cuts to cover an inflation-busting pay rise for doctors and nurses.

It is feared this could exacerbate the crisis in the NHS caused by staffing shortages and the flu outbreak, which has left many hospitals overstretched. The issue surfaced because the pay-review bodies for 1 million public- sector workers are expected to report within the month to Tony Blair, and ministers are braced for recommended pay rises of over 5 per cent for nurses and doctors.

Frank Dobson, Secretary of State for Health, has told colleagues he wants to pay the nurses in full, without staging, to ease the shortage of staff. The shortages are so severe that a hospital in North Tyneside has hired a doctor from Australia and nurses from the Philippines are being recruited in London.

Mr Brown has warned the Cabinet to keep pay rises in line with the Treasury's 2.5-per-cent inflation target. Yesterday ministerial sources told The Independent that although the pay rises could be approved by the Cabinet, they are likely to be "under-funded", leaving health authorities to meet some of the extra pay bill from their own resources, further squeezing the cash for patient care.

The problem facing the Chancellor threatens to add to pressure on hospitals, where there is evidence of patients being left on trolleys as doctors try to deal with bed and staff shortages. The British Medical Association, which has been gathering evidence to present to ministers, has had reports of district nurses being moved out of family doctor surgeries to plug the gaps in hospitals, leaving GPs furious at the loss of their nursing staff.

"It's pretty awful. There is not an epidemic as such but the way that things have been managed on the ground is pretty poor. Staff are being removed from general practice to work in hospitals with scant consultation. The Midlands and Liverpool have been hit pretty badly by the flu, but it is not classified as an epidemic and we have been getting complaints about the way it has been handled. It was hardly unexpected, but we are getting some pretty awful tales," said a BMA source.

A big increase in pay for nurses and doctors is regarded by ministers as vital to ease staff shortages. Mr Dobson set a target of training an extra 6,000 nurses over the next three years, when he announced an additional pounds 21bn for the health service over the same period. He privately fears the crisis means he may fail to meet his pledge, in March, that waiting lists "will be shorter" by next April, in spite of priority given to slashing numbers waiting, including a drive to end "bed blocking" by getting the elderly out of hospital with community support.

Because of the flu outbreak more than 45,000 people had to cancel Christmas plans and take to their beds. Experts said numbers might continue to rise over the next few weeks.

Emergency services in the North West are bearing the brunt of the crisis, which has seen 999 calls double in some of the worst-hit areas. Yorkshire hospitals were reported to be close to breaking-point only two months after they received pounds 21m to ease winter pressure, prompting calls from MPs to find out how the money had been spent.

As the outbreak spread south, Mr Dobson gave details of how the pounds 250m allocated before Christmas for the winter crisis was being spent on 2,000 initiatives. They include pounds 750,000 extra for improving intensive care and high dependency care in London.