industrial action is inevitable if the government insists on paying the NHS pay award in stages, UNISON warned yesterday.

‘If there is no change of heart over the staging of the award, a ballot for industrial action is inevitable,’ UNISON’s Ann Mitchell, told News Line.

She was speaking in the light of revelations that last year the NHS in England ‘underspent’ half-a-billion pounds, leading to cuts in jobs and services and harming patient care.

Mitchell said: ‘The government should now look seriously at reversing the decision to stage this year’s 2.5 per cent pay award for nurses and other health workers.

‘It’s clear that the money is available and would give a very real boost to staff morale.’

She added: ‘Health workers have gone through a lot of unnecessary pain over the last year and this will have had a knock-on effect on patients and patient care.’

Figures published yesterday revealed that the harsh squeeze on spending over the winter, when many NHS Trusts closed wards, axed jobs and delayed operations, openly blaming government budget restrictions for doing so, led to a £456.8 million ‘underspend’ in England.

At least 22,300 jobs were cut, mainly through recruitment freezes, although there were at least 1,500 compulsory redundancies.

Only two regions failed to balance their books – the east of England and the south-east coast. The north-west on its own ran up a massive £161 million surplus.

There were also numerous reports of Trusts imposing ‘minimum waits’ for operations in a bid to avoid paying for treatment until the new financial year.

Royal College of Nursing Executive Director Janet Davies said: ‘At the very least the government should deliver the £60 million needed to honour this year’s pay award in full, and reinstate lost nursing posts to employ all the newly-qualified nurses without jobs.’

Meanwhile, a survey of 2,000 nurses in this week’s Nursing Times magazine found 70 per cent suffer from physical or mental health problems linked to work-related stress.

Nursing Times blamed the pressure of financial deficits and the threat of job cuts in the NHS.

The poll also found one in 10 nurses were smoking more, and almost a third reported taking off more days sick than usual.

More than one in five of those surveyed had taken 30 or more days off during the last year.

Dr Peter Carter, general secretary of the Royal College of Nursing said: ‘Nurses are under pressure, undervalued and underpaid.

‘Stress is a serious issue for nurses who run the daily gamut of violence and abuse from patients and relatives, as well as coping with the day-to-day pressures of having to do ever more with fewer resources because of deficit-led cost cutting.

‘When you add to that worries about job security and a pay cut, it comes as no surprise that stress levels are affecting nurses’ personal lives and relationships.’

An RCN poll last year found more than a quarter of nurses surveyed had been physically attacked at work, while nearly half had been bullied or harassed by a manager.

Dr Carter said: ‘We need to tackle these issues if we are to keep nurses in the profession, while at the same time attracting new recruits so they can continue to deliver high quality patient care.’