A nurses' union has lashed out at a "cartel" of local health trusts for cooking up regional pay plans which could see thousands of NHS staff in south-west England working longer hours for less pay.
A leaked document obtained by the BBC has outlined the scale of possible changes in the region, which could be among the first areas to have the controversial proposals introduced.
It has been put together by a consortium of local health trusts, which the Royal College of Nursing union branded as a "cartel" and vowed to fight plans.
The document, by the newly formed South West Pay, Terms and Conditions Consortium, is marked "For discussion only, not to be forwarded."
A key objective is to reduce the pay bill from 68 per cent to 60 per cent of running costs, which the document suggests could be achieved by cutting salaries, allowances, leave entitlement, sickness benefits and making staff work longer hours.
Unions have already pledged they'll fight regional pay ideas - part of the government's latest loony plans - and the document reckons that "trusts would be obliged to dismiss and re-engage staff" to tackle union backlashes.
RCN regional secretary Sarah Zanoni said her members wanted money to be focused on patient care, but staff should also be appropriately rewarded.
"We'd rather the trusts worked in partnership with us, the trade unions, to try to work out how we can do things more efficiently.
"They don't need to go to a cartel to start reducing people's pay and their terms and conditions."
RCN said NHS staff do the same work - whether they are in Truro or Torquay - and so deserve the same rates of pay.
If regional pay was introduced it would replace the current NHS national pay bargaining model.
South West Pay, Terms and Conditions Consortium said: "This is not about reviewing pay scales based on where people live - it is about exploring more flexible ways of rewarding and incentivising staff.
"The project group will simply be considering possibilities at this stage, and will work closely with trade unions and staff representatives on any proposals that are subsequently developed."
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