THE four per cent pay rise recommended for nurses may be an inflation-busting increase, but it seems unlikely that it will cure their blues - or the trickle-down bad effect on patient care.

For a survey by the Royal College of Nursing reveals that in East Lancashire and other parts of the country the lot of members of the profession is crippling workloads, long stretches of unpaid overtime and a steady drain in numbers.

In short, there is a shortage of nurses.

That means bigger burdens for those on the wards - when, already, nurses are responsible for 80 per cent of hands-on care in the health service.

And, for patients, thin levels of nursing cover are reflected in early hospital discharges and cancelled operations.

All of this suggests that vital, front-line care is suffering as a result of short-term thinking in the past and the impact of changing treatment methods.

Thousands of nursing jobs have gone with the widespread cuts in beds caused by patients needing to spend less time in hospital. But is it not the case that some of the reductions in staffing levels have also been caused, not by a reduced need for nurses, but by what the hospital authorities have been able to afford - particularly when, in the past, the government's failure to fully fund nurses' pay increases has put pressure on local budgets?

Do we not also recall such financial restraints being responsible for beds being taken out of use in East Lancashire, not for lack of patients, but because of freezes on nursing vacancies?

And have we not seen the sad spectacle of student nurses heading for the dole once they had qualified?

Now, evidently, the screw has been tightened too far.

There are too few nurses and too many unfilled vacancies.

And too few are being trained.

Yet it seems that more of the bad old medicine might have to be swallowed by the profession as unfilled posts could stay empty for lack of cash.

For Chancellor Kenneth Clarke is warning that the government will not provide the health trusts with extra cash to pay for the nurses' latest pay rise. It is little wonder that the increasingly hard-pressed nurses in the front-line are suffering a huge slump in morale and many are quitting - particularly against the background of a boom in NHS management jobs and, as we learn today, while the pay of trust bosses has risen twice as fast as theirs.

The time has come for staffing at the front-line to be reviewed and for proper resources to be provided - not robbed from elsewhere in health care funding - in order that they are tilted back quickly to the right levels, for the sake of both nurses and patients.

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