Senior NHS nurses and therapists will be able to earn more than £80,000 a year under a pay deal that was given a green light yesterday from Unison, the public service union.
Its members voted by three to one in favour of the "Agenda for Change" proposals for restructuring the salaries and conditions of more than a million NHS staff in England to establish equal pay for work of equal value.
The deal - backdated to October 1 - will increase the NHS pay bill by at least £1bn. It was intended to give the most benefit to the lowest and the highest paid.
Cleaners and staff on the bottom grade will gain £24 a week and fewer working hours after the Department of Health agreed to set a minimum wage of £5.69 an hour in the NHS. The old minimum was £4.85.
At the top end, the maximum pay of nurse and midwife consultants will rise from £49,740 to £57,539. The new top rate for the most senior nurses with clinical responsibilities will range from £66,063 to £83,546 - putting them on par with many consultant doctors.
The starting salary for newly-registered nurses will rise from £17,060 to £18,114 - almost the same as newly qualified teachers whose starting rate is £18,558.
The health minister John Hutton said: "We have broken through the glass ceilings that held professions back in the NHS. It is an important step for the NHS to give proper reward for the jobs people do, not the title they hold."
The deal should help avoid staff shortages by creating opportunities for training and promotion. This should make it possible for hospital managers to recruit healthcare assistants locally and help them qualify as nurses, instead of bringing in staff from abroad.
It is designed to break down the old demarcation lines in hospitals and reward nurses and therapists for taking on jobs previously performed by doctors.
The deal has been under negotiation for three years and has already been approved by the Royal College of Nursing. But without the support of Unison, the UK's largest union, its purpose would have been thwarted.
Its members voted by 75.2% in favour of acceptance. Dave Prentis, the general secretary, said: "Thanks to this vote the NHS is closer to the goal of achieving a modern pay and conditions system which properly recognises and rewards the skills of the workforce.
"It also means that no one will be paid less than £5.69 an hour, which is a major breakthrough for low paid NHS workers ... We will be discussing in particular how we extend the unsocial hours payments to all staff."
Alastair Henderson, the deputy director of the NHS employers' organisation, said: "The Unison result is one of the final pieces in the jigsaw after years of planning and negotiations."
Beverly Malone, the general secretary of the RCN, called the deal the biggest ever change to pay, terms and conditions for NHS staff. "The changes to the pay system will help improve services to patients by improving morale."
Last month radiographers voted to reject Agenda for Change. The Society of Radiographers, representing 16,000 staff, said it would ask members if they were prepared to take industrial action in support of their vote. They were concerned about increases in working hours without extra pay and less money for on-call duties outlined in the package.
