Lives are being lost because of the central negotiation of pay rates for nurses, a study has found.

Hospitals in prosperous areas such as London and the South East find it harder to recruit and retain nurses than those in areas where local wage rates are lower. This is because regional differences in nurses’ pay are not as big as regional differences in the wider labour market.

As a result, hospitals in prosperous areas treat fewer patients and have worse results than those in poorer areas, says a team from Bristol and London in a report for the Centre for Economic Performance and the Centre for Market and Public Organisation.

A gap of 10 per cent between nurses’ pay and that of women working locally in the private sector was said to raise the death rate among people admitted to hospital after a heart attack by 5 per cent. The NHS and the Royal College of Nursing (RCN) are wedded to the idea that nurses everywhere in the UK should be paid the same. There are some regional variations, say Professor John Van Reenan, of the London School of Economics, and colleagues, but they do not fully reflect differentials in the labour market.

In inner London, for example, white-collar wages for women are 60 per cent greater than those of women in the North East. Allowances are paid to nurses who work in inner London, but they amount to only about 11 per cent more than the wages of their colleagues in the North East.

The new research by Emma Hall, Carol Propper and John Van Reenen tracked changes in wage rates and changes in performance in more than 100 English hospital trusts between 1995 and 2002.

Hospitals in areas where the outside labour market is strong treat fewer patients per staff member. They have higher death rates among patients who are admitted after heart attacks.None of these effects is found in private sector nursing homes. Nor do they seem to arise from financial problems faced by hospitals in high-cost areas.

There is a 15 per cent increase in death rates between hospitals where outside wage rates are in the top 10 per cent and those in the bottom 10 per cent. Productivity varies by 18 per cent between the top 10 per cent and the bottom 10 per cent.

The results have important implications for regulated labour markets, and the NHS, the report concludes. “Rather than focusing on across-the-board increases in national pay, which we found not to be cost effective, relaxing the regulatory system to allow local wages to reflect local market realities would improve productivity and save lives,” it says.

Peter Carter, the general secretary of the RCN, said: “In the RCN’s experience, poor hospital performance tends to be related to an absence of clinical leadership, inadequate resources and staffing levels or ineffective financial management.

“The modelling in this study can lead to simplistic conclusions on very complex issues.”

— An NHS mental health trust is advertising jobs in Polish. The Gloucestershire Partnership NHS Foundation Trust placed an advert in English and Polish in local newspapers for porters and service assistants. David McGrath, the director of corporate affairs at the trust, said: “These jobs are notoriously difficult to recruit. We are doing it in Polish is because there is a growing community of people from Eastern Europe. We are just trying to make sure people can get the message.”

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