As anticipated following Chancellor George Osborne’s budget, Health Secretary Andrew Lansley has now declared that ‘regional’ pay for health workers is on the agenda.

Needless to say, those in the South-East will earn more under this arrangement than colleagues further North.  This is not however ‘only’ a question of health-care inequity and the salaries of health workers.

The wider issues, such as housing, are pressing and grim.  And the political fracture points for the Conservative-LibDem coalition may soon start to reflect these tensions.

Health divide
As might be expected, protests about Lansley’s proposals are already voluble, not least from the BMA, where their consultants committee joint deputy chair Paul Flynn has said:

‘Differential regional pay rates will only add to health inequalities.
‘Most foundation trusts recognise that offering national terms and conditions helps them recruit the best candidates, and very few have chosen to exercise their freedom to offer different terms.’

And of course health inequalities will get even worse, if the competition for decent income reduces the interest in employment Up North of top researchers and clinicians – this has horrendous implications for, e.g., some medical schools and associated teaching hospitals.

But there are also other considerations, such as housing.

Housing divide
Even now, those in many professions who are fortunate enough to be able to keep accommodation which they own in the South usually keep it, when they move North for career experience.  There is already a vast divide between (a) people, often mobile professionals, who can own property in the South-East and also when their careers require it live further North, and (b) those who started in the North and can barely buy anything in the South, however much they need to get professional experience there.

Reducing incomes away from the South-East will exacerbate this divide significantly, and will have serious impacts for national and regional housing markets, with all the additional outcomes which will inevitably follow.

Regional strategy destroyed
‘Regional’ pay in the public sector is, in many ways, about the most retrogressive step which any government could impose on an inequitable and ailing economy.  Apart from other considerations, the further north, the more reliant on public sector jobs regional and local economies become.  (It’s not that there are ‘too many’ public sector jobs in the North; more that there aren’t enough private sector ones to balance the local economy.)

This proposal kicks any remaining shred of regional strategy way out of sight, and announces loud and clear that Tory ministers – Osborne, Lansley, Cameron and all – have absolutely no interest in achieving greater equity of well-being amongst UK citizens.  Some of us may already know that, but now many more will also recognise this stark truth.

Are the LibDems past caring?
The response of the Liberal Democrats to these proposals for regional pay will be interesting.

Their support has traditionally be greater in areas where pay will now be falling relative to the South-East; but can the LibDems sink any further in electoral terms?

Will Nick Clegg and the rest of his party sign up to the Osborne-Lansley axis, on the basis that electorally things can’t get any worse for the LibDems; or will there be resistance in the hope that ‘fighting back’ will bolster their future prospects with the voters?

An opportunity to arrest De-governance?
Whatever, it’s probably a vain hope that the Clegg response will be based on much more than short-term party political advantage.  He has already capitulated completely to the De-governance, anti- serious social policy, agenda of his Tory minders, and the LibDem party as a whole is it seems powerless to change this.

Perhaps though there’s a small hope that others may put this further LibDem discomfort to better use.  We need very urgently to arrest the disastrous trajectory of the ConDem mission by any means available, and this political fissure is grist to that mill.