NHS pay proposal criticised by health unions
The NHS's £109bn budget is under severe pressure
Unions have criticised proposals to halt an increase in NHS pay in England.
Rises across the public sector have been capped at 1%, but the Department of Health wants to withhold this increase for its 1.3m staff.
It told the NHS pay review body the rise was not affordable alongside the current system of small, automatic annual rises.
Rachael Maskell of the Unite trade union said staff deserved the pay reward for "holding the NHS together".
Health trusts are currently under pressure to make savings and the NHS wage bill accounts for around 40% of its budget.
The Department of Health (DoH) proposes using the funding intended for the 1% rise to "modernise" pay structures.
It says these increments - linked to length of service and satisfactory performance - add £700m to salary costs.
But the DoH has stressed no decisions on changes to pay have been taken, insisting independent bodies will make their recommendations next year.
The plans, which were outlined in the DoH's submission to two independent pay review bodies, have been criticised by Unite.
Ms Maskell said: "The Department of Health have got other choices. They're entering into a re-organisation which is costing £3bn, which nobody asked for and isn't adding anything to patient care.
"It is about choices and the NHS staff have already had two years of a pay freeze - 1% last year - and, quite frankly, are really falling behind inflation now with their wages."
Ms Maskell told BBC Radio 4's Today programme that motivation and morale was down among frontline health workers.
"The reality is that staff do deserve this pay reward because they're holding the NHS together at this very difficult time," she said.
However, in its submission to the NHS pay review body, the DoH points to a staff survey suggesting high levels of motivation and morale.
"The government's view, therefore, remains that basic pay increases should only be implemented if there is strong evidence that recruitment, retention, morale or motivation issues require this," the department says in its written submission.
'Inflammatory' plan
The department wants the pay review bodies - which are due to make a recommendation on pay in February or March - to defer the planned 1% pay rise until it has negotiated a move to seven-day working with unions.
But staff representatives have reacted angrily to the plans.
"What they have done is inflammatory," said Christina McAnea, head of health at Unison and joint chair of the NHS Staff Council.
"They must have known how unions would react. We are not going to negotiate while a gun is held to our head for a paltry 1% pay rise - our members will not react well to that."
Dr Mark Porter, chairman of the BMA Council added: "We recognise fully the economic constraints the NHS is working under but the continued erosion in the real value of contracts for doctors has now reached a critical point."
And he told the Guardian newspaper that it was "insulting at best" for the government to "imply that unless NHS staff endure what is effectively another year of pay cuts they will put patient safety at risk".
'Affordable' service
However, a DoH spokeswoman stressed that the proposals would "help protect jobs and improve care".
She said: "Many NHS staff have continued to receive pay rises of up to 6% and we want to keep working with the trade unions and employers on affordable pay.
"The measures we are proposing will help increase quality for patients and help us realise our vision of an affordable seven-day service."
Setting out the government's spending plans in June, Chancellor George Osborne said ministers were working to "remove automatic pay rises" for teachers, health professionals, prison and police staff.
The department drew attention to Mr Osborne's comments and confirmed it wanted NHS pay to have "stronger links to performance, quality and productivity".
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