Have you noticed how trade union leaders who endlessly bang on about the NHS being a free service and how ‘people’s healthcare is so important that it should be beyond monetary consideration’ are at the same time the most vocal when it comes to obsessively demanding more money?

Peter Carter of the RCN is no exception. No sooner than he has arrived in post the RCN Bulletin read’s “We will be worse off with 1.5% rise. RCN members angry over pay proposals”. Forget a free NHS here – for the RCN it is all about money, money, money!

NFR believes the RCN and Unison should get real about nurses pay and stop trying to live in an axiomatic cloud cuckoo land. The bottom line is if you want nurses to be valued and well paid you have to stop arguing such incoherent nonsense as ‘people’s healthcare is so important it is beyond monetary consideration’. In the real world all healthcare has a monetary dimension and we should not be ashamed of this fact.

Given all healthcare is financially rooted these trade unions should start their campaigns by pointing out that if you want quality healthcare you first have to pay for it and secondly you have to have an institutional framework in place which provides the optimal incentives for the professionals involved to actually deliver.

On this latter point there are only two possibilities: (a) a state system driven by the vote motive; (b) a market system driven by the profit motive.

It is only when trade unions fully and openly understand the pros and cons of both these systems and get real about the central importance of money in all healthcare that they will do nurses and the public a favour.

NFR says stop the flannel and camouflage. The NHS is not free. No healthcare can be. All healthcare in any system is about money and nurses want to be valued appropriately.

We know that a state healthcare system is primarily driven by the vote motive. Would we and our patients not do better in a system driven by profit and surplus?