Practice managers are steadying themselves for difficulties after Health Secretary Alan Johnson reiterated his stance on the NHS pay award.
NHS workers in England, including nurses, midwives, admin staff, cleaners, and pharmacists, have been offered a staggered 2.5% rise.
But The Royal College of Midwives (RCM) is currently balloting 23,000 members on industrial action, and The Royal College of Nursing (RCN) is carrying out an indicative ballot of its 200,000 members.
They are angry that staff in Scotland, Wales and Northern Ireland will receive the wage hike in one go.
And they claim the government's plan to offer the increase in stages has reduced its value to 1.9%.
But Mr Johnson told MPs at the Commons Health Select Committee there will be no movement over the arrangements for healthcare professionals in England.
He admitted the staggered award is never going to get a "round of applause", but claimed the decision "is not going to change".
He also said he believes the pay award is right, adding that it was a Cabinet decision to limit the rise.
Mr Johnson revealed he understands how nurses feel and hopes more discussions can be held, but added: "You won't win an argument with public sector workers on this".
<http://www.dh.gov.uk/en/index.htm> Department of Health
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