Agenda for Change promised - 'recognition and reward for skills and competencies', it also purports to be a system that 'should improve recruitment and retention and contribute to making the NHS a model employer. In the case of ambulance personnel it would seem the NHS has based its model on Soviet farm collective - why can't the mandarins understand that even surly teenagers working as swimming pool attendents earn £7 per hour. You can be certain that when crews are receiving plaudits after the next 'major incident', none of the media-seeking politicos would dare to mention anything about miserly pay.