By Chris Hogg BBC Health Correspondent

The deal would set porters' pay

'Nothing much has changed'.

Not much of a headline that.

But in this instance it is the best I can do.

Although Britain's biggest health union has agreed not to reject the new NHS pay system 'Agenda for Change' it hasn't really backed it either.

So, as I say, nothing much has changed. The 'Special Conference' Unison called to debate this issue has ended up fudging it.

Those who tried to persuade the conference to reject Agenda for Change spoke with passion and were rewarded by much more applause than those backing the leadership

They have agreed to hold a postal ballot, next month, in which members will be asked to sanction the new pay system's roll-out in 12 pilot sites or 'early implementers'.

It will then be another year before members will be asked to vote on whether it should be imposed across the NHS.

It also sounds rather dry I know. Believe me after 48 hours here in Harrogate I could go on and on about this procedural wrangling the union's Health Service Group Executive had to go through to get this passed by their delegates.

But I won't.

What is more interesting is why it came to this - activists actively trying to sink proposals their union had spent more than four years negotiating with the government.

Passionate debate

Those who tried to persuade the conference to reject Agenda for Change spoke with passion and were rewarded by much more applause than those backing the leadership.

At the heart of their objections was the perception that the 17 staff-side organisations who negotiated with the Department of Health - including Unison and the Royal College of Nursing - have sold out the lowest paid workers in the NHS.

Many thousands of the lowest paid staff in the health service will either have to work longer hours or see their hourly rate reduced

They do not believe it is acceptable for trade unions to admit that 8% of NHS staff will be worse off under this deal.

Before the Department of Health head off into a tailspin I should point out that in the short term there will be a financial cushioning for existing staff to try to ensure no-one loses out.

Many of the lowest paid staff in the NHS will see their hourly rate increase and their hours reduced.

Yet activist after activist stepped up to the podium to claim that they had done the sums and they or their colleagues would lose out.

For the activists who oppose Agenda for Change, it is inconceivable that a union can accept a deal which they say will end up in pay cuts for their members.

Agenda for Change ties NHS staff into a three year pay increase worth just over 3% a year on average.

With inflation rising to around 3% and the impact this month of the increase in national insurance of 1% they say that wage packets will shrink.

In any case, they argue, if you accept the figure of 8% 'losing out' that equates to around 80, 000 NHS workers.

As one delegate pointed out, many unions do not have that many members, yet Unison and the other staff organisations and unions are proposing to sell these people down the river.

No enthusiasm

On the other side of the argument delegates were not enthusiastic supporters of Agenda for Change.

They feel the government has handled it badly.

In their eyes the negotiations were ended abruptly at the end of last year by ministers impatient to begin the modernisation process and with an eye to winning over public opinion in the fire-fighters dispute.

Modernisation in the NHS but not in the fire service was a great slogan.

Now UNISON characterises a deal its negotiators were happy to launch alongside ministers as a 'take it or leave it' package which was thrust upon them.

They complain that there has not been enough detail released, that the process towards setting up the early implementers is being rushed, and that as a result it is difficult for members to judge whether or not it is a good deal for them.

So they have not recommended the deal to their members.

But they knew they could not afford for it to be thrown out either.

The speakers who defended the rather messy compromise UNISON has come up with reminded their fellow delegates how long they have waited for this new pay system.

The complex system in place at present is unsustainable they argued.

The reality too is that they are only too well aware that they are likely to be unable to wring more concessions out of the government.

One activist told the conference she could see from the look of the Prime Minister that he was under pressure due to war and economic difficulties.

"We should put him under more pressure," she said.

But conference disagreed with her, or at least it voted to give the government a bit more breathing space rather than a bloody nose.

Left behind

For the truth is that despite the fact that Unison has more members, if all or, at least most, of the other unions back Agenda for Change, there's a risk that it may get left behind.

Once staff in the pilot sites are put on the new scales and the changeover of IT systems, job descriptions, pay arrangements and rotas is put in place, is it likely to be dismantled again 12 months later?

What is more likely surely is that any problems which occur will be gradually ironed out, but some of the fundamental issues that many of Unison's activists have real concerns about will remain.

Department of Health officials believe a flexible workforce working in new ways to maximise efficiency is vital if Alan Milburn is to persuade people the extra money being spent in the NHS is producing results.

If Unison had derailed Agenda for Change that drive for modernisation would have been put in doubt.

It wasn't .. it is still there on the tracks. But the complaints from those delegates bitterly opposed to the new pay system should be a warning sign for the ministers.

Proceed with caution on this issue, because there are many within the NHS who believe they are being taken for a ride.