Managers at Oxfordshire's major hospitals must wonder whether they can ever win.
Against the odds, they have made progress recently in filling some of the many nursing vacancies in the county.
Now a new threat emerges. The latest pay deal will allow nurses in central London to earn bonuses of up to £5,000 a year.
There are fears that some of our nurses could be tempted to the capital by the higher salaries.
It must be a real possibility.
The high cost of living here is the main reason why the recruitment and retention of nursing staff - and other professionals like teachers and the police - has been so difficult.
Some will feel no allegiance to Oxfordshire to stay. Others could buy a £900 annual bus pass, benefit from higher pay in London and still enjoy the delights of living in Oxfordshire.
It is always difficult to know where to draw the boundary when wage levels are set on a regional basis. But Oxfordshire is clearly too close to London to have wide variations.
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