In 1982, almost at the outset of his tenure he began negotiations with the UK government over a labour disagreement concerning nurses' salaries, then at yearly levels of no more than £5,833.
As a result, a "Pay Review Body" characterized by autonomous operation was created; the compensation of the nurses he represented was also increased.
With a membership in excess of 285,000 at the time of Clay's pensioning off due to illness in September 1989, no labour organisation unaffiliated with the Trades Union Congress surpassed the RCN in size, and none had a greater rate of expansion.
The occasion was marked with a reception in the Banqueting Hall, Whitehall[2] which was attended by, amongst others, Kenneth Clarke, secretary of state for health, and Princess Margaret.
[7] In retirement he was active as vice president of the International Council of Nurses and in founding a Breathe Easy Society, with the British Lung Foundation.