Exclusive: Number of NHS chiefs earning £250,000 or more jumps by 50pc

The number of NHS executives earning at least a quarter of a million pounds has risen by more than 50 per cent in the past year, The Telegraph can reveal, as it emerged that Sajid Javid had opened the door to a pay increase for the health service’s most senior managers in 2022.

Official figures showed that there are now 36 managers at NHS trusts and clinical commissioning groups who earn £250,000 or more, some £100,000 more than the Prime Minister’s salary, compared to 23 in 2020.

The increase was described as “unacceptable” by a senior Conservative MP who warned that the rise was “not what the public expected to be paying for” when Boris Johnson announced a National Insurance increase from April to fund a £36 billion boost for the NHS. 

The figures are also likely to infuriate medics, after unions criticised a three per cent pay rise for staff for being too little and failing to include junior doctors.

How pay has increased for NHS staff in the past year

They demonstrate a swelling of the existing ranks of top paid NHS executives even before the health service recruits 42 chief executives of new integrated care boards in England, on an average salary of £223,000.

The figures were revealed as Jeremy Hunt, the former health secretary, warned that the Conservatives will “pay a heavy price” if the 1.25 percentage point rise to National Insurance is not spent “wisely”. 

Senior Tories feared that the issue could be highly damaging at the next election if money intended to help tackle with Covid-19 backlogs appeared to have been squandered.

In a poll conducted by Redfield & Wilton Strategies, 48 per cent of people agreed that there was too much waste in NHS spending, compared to 21 per cent who disagreed. More than one in three, 34 per cent, of respondents believed that the health service will not spend the proceeds of the tax rise efficiently, although 37 per cent believed that it would.

Separately, it can be revealed that Mr Javid has written to the Senior Salaries Review Body asking for “a pay recommendation for very senior managers [VSMs] in the NHS… for 2022 to 2023”. 

The Health Secretary warned that the NHS must be able to “recruit, retain and motivate its senior workforce, as well as deliver on other key priorities, including tackling elective recovery”. He urged the body, which provides pay recommendations to ministers, to “please review” proposals being drawn up by “independent consultants at NHS England” for a “revised VSM pay framework”.

Liam Fox called the rise in the number of top paid managers ‘unacceptable’, while Jeremy Hunt urged Number 10 to show it is capable of funding the NHS and reforming it

Credit: Eddie Mulholland for The Telegraph

NHS England insisted that it was “one of the most efficient health services in the world”.

However, writing in The Telegraph, Mr Hunt urged the Government to demonstrate that it is capable of both funding the health service and reforming it.

“Money matters. But without reform it is wasted, as countless governments have found out,” he stated.

Figures provided by Edward Argar, the Health Minister, in response to a question by Liam Fox, the former defence secretary, showed that there are now 7,018 NHS managers earning between £80,000 and £129,999. They include 1,071 who earn between £130,000 and £199,999, 114 who earn between £200,000 and £249,000 and 36 who are paid £250,000 or more. 

Overall, the number of “very senior managers”, defined as executives who sit on trust boards and others who report to their chief executive, had risen from 944 in September 2009 to 2,788 last year, according to the most recent figures.

Pay revelations ‘strain credibility’

Dr Fox, a former GP, said: “No one believes that the NHS does not need good management. But it strains credibility and the patience of taxpayers that we should have this number paid at this level.

“I am sure this is not what the public expected to be paying for when a rise in National Insurance was asked of them.

“When we are asking relatively low paid people to pay more tax for the NHS, it is unacceptable to see an acceleration in the number of top paid managers.”

An NHS spokesman said: “The NHS is one of the most efficient health services in the world, with administrative costs of less than 2p in every pound of NHS funding, compared to 5p in Germany and 6p in France. Managers are essential to ensuring that the NHS has the right staff, with the right skills to deliver the improvements for patients set out in the Long Term Plan.”

The pay of board members earning more than £150,000 is signed off by Department of Health ministers. A spokesman for the department said: “We recognise that senior pay needs to be set at a level that enables the NHS to recruit, retain and motivate talented individuals to executive board level roles, while ensuring value for money for the taxpayer.”

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