Nearly 600 senior managers within the National Health Service (NHS) are earning base salaries that surpass the Prime Minister's remuneration, according to a new report from the TaxPayers' Alliance. The study found that 574 NHS trust bureaucrats banked salaries higher than the Prime Minister's £182,000 entitlement, marking a 12% increase from the previous year.
Furthermore, 1,758 senior managers received total compensation in the six figures, a 4% rise. The number of executives earning at least £300,000 more than doubled, increasing by 134% to 292 individuals.
These figures emerge at a time when NHS waiting lists have seen minimal reduction. The findings have prompted renewed calls for greater accountability in NHS executive pay, with a focus on ensuring funds are directed towards frontline patient care rather than administrative compensation.
Yvette Cooper, the newly appointed Health Secretary, has faced pressure to ensure that spending is prioritized for patient services. Stuart Andrew, the Conservative shadow health secretary, stated that while managers should be rewarded for performance, substantial payments to managers while patients experience poor care represent poor value for taxpayers and are unfair to frontline staff. He argued that Labour should focus funding on essential services instead of increased managerial payouts.
Dr. George Findlay, chief executive of University Hospitals Sussex NHS Foundation Trust, received a total package valued between £490,000 and £495,000, including a bonus of £30,000 to £35,000. This trust was noted as being near the bottom of official performance rankings.
Another example cited is Ged Murphy, the departing boss of East Cheshire NHS Trust, whose total remuneration increased from a range of £170,000-£175,000 to between £375,000 and £380,000. This occurred despite the trust being the worst-performing for A&E waiting times in the previous month, with less than half of patients being seen within the four-hour target, significantly below the national average of approximately 75%.
Chesterfield Royal Hospital NHS Foundation Trust, also identified for poor A&E and referral waiting times, saw its medical director, Kevin Sargen, receive between £540,000 and £545,000 in total remuneration.
Dr. Chris Deighan, medical director of NHS Lanarkshire, which has consistently ranked last for A&E waiting times in Scotland, earned between £460,000 and £465,000.
Other high earners include Ajit Abraham, group director of inclusion and equity at Barts Health NHS Trust, with a salary exceeding £200,000, and Shane Gordon, director of strategy for East Suffolk and North Essex NHS Foundation Trust, receiving between £250,000 and £255,000.
The report, which covers the 2024-25 financial year, highlights the situation for millions of patients experiencing long waits. Approximately 6.16 million patients, relating to 7.28 million cases, are currently on waiting lists, with 2.5 million waiting over 18 weeks and around 105,000 waiting more than a year.
Former health secretary Wes Streeting had previously announced new rules in November 2024 to link senior NHS managers' pay to performance. These rules allow high-performing leaders to receive bonuses of up to 10%, while those failing to meet targets may face docked pay rises. Temporary increases of up to 15% were also permitted in underperforming areas to attract top talent, which may contribute to some of the remuneration increases noted in the report.
A spokesperson for the Department of Health stated that competitive salaries are necessary to attract and retain talent, thereby improving patient services. However, they reiterated that pay must be linked to performance, ensuring only high-performing leaders are rewarded and those who fail to improve services or reduce waiting times will not receive automatic pay increases.
