Runaway pay

As NHS frontline workers barely eke out a living on meagre wages – a reality most recently reflected in the junior doctors dispute – NHS senior managers continue raking in increasingly larger salaries.

 
Nearly 80 per cent of top NHS bosses took home more than ÂŁ100,000 each year in 2015, with almost a quarter earning more than ÂŁ142,000, a new pay survey has revealed.

 
The study also found that there has been an uptick in the number of non-medical directors at NHS trusts earning over ÂŁ100,000, with 77 per cent earning more than ÂŁ100,000 last year.

 
Average chief executive pay in the health service substantially exceeds £100,000 – chief executives at acute NHS trusts earn on average £182,000, while top bosses at ambulance trusts, many of which fail performance targets across England, take home an average of £157,000.

 
The survey found that NHS executives were most handsomely rewarded at the largest trusts , as measured by income. For example, chief executives at University College London Hospital, Guy’s and St Thomas’ and Cambridge University all earned in excess of a quarter of a million pounds.

Big pay for short-term contracts
The survey, conducted by pay analysts E-reward.co.uk, noted that interim directors, which were not accounted for in their averages, can earn several times more than even the highest paid full-time directors.

 
It is a persistent problem that health secretary Jeremy Hunt said he would address, when he wrote to all NHS trusts in June of last year, ordering that they clamp down on runaway interim director pay.

 
But as the Daily Telegraph reported yesterday (February 2), health organisations are continuing to offer enormous pay deals for short-term contracts.

 
It was revealed that one NHS finance director, Tim Bolot, was paid ÂŁ1.5m over the 18 months that his firm, Bolt Partners, was employed for the Medway Foundation Trust from June 2014 to December 2015. The deal amounted to a pay package worth ÂŁ85,000 a month.

 
Meanwhile, the Medway trust is one that’s been described as one of the worst hospitals in the NHS – it is rated ‘inadequate’ and has been on special measures for the last three years. The trust is forecasting a year-end deficit of ÂŁ48m.

Worrying turnover rates
The survey, which examined 1,400 NHS hospital trust directors, also highlighted alarming levels of board turnover.

 
Excluding directors who had retired, the survey found that turnover rates at trusts in England, Wales and Northern Ireland all stood at 30 per cent or more, with wide variation between rates at foundation and non-foundation trusts in England.

 
Non-foundation trusts in England had turnover rates of more than 35 per cent, while foundation trust levels stood at 27 per cent.

 
These rates have increased remarkably since the introduction of the Health and Social Care Bill 2011, when substantial reorganisation of the NHS first began. In that year, English foundation and non-foundation trusts had turnover rates of 28 and 20 per cent respectively, figures thought to be very high at the time.

 
It was found that 229 NHS trusts and health boards spent ÂŁ116m in redundancy costs last year.

Growing pay disparity
Like all public sector organisations, NHS trusts are required to publish pay ratios between median full-time earnings and the highest paid director. England and Northern Ireland had the highest pay ratios, with the median being 7:1. Scotland had the lowest ratio at 6:1. There were wide variations, however – some trusts had pay ratios as high as 21:1

 
Unite national officer for health Barrie Brown criticised the growing disparity between NHS bosses’ pay and staff on the frontlines.

 
“What we have here is the Alice in Wonderland world of NHS pay when many NHS top bosses –who do not treat patients –are taking home much more than the Prime Minister’s salary of £142,500, while nurses and other health professionals on £22,000-a-year have seen their real incomes eroded by 15 per cent since 2010,” he said.

 
“Health secretary Jeremy Hunt is keen to impose contract changes on the junior doctors, but seems strangely adverse to tackling the mega pay packets of NHS chief executives,” he went on to say.

 
“Yet despite these handsome salaries, there still seems to be vacancies for the top jobs and chief executives don’t stay very long at trusts. This jobs’ merry-go-around also needs to be investigated by Hunt.”

 
“A legacy of Andrew Lansley’s disastrous tenure as health secretary has been an enormous redundancy bill as organisations such as NHS England and Public Health England expensively restructured and ‘hired-and-fired’,” Brown noted.

 
“These all leaves a very sour taste in the mouth for all of us who use the NHS and can see dedicated frontline staff with increasing workloads under intense daily pressure.”