Nearly 600 senior NHS managers earned more than the Prime Minister in the 2024-25 financial year, according to an analysis by the Taxpayers’ Alliance. The report found that 574 healthcare executives received base salaries exceeding the Prime Minister’s pay of £174,039, marking a 12% increase in the number of high earners from the previous year. Overall, 1,758 NHS senior managers were paid more than £100,000 in total remuneration, a rise of 3.8%, while the number of those earning at least £300,000 more than doubled to 292.

The report highlighted significant salary increases for some managers, including Ged Murphy, chief executive of East Cheshire NHS Trust, who saw his remuneration rise from approximately £172,500 to around £377,500 despite the trust’s consistently poor performance in A&E waiting times. East Cheshire NHS Trust was noted for having some of the worst emergency department wait times in England, with roughly six out of ten patients waiting more than four hours for treatment, well below the national target.

Other senior NHS figures with large pay packets included the medical director of Chesterfield Royal Hospital NHS Foundation Trust, Kevin Sargen, who earned between £540,000 and £545,000, and Dr. George Findlay, chief executive of University Hospitals Sussex NHS Foundation Trust, with a total package just under £495,000 including bonuses. NHS Lanarkshire’s medical director, Dr. Chris Deighan, also received a salary between £460,000 and £465,000, despite the trust’s poor record on A&E waiting times.

Critics argue these remuneration figures come amid ongoing challenges within the NHS, including long patient waiting lists and delays in treatment. Around 6.16 million patients across Britain remain on waiting lists, with approximately 2.5 million waiting more than 18 weeks for care. Shadow Health Secretary Stuart Andrew stated that while running the NHS is demanding and managers should be rewarded for results, it is not acceptable to pay large bonuses when patient care is suffering. He emphasized the need for funding to prioritize frontline services rather than managerial pay.

Anne Strickland, a researcher with the Taxpayers’ Alliance, urged the new Labour government led by Andy Burnham to address what she described as a "culture of rewarding failure," calling for pay to be more closely linked to performance so that underperforming managers are held accountable and resources are redirected toward patient care.

In response, the Department of Health and Social Care maintained that competitive salaries are necessary to attract and retain skilled leadership to improve NHS services. A spokesperson stated that new policies ensure pay is linked to performance, with only high-performing leaders receiving rewards while those failing to improve services or reduce waiting times will not receive automatic pay increases.

The findings come after former Health Secretary Wes Streeting introduced a “carrot and stick” approach last year, granting pay rises and bonuses for high performers and withholding increases for poor-performing trusts. Additionally, some struggling areas saw temporary pay boosts intended to attract experienced executives to challenging roles, which may partially explain the rise in some remuneration packages.

NHS England was approached for comment but did not respond. The Taxpayers’ Alliance report covers salary data from more than 200 NHS trusts across Britain but does not include NHS England itself, which is currently being phased out by the government.