Nearly 600 senior NHS managers earn more than the prime minister, it has been revealed. Some 574 healthcare bosses had higher salaries in 2024-25 than the prime minister’s £172,153 salary entitlement. This is an increase of 12% in a single year, according to the Taxpayers’ Alliance (TPA), which published its latest NHS rich list on Sunday.
Shadow Health Secretary Criticises Large Bonuses
Shadow Health Secretary Stuart Andrew said: "Running the NHS is a demanding job and managers should be rewarded for delivering results. But paying managers large bonuses while patients receive poor care is not good value for taxpayers or fair on NHS frontline staff."
He added: "Labour is handing out bonuses while patients bear the brunt of long waits and poor performance. Funding should be focused on frontline services and better patient care, not bigger payouts for managers."
Soaring Remuneration Packages
A total of 1,758 senior managers received more than £100,000 in total remuneration in 2024-25, an increase of 3.8% from the previous year. The number of NHS senior managers receiving at least £300,000 in total remuneration more than doubled to 292 people, a rise of 134% in a single year.
The TPA said managers in hospitals with poor A&E performance and long waiting times from referral to treatment are picking up “handsome” remuneration packages at taxpayers’ expense. Some 1,603 managers had salary entitlements of at least £100,000, including 319 receiving between £200,000 and £300,000 and 17 who received over £300,000.
Call for Performance-Linked Pay
Former Health Secretary Wes Streeting announced that NHS leaders would face a new “carrot and stick” performance drive. The TPA urged the incumbent Yvette Cooper to follow through with those plans. Anne Strickland, researcher at the TPA, said: “Taxpayers will be appalled that NHS executive pay is soaring while patients are still left waiting for care.”
She added: “Andy Burnham’s new government has an early opportunity to show taxpayers that it will get a grip on this culture of rewarding failure. Ministers must keep their promise to link performance to pay, so that failing NHS bosses are held accountable and money goes into patients’ care not managers’ pockets.”
Government and NHS Responses
A Department of Health and Social Care spokesman said: “Competitive salaries and rewards enable the NHS to attract and retain the best talent available, driving up the service delivered for patients. But we have made clear that pay must be linked to performance, with a new policy that means only high-performing leaders are rewarded, while those who fail to improve services and cut waiting times no longer receive automatic pay rises.”
An NHS spokeswoman said: “The Department of Health and Social Care and NHS published a new pay framework for very senior managers last year to strengthen the link between performance and reward and support NHS organisations to secure the best leaders to improve care for patients. With the new pay framework increasing transparency and helping attract talented leaders to areas with the greatest challenges, waiting lists have been brought down to their lowest level in almost three years, a £6.6 billion NHS deficit has been eradicated and public satisfaction with the NHS has increased for the first time since 2019.”
