Temporary NHS managers brought in by failing health services are being paid record rates of up to £400,000 a year.
Ministers have repeatedly ordered clampdowns on “excessive and indefensible” management pay and promised extra scrutiny of deals which pay more than the £142,500 salary of the Prime Minister.
But a Telegraph investigation of 32 clinical commissioning groups (CCGs) failing so badly that they have been taken over by NHS England shows that in fact rates have reached a record high.
Nurse leaders last night said executive pay was “spiralling out of control” amid warnings that “sky-high” remuneration packages were not being matched by improvements to frontline services.
Executive pay appears to be spiralling out of control
Janet Davies, Royal College of Nursing
Health services insisted they were forced to pay “premium" rates to attract good managers quickly.
The figures, from NHS annual reports for 2016/17, disclose 21 managers at the struggling organisations on rates equal to at least £200,000 a year - including five on more than £300,000.
Among the organisations which hired them, just three are no longer deemed to be failing.
The highest rates were paid by Enfield CCG, who hired Mike Seitz as “director of recovery” on rates of £34,000 a month. The sum paid for five months’ work is equivalent to an annual salary of £408,000.
At North, East and West Devon Martin Shield cost over £90,000 for three months – an annual rate of £375,000 - as “turnaround director.”
At Surrey Downs CCG, Antony Collins was on rates of £30,000 a month as “turnaround director” for three months - equal to an annual rate of £360,000.
In Enfield, Mr Seitz was director of recovery for five months, ending last September. He was replaced by another interim boss, Mark Eaton, whose annual rates were £214,000.
It came as the organisation drew up plans for swingeing cuts, including refusing to fund hearing aids for all but the most extreme cases. The same organisation paid a third interim manager rates of £2,000 a day for 23 days work.
Janet Davies, chief executive of the Royal College of Nursing said nurses would find the disclosures “galling”.
“Despite all the rhetoric from Government, executive pay appears to be spiralling out of control at the very moment that nurses’ pay is cut year-on-year in real terms. Morale is already low and the widening gap helps to push it towards collapse,” she said.
NHS bodies have to secure approval from central authorities if they pay managers rates of more than £600 a day. They are also discouraged from allowing such appointments to carry on beyond six months.
But some of those on rates of more than £200,000 a year remained in post for 11 months, the reports show. And in several cases, NHS England was closely involved in the decision to appoint a highly paid interim, with a representative sitting on the interview panel.
The 32 CCGs were all put under the legal direction of NHS England during 2016/17 because their financial problems or quality of local services are so poor that they are deemed to be failing or at risk of failing to perform their basic functions.
The central authority agreed the high pay rates, despite the fact the NHS’ own guidance suggests maximum rates of £130,000 for those leading CCGs.
This appointment was made at extremely short notice and for a time-limited period. As a result it attracted a premium which would not apply to an annual salary
It comes as NHS battles the worst financial crisis in its history. Services across the country are drawing up plans to make £22bn savings, while waiting lists for routine operations like hip and knee surgery have reached a 10 year high.
John O'Connell, Chief Executive of the TaxPayers' Alliance said: "We have been repeatedly assured that sky-high remuneration packages are justified because they attract the right people to the job who yield results. But too often taxpayers are left out of pocket without anything to show for it, which seems to be exactly what has happened in this case.”
Until now, the previous record for interim pay at CCGs was an annual rate of £390,000 paid to Mr Collins the year before.
The CCGs said they had been required by NHS England to put recovery directors in place, with appointments used as a short-term measure when particular expertise was needed to deliver savings and improvements in care. Some of the payments include fees to agencies and VAT.
North, East and West Devon CCG, Surrey Downs CCG and North Hampshire CCG have now been taken out of directions.
Shropshire CCG said it was misleading to calculate an annual rate based on rates for shorter periods. It said its appointment was paid at a “premium rate” because it was time-limited and made at “extremely short notice”.
A spokesman for NHS England said overall spending on temporary staff had fallen.
He said: “Since 1st August 2016 all local health organisations whether under legal directions or not have been operating under new guidance setting out clear, tough controls on the use of interim staff. However there are occasions when it’s necessary for such steps to be taken in order for the CCGs to be able to turn around their financial performance.”
Rich pickings: the five highest rates paid at failing CCGs
Mike Seitz, director of recovery at Enfield CCG - £175,000 for five months - annual rate £408,000
Martin Shield, turnaround director North, East and West Devon CCG - more than £90,000 for three months - annual rate £375,000
Antony Collins, director of turnaround Surrey Downs CCG - £90,000 for three months - annual rate £360,000.
Paul Sly, accountable officer North Hampshire CCG - £310,000 plus £30,000 expenses for 11 months. Annual rate £338,000 plus expenses
Deborah Hayman, Shropshire CCG’s chief finance officer, £50,000 for two months - annual rate £300,000.