Inflated NHS Salaries

The Mail on Sunday had an interesting story last week - about the enormous salaries that are paid to senior staff in parts of the National Health Service (NHS).

Apparently the highest paid NHS employee is the medical director of Ayrshire and Arran health board - who enjoys a salary of £245,000 a year - would you believe.

Whether this huge sum includes pension contributions is unclear - but it's difficult to see how any job in Scotland's public sector is worth such a large amount of money.

The reason why such high salaries exist is that many hospital consultants and GPs are very well paid these days - but the way in which the NHS is managed encourages these costs to spiral  out of control.

As soon as one medical person is put in charge of a wider group of medical staff - their salary is bumped up to reflect additional managerial responsibilites.

Yet the skills required in the job are those of a good manager and efficient administrator - not the skills of a medical person - nonetheless the direct manager of medical staff in the NHS must be much more highly paid that the staff they manage.

So senior doctors and other groups believe they should be managed by members of their own profession - which encourages elaborate and expensive arrangements right across the board.

To the outside world the NHS might be a great leveller in terms of access to care and health services - yet internally it's a basket case of status driven rules and vested interests. 

The end result is a bureaucracy gone mad - and management arrangements which send the public paybill through the roof.   

In Scotland there are now more than 3,000 NHS staff earning over £100,000 a year - which  amounts to an annual  bill in excess of £300 million. 

The Mail on Sunday highlighted the case of a Dr Frances Elliot - chief executive of Health Improvement Scotland (HIS) - earning a salary of £152,187 a year.

Again the paper failed to say whether this figure included pension payments - but I suspect not.

Previously Dr Elliott was head of another part of the NHS - Quality Improvement Scotland - on a lower salary of £135,000 - until this organisation merged into HIS.

But  the point is that the good doctor is not using her medical skills in HIS - she is acting as a senior manager and chief executive.

So why is she paid an inflated salary of £152,187 a year - when HIS has a staff of 290 employees and a annual budget of £19 million? 

Because this NHS salary (which may be understated at £152,187) is on a par with the chief executive of Glasgow City Council - which has an budget of £2 billion a year and employs  30,000 staff.

In other words GCC is roughly 100 times the size of HIS - and while there are no big  bonuses involved - it's still a scandalous way to use public money.