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Abolish the NHS: Bloated, Broken, and Run by Overpaid Bureaucrats

The NHS is a Bureaucrat's Paradise, and it's time they were all put on the dole queue.


The NHS needs to be abolished. A relic of the Cold War, it’s bloated with idiots and parasites—many of them raking in over £100K for invented roles requiring no real skill. Senior managers? Most wouldn’t last five minutes in the private sector, where results actually matter.


Hundreds of these NHS bosses are pocketing salaries higher than the Prime Minister's, a report reveals today. Despite failing to bring down waiting lists, nearly 1,700 fat-cat bureaucrats at NHS trusts were each handed more than £100,000 a year.


With record sums already being poured in by taxpayers, the first-ever NHS Rich List found that 512 managers banked salaries higher than Sir Keir Starmer (£172,153).  Nearly 300 received packages of £200,000 or more.


East Cheshire NHS Trust paid eight managers £100,000 or more despite being the worst-performing trust in percentage terms for seeing A&E patients within four hours. 

It saw just 50.6 per cent within the target time, well below the 78 per cent expected.

Among the managers was the trust's 'director of people and culture' and deputy CEO Rachael Charlton, who raked in a package of £367,500.


Cambridgeshire and Peterborough NHS Foundation Trust also gave eight bosses £100,000 or more despite having the worst referral-to-treatment median waiting times. Chief medical director Catherine Walsh banked £387,500 in pay and perks.


The figures, covering more than 200 trusts for the 2023-24 financial year, will anger the millions of patients stuck on waiting lists. Around 6.25 million patients, relating to 7.42 million cases, are languishing on them, with nearly 3 million waiting for more than 18 weeks.


The study by the TaxPayers' Alliance will also fuel suspicions that much of the money lavished on the health service is not making it to the front line and is instead helping to fund 'non-jobs' such as diversity roles.


Referring to Labour's plan to hand 10 per cent bonuses to NHS bosses whose trusts perform well, Tory health spokesman Edward Argar said: 'The Labour Government plans to hand generous bonuses to NHS managers for simply doing what they are already paid to do as part of their jobs.


'Patients will rightly be shocked, and asking why Labour aren't focusing instead on making sure those who are already very well paid are delivering the results taxpayers have a right to expect. Diverting public funds into executive bonus schemes, instead of investing that money in frontline care for patients, is simply wrong.' 


Shimeon Lee, who compiled the report, said: 'Taxpayers will be appalled that while NHS patients face prolonged waiting lists and dismal A&E performance, hundreds of senior managers are pocketing six-figure pay packets.


'This rich list shows that there are sky-high salaries for senior bureaucrats... that are impossible to justify. 'If ministers are serious about getting the NHS back on track, they need to ensure that managers of poor-performing trusts aren't being rewarded for failure.'


TaxPayers' Alliance Report Summary:

NHS spending is set to reach £215.6 billion in 2025-26, rising 3.2 per cent per year in real terms from 2023-24. Even after accounting for changes in population size and age, NHS spending will be 24.5 per cent higher than it was in 2013-14. Yet despite having significantly more resources available, outcomes have continued to deteriorate. Waiting times for hospital procedures have risen, with the number waiting for more than a year rising by 15 times compared to 2010. A&E performance has also declined sharply, with the number waiting more than four hours increasing sixfold to 40 per cent.


Responsibility for this decline has been placed squarely at the feet of NHS senior management, with health secretary Wes Streeting declaring that “poor performance is too often tolerated in the NHS” and warning that there will be financial implications for senior managers if trusts do not improve. His comments came even as senior managers received an above inflation five per cent pay rise in 2024.


This note examines the remuneration of senior managers across NHS trusts in 2023-24 and compares it with their trust’s performance on A&E and referral to treatment (RTT) waiting times for January 2025.


Key findings

  • In 2023-24, there were 1,694 senior managers receiving over £100,000 in total remuneration (comprising salary, expenses, benefits, bonuses and pension benefits) across 224 NHS trusts.[5]

  • Of these, 1,557 had a salary over £100,000,[6] comprising:

    • 17 who had salaries over £300,000

    • 279 who had salaries between £200,000 and £300,000

    • 1,261 who had salaries between £100,000 and £200,000

  • 512 senior managers had a salary greater than the prime minister’s £172,153.


In January, it emerged that the NHS was hiring diversity staff at a rate of one a week despite orders to cut back on the initiatives.


A recent poll found that nearly two-thirds of voters back the idea of a new US-style 'Department of Government Efficiency' to slash billions of pounds of wasteful spending on bureaucracy and 'non-jobs' such as diversity and inclusion officers.

The TaxPayers' Alliance study related to managerial roles at NHS trusts and not NHS England, the quango which runs the health service but which is being scrapped by the Government.


A Department of Health spokesman said: 'This Government is introducing tough new measures in relation to senior managers' pay, to drive progress on cutting waiting lists.

'The NHS should pay to attract top talent, but there can be no more rewards to failure.'

Andrew Fenton

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