The must-read stories and debate in health policy and leadership.
Comparing chief executives’ pay has never been harder. Rapid turnover of those in the top job, chief executives taking on additional trusts and the growth of pay in lieu of pension contributions has made it harder than ever to see who tops the charts.
HSJ has had a stab at it – doubtless, some would rather we hadn’t – and has tried to use a fair methodology to compare what CEOs are getting. It’s inevitably imperfect but some things shine out.
- Many more chief executives are getting additions to their salary rather than NHS pension contributions because they have hit the lifetime allowance – but it is not something available to lower paid staff who opt out of the pension.
- Some CEOs got substantial pay rises for a variety of reasons. Many seem wholly justified but it may not be a good look in a year where many staff have struggled with the cost of living.
- More CEOs are being paid £300,000 or very close to it. That’s sometimes mentioned as an invisible ceiling to pay but now seems to have been breached.
- Overall, the presentation of executive pay in annual reports is a mess and hinders comparisons. The DHSC should enforce uniformity.
Marginal decisions
Questions still remain over how the 40 “new hospitals” being built in a major infrastructure programme were chosen.
Concerns were raised over the selection process in a report by the government spending watchdog last year.
A shortlist was firstly drawn up from a list of NHS-proposed options. However, this was subject to chopping and changing for the final version.
National Audit Office concerns were over a gap in record keeping to explain these later decisions.
A general election was looming when the Health Infrastructure Plan, now the New Hospital Programme, was first announced in 2019. And the 40 “new hospital” projects quickly became a key pledge in Boris Johnson’s campaign.
HSJ has obtained the names of the chosen schemes that were not shortlisted for the programme and analysed MPs involved in their areas.
These were twice as likely to impact marginal seats contested by the Conservatives in 2019 than those shortlisted schemes removed from the programme.
All involved are in need of redevelopment and proposed as options by NHS. Imperial, for one, has a huge maintenance backlog, and West Suffolk and James Paget have reinforced autoclaved aerated concrete.
But for those who missed out, the quest continues for a new hospital. Just ask Doncaster, who are still grappling with major estates issues to this day.
Also on hsj.co.uk today
Narinder Kapur makes the case for dedicated corporate psychologists to be assigned to major hospital trusts, and we report that a trust grappling with an “inadequate” rating at its high-profile high secure hospital has begun a major management restructure expected to include redundancies.
