Today’s must read health policy stories and debate

Jumping through hoops

With the wind of an election victory in his sails, last June Jeremy Hunt told trust chairs they would need to get permission from the Treasury if they want to pay any new executives more than the prime minister – or £142,500 a year.

He told The Daily Mail – scourge of public sector “fat cats” – that “the NHS needs to make every penny count, so it is right to question why so many staff are paid more than the prime minister”.

Research by HSJ, published on Wednesday, has found that between June and December only 15 trusts have gone cap in hand to the Treasury, mostly for salaries for new chief executives or medical directors.

HSJ readers have been scathing in their assessment of Mr Hunt’s PM pay threshold, calling it “arbitrary” and “a red herring”, as well as observing that NHS managers don’t tend to get “a central London apartment, country house, chauffeur driven car, allowances” thrown in with their salary.

More than anything, there was appreciation below the line that “top NHS roles are hard to fill and hard to do”, so “pay properly and pay well”. One reader said: “Managers in the NHS are worth every penny, the equivalent leader in the private sector earning far more” – and with a much lower level of public and state scrutiny.

But hold on a second – the health secretary has given mixed messages over the years on how much people in top NHS jobs should be paid.

In February 2014, Mr Hunt told HSJ he had no problem with managers being paid more than the PM if they were “outstanding” candidates.

Life outside the ringfence

The government’s track record on nursing has taken another hit today as Health Education England boss Ian Cumming told HSJ the organisation would “have almost certainly” commissioned more adult nurse training places in 2016-17 were it not for George Osborne’s spending review, which imposed a flat cash settlement on HEE.

Ian Cumming told HSJ that the organisation had to balance increases in training numbers against what it could afford after the spending review meant its national workforce place had to be hastily rewritten.

Since 2013 HEE has delivered a 15 per cent increase in nurse training numbers but Mr Cumming said HEE would probably have commissioned a “couple of hundred” more nurses this year were it not for the spending review.

HEE is confident it has produced enough nurses to meet the demands of NHS providers and the government believes scrapping the NHS bursary and making nurses pay for their education will mean universities will be able to increase the numbers training in 2017 onwards.

Mr Cumming also told HSJ that retention was the biggest risk that could undermine increases in workforce supply and he also highlighted discrepancies between NHS providers predicted workforce demand to 2020 and the Five Year Forward View new care models.