The salaries of foundation trust chief executives bear little relation to the performance of their organisations, a pay analysis has revealed.
A report by management consultants Aquarius shows that bosses at trusts scoring excellent for quality of services in the annual health check were, on average, paid less than those rated only good.
In 2007-08, the average chief executive at an excellent trust was on£160,000 a year, compared with£165,250 for good trusts,£150,000 for fair trusts and£142,500 for those classed as weak.
The report concludes: "Performance does not appear to be an important factor in determining chief executive remuneration."
Total remuneration for chief executives was, on average, lowest in the South East -£132,600 compared with£177,500 in the West Midlands, which was the highest paid region. There was a close link between pay, trust income and staffing numbers.
Overall, foundation trust chief executive pay rose by 13 per cent last year and ranged from£87,500-£232,500. Less than one third of chief executives received benefits in kind, and the average payment was£7,000.
The leap in pay was less for board directors. Finance directors' salaries went up by 9 per cent, followed by medical directors and nursing directors, whose pay rose by 6 per cent.
Human resources directors were among the lowest paid executive roles, with an average 1 per cent uplift. Nursing directors and HR directors in foundation trusts are paid a slightly smaller proportion of their chief executive's salary than their counterparts in primary care trusts. The report says: "This may be a reflection of the increased responsibilities of chief executives and finance directors in foundation trusts."
However, medical directors were paid on average 10 per cent more than chief executives.
The highest earners were at Newcastle upon Tyne Hospitals, University College London Hospitals, Guy's and St Thomas', Gateshead Health, Luton and Dunstable Hospital and Bradford Teaching Hospitals foundation trusts.
Medical directors at these trusts all received combined executive and medical specialist pay in excess of£200,000.
The highest paid chair was at Guy's and St Thomas' and received£60,000, the upper limit proposed by the Foundation Trust Network in 2005. But some trusts paid chairs well below the proposed lower limit of£35,000. The lowest paid chair was at Tavistock and Portman, earning£17,500.
Total remuneration for non-executive directors ranged from£5,000-£20,000.
A Foundation Trust Network spokeswoman said the proposed pay limits, set when foundation trusts were being established, were less relevant now. She said: "The salary of a foundation trust chair is a matter for a foundation trust's board of governors, who are be accountable to local people through the membership."