Members of one of England's smallest primary care groups are protesting that they have been unable to appoint a chief executive because the health authority is insisting on a salary of just £26,000.
Dr Charles West, chair of South-West Shropshire PCG, believes that two out of four short listed candidates failed to turn up for interview when they learned of the salary figure.
He said the failure to appoint a chief executive was 'no surprise' and described the proposed earnings as 'unacceptable'.
Department of Health guidance last October said there should be salaries 'at the lower end' of range 3 or at range 4' -£26,000 to£34,000 - for chief executives of 'significantly smaller' PCGs.
But Dr West insists that the PCG, which covers 46,000 patients and is due to operate at level one, the lowest outlined in The New NHS white paper, needs 'a good chief executive at a reasonable salary'. Between£30,000 and£40,000 'feels right', he added.
Shropshire HA chief executive Colin Hayton said the salary had been set after a study comparing the post with HA jobs.
But Dr West said that HA staff had a 'whole back-up team' behind them, while the PCG post would be based in an 'isolated' office in the Welsh borders with the support of only one other manager.
He added that one of the original applicants was earning£76,000 and none was earning less than£30,000.
'They are not going to take a job with a£4,000 salary cut, ' he said.
Dr West admitted that GPs had chosen to form a very small PCG, based on a 'natural community', but added: 'We have decided on this configuration; now we have to get the show on the road.'
Dr West was due to meet Mr Hayton this week to discuss re-advertising the post with a different salary and job description, possibly working with some of the other PCGs in the area.
But Dr West said: 'If we re-advertise now we will not see our chief executive in post before July, so it is very difficult to see how we will function.'
Mr Hayton said the failure to recruit 'could be the salary, but I haven't been told that by the applicants'.
He added: 'Nothing is set in stone, ' and said he was happy to discuss the problem with Dr West.