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NHS Rich List


The NHS is forever pleading poverty. Yet while patients wait in corridors and taxpayers are told to dig ever deeper to fork over more cash, the management class at the top of the health service is doing rather nicely.

The latest TPA NHS Rich List [[link removed]] lifts the lid on senior pay across 220 NHS trusts, and the figures are hard to defend.

In 2024-25, 1,758 senior managers received at least £100,000 in total remuneration, covering salary, expenses, benefits, bonuses and pension benefits. Some 574 had salaries higher than the prime minister, up 12 per cent in a single year. Even more strikingly, the number receiving at least £300,000 in total remuneration surged from 125 to 292, a rise of 134 per cent.

For patients stuck on waiting lists, these numbers will be galling enough. But the real sting is that bumper pay packets are still showing up at trusts with dreadful performance. East Cheshire was the worst-performing trust in England for A&E waiting times for the second year running, with just 43 per cent of attendances seen within four hours. Yet its chief executive’s total remuneration rose from £172,500 to £377,500. Crazy, right?

The rich list caused the attention of the press, the Daily Mail [[link removed]], the Times, the Sun [[link removed]], the Telegraph, the Daily Express [[link removed]], GB News [[link removed]], and local papers around the country, with our investigations campaign manager Callum McGoldrick penning an OP; ED for Conservative Home [[link removed]].

Anne Strickland, lead researcher on the project, told reporters [[link removed]]: “Taxpayers will be appalled that NHS executive pay is soaring while patients are still left waiting for care…Ministers must keep their promise to link performance to pay, so that failing NHS bosses are held accountable, and money goes into patients’ care, not managers’ pockets. ” Well said, Anne!

The rich list also received support from shadow health secretary Stuart Andrew MP, who agreed with us when he said: “Paying managers large bonuses while patients receive poor care is not good value for taxpayers or fair on NHS frontline staff.”

We all want a well-run health service, and taxpayers are not asking for miracles. NHS bosses who deliver better care and shorter waits should be rewarded. But bosses at failing trusts should not be able to sit back on bloated pay deals while patients are left waiting and services struggle.

That is exactly why ministers promised a “carrot and stick” approach to NHS leadership pay last year. Now the new health secretary, Yvette Cooper, has a chance to prove Labour is serious about value for money. Let’s see if she follows through.

Help us produce our next agenda-setting research by clicking here to donate  [[link removed]]


Exposing Britain's NHS Manager Fat Cats


The NHS keeps demanding more money, but patients are still stuck on waiting lists while senior managers take home bumper pay packets.

Podcast host Duncan Barkes is joined by the TPA’s Jonathan Eida and Anne Strickland to discuss the latest NHS Rich List, which reveals 574 NHS bosses now earn more than the prime minister and the number receiving at least £300,000 in total remuneration has more than doubled in a year.n to the latest episode of A Nation of Taxpayers on Apple Podcasts [[link removed]] and Spotify [[link removed]] or watch on YouTube [[link removed]].


Burnham’s debt interest bill


While our hard-hitting NHS rich list was being released, the research team took no time off and was once again busy cooking more research. This time they turned their guns onto debt interest. 

Before Andy Burnham has even implemented any policies, he is already being weighed down by the inheritance of previous government borrowing. In fact, according to our new briefing note Debt interest over time [[link removed]] and based on current OBR forecasts, Andy Burnham would have the second highest average annual debt interest bill of any prime minister on record, at £112.8 billion per year in 2025-26 prices.

In 2025-26, more than one pound in every twelve spent by the government was used to service debt. This is all money that is being burned instead of being used to run public services or make room for tax cuts. 

Fundamentally, though, this is the cost of reckless spending by previous governments who have spent beyond their means and have maxed out the country’s credit card. This needs to stop, or even more money will be wasted pouring more fuel onto the fire. 

Research director Darwin Friend was spot on with his warning [[link removed]] to our new Prime Minister when he told the nation’s media: “Burnham must not make a dire situation worse with yet more borrowing and spending. He should get a grip on the public finances and provide the breathing space for Britain that he promised.” But the real question it this: will he listen? Only time will tell, but we’re not optimistic.


Can Andy Burnham really fix social care?


This week the prime minister visited a care home to announce his ambition to solve social care in the country. How? Don’t know. How much will it cost? Stop asking questions, he told the media. So much for accountability. We have our work cut out at the TPA! 

This is exactly the attitude that has caused our spiralling national debt. Handing out money through expensive government schemes with no way to fund them other than tax and borrow. But taxpayers across the country have had enough.

Campaigns director Will Yarwood was quite right when he told GB News [[link removed]] that “there's no pain-free way to deal with social care” and that the policy was “going to have a massive cost” whatever Burnham decides to do. The expense will be borne by the taxpayer in one form or another. 

Likewise, Anne Strickland was bang on the money when she spoke to GB News [[link removed]] about Burnham’s plans, arguing that “this is a real issue facing  hundreds of thousands of families across the country but to put up the burden on taxpayers even further that is also unfair.” Quite right, Anne. 


TPA at Gravesham Reform


On Monday, Callum made a trip out of SW1 to Meopham in Kent to speak to the Gravesham Reform Branch. His talk included an overview of particularly egregious foreign aid projects, an analysis of what’s gone wrong with our welfare system and a look at public sector productivity.

Speaking to a crowd of about 40, Callum reports that the members were outraged, if not surprised, to hear just how wasteful successive governments have been. 

If you’re one of the attendees who signed up, welcome! Or, if you’d like the TPA to speak at one of your events, get in touch! [[link removed]]


Data decoded


As you may remember, last month we launched our latest research blog series, Data Decoded. [[link removed]] Our blog this week is the latest installment of it, courtesy of our researcher, Anne.

Take a read [[link removed]] to find the best analysis on July’s biggest data releases from the terrifying scale of our national debt to the fiscal drag hammering grieving families ever harder thanks to IHT thresholds being frozen.

As Anne finds, “IHT liabilities hit a record £7.03 billion in 2023-24, and 4.72% of deaths now result in an IHT charge. This is the highest share of deaths liable for IHT since 2006-07, driven not by a rate rise but by frozen thresholds and rising asset values.” 


Non-job of the week 


This role [[link removed]] is open to someone with ‘lived experience’; to me this raises the question of what is experience if not lived? 

Taking home a salary of about £60,000 per year, the Midland Partnership NHS Trust is seeking someone to “ensure that lived experience & co-production is embedded in the care group”. 

The job ad reads like a who’s who of buzzwords from 2016; good luck making any sense of it!   

Thanks for reading, until next week.

Benjamin Elks, Grassroots Development Manager



















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