Hammersmith Hospital: the top payer

The analysis by Incomes Data Services found total remuneration of NHS chief executives has risen by more than 70% in the past decade.

Over the same period nurses' earning have risen by about 50%.

Top earner was Derek Smith, chief executive of Hammersmith Hospitals, who earned between �210,000 and �215,000 during the last financial year.

This was a 35% increase on the previous year.

Average total remuneration for trust chief executives England: �107,500 Wales: �116,000 Scotland: �95,500 Northern Ireland: �87,500 Median figure

The report analyses the remuneration of 2,500 chief executives and directors, details of which are contained in trust annual reports for the year 2003/04.

The results cover about 90% of all NHS hospital and primary care trusts in the UK.

The results showed that chief executive salaries varied markedly by trust type.

Acute hospitals paid the highest average salary of just over �112,500, while ambulance trusts paid an average of �85,000.

Among the recently created primary care trusts, the average salary of chief executives was �92,500 - 10% lower than their counterparts in hospital trusts.

Top money

It seems earnings of NHS directors have outpaced the rest of the health workforce Steve Tatton

Other top acute hospital payers included Guy's and St Thomas' (�192,000) and Barts and the London (�182,000).

Outside London, University Hospitals of Leicester paid �162,500 and Leeds Teaching Hospital and University Hospital Birmingham both paid �152,500.

Hammersmith Hospitals issued a statement which said part of Mr Smith's pay package included a one-off sum of pension arrears going back to when he started at the trust three years ago.

"This was agreed by the Board after taking independent pensions and legal advice and reflects a broadly comparable basis of pension payment to other senior executives in the NHS."

Steve Tatton, who worked on the report, said: "It seems that pay movements in the NHS invite comparisons with the private sector, especially the widening gap between board and employee remuneration.

"As in the private sector, it seems earnings of NHS directors have outpaced the rest of the health workforce."

Dave Prentis, general secretary of the health workers union Unison, said: "Managing an NHS Trust is a big job and the NHS needs to be able to compete with the much bigger pay and perks on offer in the private sector, in order to get the best person for the job.

"However this principle doesn't only apply to top level managers. It is a principle that should apply right across the NHS workforce, so that NHS staff are fairly and justly rewarded for their skills, knowledge and commitment to delivering good quality health care.

"This report shows the gap between the top and the bottom widening at the same time as the NHS is having increasing difficulties recruiting and retaining staff at all levels."

Paul Burstow, Liberal Democrat health spokesman, said: "These figures will come as a shock to nurses, porters, technicians and other key NHS staff who have not seen such sky high rises.

"While it is important that the NHS has good managers, the recipients of these pay rises need to show that they are providing value for money."

A Department of Health spokesperson said running an NHS trust was an extremely complex operation.