An interesting piece by Kathy Gyngell for TCW. Extracts:
“Managers in NHS trusts with poor performance are picking up six figure pay packages, the TaxPayers’ Alliance has discovered. Their NHS Rich List 2025 report shows that in 2023-24 there were 1,694 senior managers receiving over £100,000 in total remuneration across 224 NHS trusts.
Total remuneration includes salary, expenses, benefits, bonuses and pension contributions. Looking at salaries alone, 1,557 had entitlements of at least £100,000, including 279 receiving between £200,000 and £300,000 and 17 who received over £300,000. There were 512 senior managers in the NHS on a higher salary than the Prime Minister [J4MB emphasis]…
The worst performing trust by percentage of A&E attendances within four hours or less was East Cheshire, with just 50.6 per cent of patients being seen within four hours. The trust had 8 senior managers who received over £100,000 in total remuneration, including the director of people and culture, Rachel Charlton, [J4MB emphasis] who received £367,500 in total remuneration.
The worst performing trust according to referral to treatment median waiting times was Cambridge and Peterborough, at 32.1 weeks. This trust had eight senior managers receiving over £100,000 in total remuneration. Their chief medical director, Catherine Walsh, [J4MB emphasis] received £387,500 in total remuneration.”
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Justice for Men & Boys 
They Are Terrified of Accountability – Richard Miniter – YouTube Richard Miniter is talking about the USA however his observation is true of the situation here. The NHS exemplifies this because it is simply part of the civil service. Having worked in Councils and the NHS I know the latter is much worse. Most councils are relatively small and though its difficult to get things done in the smaller councils action can be taken if councillors get a grip.(not the big ones like major cities) The NHS is vast with bewilderingly complex levels of management which mirrors the other big Civil Service Departments. And effectively no one holding the byzantine behemoth to account.
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