Scotland’s Health Secretary has dramatically suspended controversial 10% pay rises worth up to £20,000 for two of the country’s highest-paid NHS chiefs, just hours after unions branded the move “obscene” while nurses and porters face real-terms cuts.
The sudden U-turn came after BBC Scotland revealed executives at NHS Lothian and NHS Greater Glasgow and Clyde had quietly been handed the temporary increases for leading a major restructuring of Scotland’s health boards.
What Sparked the Backlash?
The pay supplements were approved last month for Prof Caroline Hiscox of NHS Lothian and Prof Jann Gardner of NHS Greater Glasgow and Clyde.
Both already earn between £195,000 and £200,000 a year, more than the First Minister and twice what most senior consultants take home.
The extra 10% was justified as compensation for taking on “additional responsibilities” chairing new regional planning bodies designed to make Scotland’s 14 health boards work more closely together.
But the decision exploded into public view when unions discovered frontline staff who regularly take on extra duties receive nothing like the same reward.
Unison Scotland called the increases “grossly insulting” at a time when thousands of health workers are leaving the profession because they feel undervalued.
Health Secretary Steps In
Neil Gray moved swiftly on Thursday morning, announcing the pay rises would be frozen pending an independent evaluation of the new roles.
He said: “We have worked hard to ensure an equitable approach to pay across the NHS. That is why I have asked health boards to suspend these additional payments until the roles are properly reviewed with full union involvement.”
The two chiefs will continue leading the regional planning work, but any extra money has been put on ice.
Sources close to the government described the original decision as “a serious error of judgement” that risked derailing the entire reform programme before it properly began.
The Bigger Picture Facing Scotland’s NHS
Both health boards have been under intense pressure long before this pay row.
NHS Greater Glasgow and Clyde is still dealing with the fallout from the Queen Elizabeth University Hospital scandal, where infection problems linked to contaminated water and ventilation systems contributed to patient deaths.
A public inquiry continues to hear devastating evidence about leadership failures.
NHS Lothian, meanwhile, consistently reports some of the longest waiting times in Scotland, with more than 55,000 patients currently waiting over a year for treatment.
These deep-rooted problems are exactly why ministers want boards to collaborate more through the new east and west regional structures.
But Thursday’s events have raised serious questions about whether the current leadership is best placed to drive through change.
Union Leaders Demand Full Reset
Matt McLaughlin, Unison’s head of health in Scotland, welcomed the suspension but called it “an embarrassing climbdown” for the Health Secretary.
He told BBC Scotland: “This doesn’t fix the damage already done to trust. The whole process has been mishandled from the start. Neil Gray now has two choices: completely relaunch this work with new leadership, or pause everything until after next year’s Holyrood election.”
Colin Poolman from the Royal College of Nursing said the original decision had been “tone deaf” and warned ministers must now prove they are listening to staff.
“Nurses are exhausted, burnt out, and leaving in droves,” he said. “They needed to see leadership that understands sacrifice, not executives awarding themselves five-figure bonuses.”
What Happens Next?
The Scottish government insists the regional planning work will continue, with more appointments to the new bodies expected soon.
But the pay freeze has exposed deep tensions about fairness at the very top of Scotland’s health service.
Staff on wards today spoke of feeling “sickened” when they first heard about the increases, with one senior nurse telling BBC Scotland: “We’ve been working through covid, through strikes, through endless pressure, and they think £20,000 extra is fair for some extra meetings?”
For now, two of Scotland’s most powerful health executives have had a sharp reminder that public money comes with public scrutiny.
The suspended pay rises have been stopped in their tracks by the very workers who keep the NHS running every day. Whether this marks a genuine turning point in how Scotland values its health service leadership remains to be seen.
What do you think? Should NHS chiefs ever receive bonuses while frontline staff struggle? Share your thoughts below.
