text: Jeremy Hunt said a future Conservative government would look into the findings 'in detail' The Mail’s revelations sparked outrage last night with all three major political parties backing calls for an inquiry. There was disgust too among frontline NHS staff and patients. The head of the Royal College of Nursing said nurses who had faced five years of pay freezes would struggle to comprehend the six per cent pay rise for their bosses. Patient groups said the packages were indefensible when patients were seeing spiralling waiting times and cuts to routine procedures. Professor Jane Dacre, president of the Royal College of Physicians, called for an independent review of top NHS pay while Professor Sir Brian Jarman, a senior Government health adviser, called for a public inquiry, saying bosses were manipulating the system. The main political parties promised an inquiry. Health Secretary Jeremy Hunt said: ‘A future Conservative government would ask the Department of Health to look at the Mail’s investigation in detail. 'Too often high executive pay has been awarded as a matter course, not because of exceptional performance. Labour’s Andy Burnham said: ‘Labour will conduct a thorough investigation into this, as part of our plan to ensure pay fairness from bottom to top in the NHS. We have called for loopholes to be closed to prevent abuses.’ For the Liberal Democrats, Norman Lamb said: ‘NHS frontline staff will rightly feel that this situation is unfair. It is right to have an investigation so that these contracts are looked into so that we can make the best use of taxpayers’ money.’ Calling for an independent review, Professor Dacre said: ‘Transparency in the NHS, including transparency of remuneration, is vital to ensure accountability to the patients we serve. An independent review would help to ensure that NHS CEO salaries are fair. ‘It is important that we appoint high quality chief executives in NHS Trusts and their focus should always be on standards of patient care. They should be rewarded for the difficult role that they have taken on, but this should relate to the standard of patient care that they provide and the size of the organisation they run.’ Dr Peter Carter, chief executive and general secretary of the RCN, described the findings as 'shocking' Sir Brian Jarman said: ‘It is wrong. It is as simple as that. It seems to be manipulating the system. ‘They should be putting their attention on to lowering their death rates or seeing if there’s a problem with the quality of care rather than getting themselves higher incomes. That should be their priority. It is very worrying. ‘It is something that should be investigated, absolutely, by the Department of Health. Or a public inquiry so you can subpoena witnesses and they must give evidence under oath and if they don’t give evidence that’s relevant they can go to jail for up to 51 weeks.’ The country’s foremost pensions expert, Dr Ros Altmann, said the figures showed executives were ‘milking the system’. She said NHS bosses were signing off their own pay rises and taking advantage of loopholes in the ‘exceptionally generous’ NHS pension scheme. She added: ‘It is outrageous, it is so wrong. 'They think they can get away with it just because the law allows it. But morally it is questionable. ‘It is like the MPs’ expenses scandal. The rules would never have been intended to be used in this manner – they are meant for nurses struggling, who need to keep working to make ends meet. ‘These executives are exploiting the rules for their own advantage. It is not acceptable. There should be independent scrutiny. The idea that senior executives can retire and come back to work to double-dip needs to be rethought. ‘Taking lump sums and then re-employing themselves when there is evidence of failure – that needs to be challenged.’ Dr Peter Carter, chief executive and general secretary of the RCN, said: ‘At a time when NHS finances are in crisis, it is shocking that some NHS bosses continue to receive such vastly inflated financial rewards. Nursing staff will struggle to comprehend that their bosses have had an average 6 per cent pay rise when they are only getting 1 per cent this year, having seen their pay fall further and further behind the cost of living over the last few years. Norman Lamb for the Liberal Democrats said frontline staff would rightly find the revelations 'unfair' ‘Senior managers such as chief executives do important and highly valued work, but they should not be getting disproportionate pay rises and bonuses while frontline staff continue to struggle.’ Mark Littlewood, director general at the Institute of Economic Affairs, said the revelations of ‘misallocation of money’ in the NHS required ‘serious attention.’ Roger Goss of Patient Concern, said: ‘These pay packets are simply outrageous. They are indefensible. We need a formal inquiry into this. ‘It is impossible to justify these ludicrous pay arrangements when patients who are being told they cannot have routine treatments on the NHS and are suffering huge waiting times because of stretched resources. Patients will be horrified.’ Campaigner Julie Bailey, who helped expose the horrific neglect at Stafford Hospital, said: ‘The public would be shocked with these huge salaries and added perks. ‘Where else could you fail so badly and yet be rewarded so highly, by yourself?’ Dave Prentis, general secretary of the Unison union, said: ‘Staff working in hospitals and health centres up and down the country are right to feel outraged that their pay has been reined in year after year, while their bosses see such huge increases.’ And Richard Murphy, director of Tax Research UK, and an adviser to the TUC, added: ‘This is the private sector’s influence on the NHS gone mad.’ Sue James retired for a day to claim a £155,000 payout . TRICK ONE: Retiring for a day . One of the most lucrative loopholes NHS bosses exploit is the health service’s ‘24-hour-retirement’ rule. In the past, the NHS banned employees from retiring to claim benefits and then returning to the same job. From 2008, however, an exception was written in allowing staff to ‘retire’ for 24 hours to claim retirement benefits before carrying on working. Pension experts said this was aimed to make life easier for highly experienced nurses and other low paid front-line staff and to encourage them not to leave. NHS board members are now exploiting this, allowing them to claim hundreds of thousands of pounds in lump sums from their huge pension pots when they turn 60. This cash can be taken tax-free. But because they only really ‘retire’ for 24 hours, they can carry on drawing their huge NHS salary afterwards. Peter Herring, chief executive at Shrewsbury and Telford Hospital NHS Trust, claimed a £252,000 tax-free lump sum by ‘retiring’ for 24 hours, before returning to the same position. Derby Hospitals NHS Foundation Trust chief executive Sue James did the same to claim a £155,000 payout. Despite their public positions, they did not announce their brief retirements and their trusts did not disclose the highly sought-after posts were vacant before re-employing them. Instead, the details were hidden in the small print of their annual reports the following year. Under pension rules, most NHS workers can claim the retirement benefits only if they work for 16 hours or less per week for a month after ‘retiring’ for 24 hours. But none of the executives approached by the Mail team had announced they were working part time for a month – or taken a salary cut accordingly. TRICK TWO: Compensation bonuses . Hospital chiefs were awarded extraordinary compensation payments after quitting their pension schemes for apparent tax reasons. Under national rules, there are tax benefits applied to pension pots up to a limit, which was £1.5million until last year and has since been reduced to £1.25million. As a result, many choose to stop contributing to their pots when approaching the limit. When hospital bosses found themselves in this position, however, some received top-ups to their already huge salaries as compensation. South Tyneside NHS Foundation Trust chief executive Lorraine Lambert withdrew from the NHS pension scheme in 2012/13 as she approached the tax-free pension pot limit. She was awarded £20,000 the following year on top of her £165,000 salary. A footnote in her trust’s annual report stated: ‘During 2012/13 the chief executive withdrew from the NHS Pension Scheme and received additional remuneration to compensate for the loss of the employer’s contribution to that scheme.’ TRICK THREE: Flexible new job . Many bosses retire to claim their huge lump sums – before being re-employed on ‘flexible’ contracts. North Cumbria University Hospitals NHS Trust boss Mike Walker earned more than £1million in 2012/13, including £855,000 in pension-related benefits. He is also entitled to a £220,000 tax-free pension lump sum after turning 60 last October. At the end of 2013, Mr Walker – who has a £1.6million pension pot – was allowed to ‘flexibly retire’. The former medical director is now working on the development of a new hospital and a patient feedback system. Because he is no longer on the board, his new pay is not disclosed. TRICK FOUR: Leaving after pension boost . The generous NHS pension scheme is said massively to favour high earners. The scheme – until this year a final salary system – still uses a calculation method that gives a huge pension boost as salaries increase. If an employee’s salary suddenly goes up, their pension pot will receive a huge boost – sometimes worth hundreds of thousands of pounds. As a result, staff promoted to hospital boards see their pension-related benefits for the year rise dramatically. Many bosses appear to stay in jobs until they get a promotion and a pay rise which boosts their pension, before quitting the year after they have banked the pay out.
target: A Daily Mail investigation revealed NHS bosses raked in £35m last year .
  Nearly 50 hospital separate bosses took home more than £400,000 .
  MPs and frontline staff are united in their outrage at the Mail's findings .
  All three of the major political parties have called for an inquiry .