Mike Nesbitt signed off 'unpublicised' back-dated pay rise for health chiefs - 'not dependent on satisfactory performance'

The deal means senior bosses in Northern Ireland’s health trusts received a “consolidated increase” of 6.33% in the last financial year – in an arrangement that sees automatic progression up the pay scales until 2026/27.

It is designed so that any health chief on ‘pay point 5’ when the deal was struck in 2023/24 would reach the “maximum pay value” by the end of the arrangement in 2027. The current top pay point sits at £248,572.

The Department of Heath (DoH) says the pay and grading system is “fair, transparent, affordable and defensible”.

However, DUP MLA Diane Dodds says of all the issues the minister could be prioritising, “the public will rightly be perplexed that he has chosen these unpublicised pay rises”.

The health committee member says Mr Nesbitt “has pushed ahead with senior pay increases after previously reneging on his promise to give care workers a pay rise, citing a lack of funding”.

After the policy was signed off by Mr Nesbitt in 2025, trusts were told that senior executives in post at that point “should have their salaries uplifted by 5%”. A further increase of 1% “may be awarded” to anyone in post on or before 1 January 2023.

A letter sent from DoH to health trusts last month said that during the deal: “In these years, and these years alone, progression shall be automatic, and not dependent on satisfactory performance. The Department does expect, however, that robust performance management processes will continue to operate during this period”.

The changes follow a 2023 review of Senior Executive pay, independently carried out during 2023, “and following the approval of the Minister of Health”. There was no health minister in 2023 due to the collapse of Stormont, but the arrangements were signed off by Mr Nesbitt in 2025.

There does not appear to have been any public announcement about the deal, however the DoH has provided two letters sent to trust chief in 2025 and 2026 setting out the terms of the deal which are currently online.

Mrs Dodds told the News Letter: “The Minister confirmed to me in an Assembly Written Answer last year that local health service management costs already stood at £264 million in 2023/24 and continue to rise. These new increases will add substantially to that total, benefiting not just chief executives but senior executives across the system.

“I have tabled further Assembly Questions to establish the full annual cost and how many individuals will benefit. For some, salaries could rise to a quarter of a million pounds, with even the lowest level exceeding £100,000.

“The salaries the Minister has signed off dwarf those of First Ministers, many judges and senior clinicians”.

The DUP MLA added: “This decision will do nothing for the morale of staff on the front line — in hospitals, health centres and care homes — who work in the most demanding conditions. Nurses have to fight for a fair wage, while others are handed increases without challenge. Every pound spent here is a pound not spent on reducing waiting lists, recruiting nurses or delivering care packages.

“I do not underestimate the challenges of senior leadership roles, but people will question the wisdom of this move when waiting lists are soaring, emergency departments are overwhelmed and ambulances are waiting hours – even into a second day - to hand over patients”.

The News Letter asked the DoH for minister Nesbitt’s view on why the back-dated deal was necessary, and whether any productivity or performance related clauses added to contracts.

A DoH spokesperson said the department reviewed the HSC Senior Executive Pay framework in 2023 – introducing a “modernised and reformed” scheme over a 3-year period beginning in the 23/24 Financial Year. The revised framework provides a fair, transparent, affordable and defensible pay and grading system for all Senior Executives employed within the HSC”

“The framework introduces an 8-point incremental pay scale, revalorisation of pay points and a shortening of pay scales across a 3-year period with the goal of a 5-point pay scale being in place by the 26/27 Financial Year”.

They said DoH closely monitors the performance of HSC organisations via Systems Oversight Measures (SOMs) and the Support and Intervention Framework (SIF) which “strengthen performance oversight and accountability” across the system.

“These tools are integrated into the overall accountability mechanisms which the Department uses to hold Trust senior leaders to account for performance and delivery”.