North Wales health board chief was Wales’ highest-paid NHS manager, while 39 Hywel Dda clinicians earned more than its highest-paid director

THE CHIEF executive of Wales’ largest health board received a salary of more than £260,000 last year, according to new research examining senior NHS pay alongside waiting-time performance.

The TaxPayers’ Alliance says 574 senior NHS managers covered by its latest “NHS Rich List” received salaries greater than the Prime Minister’s £172,153 entitlement during 2024-25.

Across the organisations examined, the campaign group identified 1,758 senior managers receiving at least £100,000 in total remuneration, including 292 whose reported remuneration reached £300,000 or more.

However, the headline totals require careful interpretation. In NHS annual accounts, “total remuneration” can include accounting calculations showing changes in future pension benefits. These figures do not necessarily represent money paid to an executive during that financial year.

North Wales chief had highest Welsh salary

Carol Shillabeer, chief executive of Betsi Cadwaladr University Health Board, was identified as the highest-salaried senior NHS manager in Wales.

The health board’s accounts place her salary in the £260,000 to £265,000 band for 2024-25. The TaxPayers’ Alliance recorded the midpoint as £262,500.

Her accounts also show a total remuneration figure of between £440,000 and £445,000. This included a £180,000 pension benefit calculation, rather than £180,000 being paid directly to her during the year.

The research ranked Betsi Cadwaladr sixth out of Wales’ seven health boards for referral-to-treatment performance and last for accident and emergency waiting times.

Betsi Cadwaladr’s own annual report shows that 57.2% of patients attending its major and minor emergency departments during March 2025 completed their visit within four hours, placing the health board seventh out of seven in Wales.

It also recorded 3,763 patients spending 12 hours or longer in emergency departments during that month, again placing it last among the Welsh health boards.

The health board remains in special measures after being placed under the highest level of Welsh Government intervention in February 2023.

Cardiff executive’s reported total included pension calculation

The TaxPayers’ Alliance also highlighted Cardiff and Vale University Health Board, which it ranked last in Wales for referral-to-treatment waiting times and fifth for A&E performance.

Its report stated that Emma Cooke, executive director of therapies and health science, had total remuneration of £367,500 during 2024-25.

Official accounts show that Ms Cooke’s actual salary during the year was in the £130,000 to £135,000 band. Her full-year equivalent salary was between £140,000 and £145,000.

The total remuneration figure of between £365,000 and £370,000 included £236,000 attributed to pension benefits and £10,000 in benefits in kind. No bonus payment was recorded.

Cardiff and Vale states clearly in its accounts that the pension benefit “is not an amount which has been paid to an individual by the UHB during the year”. It is an accounting calculation that can be affected by salary changes, additional contributions and wider pension valuation factors.

Thirty-nine Hywel Dda staff earned more than chief executive

The accounts also reveal a significant West Wales dimension to the debate.

At Hywel Dda University Health Board, which provides services across Pembrokeshire, Carmarthenshire and Ceredigion, the highest-paid director received remuneration in the £225,000 to £230,000 band during 2024-25.

That was just over seven times the organisation’s median employee remuneration of £32,002.

However, 39 Hywel Dda employees received more than its highest-paid director, an increase from 35 the previous year.

The health board said all 39 were medical or dental staff who had accepted responsibilities beyond their standard job plans, including additional clinical duties and, in some cases, medical management roles.

Remuneration across the Hywel Dda workforce ranged from £23,970 to £353,573 during the year.

Unlike some of the larger figures recorded elsewhere, Hywel Dda’s fair-pay calculation excludes employer pension contributions and the cash-equivalent transfer value of pensions. It includes salary, benefits in kind and any non-consolidated performance-related pay.

The accounts show that the remuneration of Hywel Dda’s highest-paid director increased by 2%, while average remuneration across the organisation’s employees increased by 11%.

Campaigners call for performance-linked pay

Across the NHS organisations examined, the TaxPayers’ Alliance said 1,603 senior managers had salary entitlements of at least £100,000.

This included 1,267 receiving between £100,000 and £200,000, 319 receiving between £200,000 and £300,000 and 17 whose salaries exceeded £300,000.

The number receiving salaries above that of the Prime Minister reportedly rose from 512 in 2023-24 to 574 in 2024-25, an increase of 12%.

Anne Strickland, a researcher at the TaxPayers’ Alliance, said: “Taxpayers will be appalled that NHS executive pay is soaring while patients are still left waiting for care.

“Ministers must keep their promise to link performance to pay, so that failing NHS bosses are held accountable and money goes into patients’ care, not managers’ pockets.”

Senior NHS leaders oversee organisations employing thousands of staff and controlling budgets worth billions of pounds. Health boards are also responsible for complex hospital, community, mental health and primary-care services.

Nevertheless, the publication of the figures is likely to intensify scrutiny of executive pay at a time when patients across Wales continue to experience lengthy waits for emergency treatment, operations and specialist appointments.

Independent review and Consumer Panel proposals highlight fragmented regulation, consumer harm and the need for a single oversight system

TWO major reports published within days of each other have raised serious concerns about the fragmented regulation of legal services in England and Wales.

An independent review of the Legal Services Board, published by the Ministry of Justice on July 13, found that weaknesses in regulatory oversight had resulted in “significant consumer detriment”.

The review, led by consumer rights expert Richard Lloyd, examined the performance of the Legal Services Board, which oversees frontline regulators including the Solicitors Regulation Authority and the Bar Standards Board.

It concluded that gaps in oversight had contributed to regulatory failures, with the Legal Services Board acknowledging that improvements were needed.

Three days later, the Legal Services Consumer Panel published its position paper, A Regulatory Framework for the Future, calling for the existing system to be replaced by a single regulator covering solicitors, barristers and other legal professionals.

The panel also proposed a unified disciplinary process and a central intelligence function bringing together complaints, professional conduct reports and financial monitoring.

However, neither report anticipates a substantially reformed regulatory system being operational before 2029.

The findings have also highlighted the pressures already facing barristers’ chambers, which must meet direct obligations relating to anti-money laundering procedures, cybersecurity and the safeguarding of client and chambers’ finances.

Unlike many solicitors’ firms, chambers are often managed by a senior clerk and a relatively small operational team, rather than a dedicated compliance department.

Compliance information may therefore be spread across several systems, including practice-management software, spreadsheets, external cybersecurity providers and separate financial controls.

VENTRiQ, which provides operational and compliance infrastructure to barristers’ chambers, said the problems identified at national level reflected challenges already being managed within individual legal practices.

Kevin Morrow, Head of Business Development at VENTRiQ, said: “What the Consumer Panel is describing nationally, a compliance picture stitched together from systems that do not talk to each other, is what a lot of sets are running internally today.

“AML checks might be held in one place, cybersecurity managed by an outside contractor and financial safeguards recorded on a spreadsheet.

“None of it is connected or visible in one place to the person who is ultimately accountable.”

Mr Morrow said chambers did not need to wait for the introduction of a new national regulatory structure before improving their internal oversight.

He added: “Most of what is being proposed, including having one place to view risk, complaints and financial exposure together, is something a set can already put in place.

“Better-connected systems can give chambers a clearer picture of their obligations and allow potential problems to be identified much earlier.”

The Legal Services Consumer Panel said its preferred model would simplify accountability, improve information sharing and create a more consistent disciplinary process across the profession.

Its recommendations are expected to contribute to a wider debate over the future regulation of legal services and whether the current structure remains capable of protecting consumers.

New £2 million Nofio Ysgol programme will begin in nine council areas this September before expanding across Wales

EVERY child in Wales is to be given the opportunity to learn how to swim and stay safe around water under a new national school swimming programme.

The Welsh Government has announced that its Nofio Ysgol programme will begin in September 2026, providing pupils with a minimum of 20 swimming and water safety lessons, primarily during Years 4 and 5.

The scheme is intended to address major differences in access to school swimming across Wales. Around one in five maintained primary schools currently offers no swimming lessons, while relatively few children take part in swimming activities outside school.

For many pupils, lessons organised through their school are their only opportunity to become confident in the water, learn essential swimming techniques and develop potentially life-saving self-rescue skills.

The first phase of the programme will begin in nine pathfinder local authority areas in September, backed by £2 million of Welsh Government funding.

It will then expand to as many as 16 council areas from September 2027 before being introduced across all 22 Welsh local authorities from September 2028.

The programme will include swimming instruction, water safety education and Swim Safe Cymru sessions, together with classroom resources linked to the Curriculum for Wales.

Additional support will be provided to children and communities facing the greatest barriers to participation, including pupils in rural and deprived areas, Welsh-medium schools, disabled learners and children with Additional Learning Needs or healthcare requirements.

The programme will be funded directly by the Welsh Government and delivered through participating local authorities, with national support from Swim Wales.

Announcing the Nofio Ysgol Implementation Plan for 2026–2029, Cabinet Minister for Culture and Sport Heledd Fychan said swimming was both a life-saving skill and an important foundation for lifelong physical activity.

She said: “Every child in Wales should have the opportunity to learn to swim, understand how to stay safe in and around water, and develop skills that could one day save their life.”

The Welsh Government said the phased introduction would allow councils and schools to test different delivery models, strengthen the swimming-teaching workforce, improve the collection of information and assess the programme’s impact.

The scheme forms part of the Government’s commitment to improving preventative health, physical activity and children’s mental and physical wellbeing.

Ministers said the long-term aim was to ensure that a child’s access to swimming lessons was not determined by where they lived, the school they attended or their family’s ability to pay for private lessons.