Health board cuts questioned as staff costs soar by £20m

Despite being halfway through the initiative - with 700 full-time equivalents having left - the health board's wage bill has increased to 780m.

It is understood "incremental drift", or automatic contractual pay rises for employees, is undermining the work to reduce the headcount.

It had been hoped a reduction from 29,000 to 27,000 staff would help save around 70m by April 2012.

But an initial draft of the organisation's accounts has revealed the whole cost, with sources and politicians saying more must be done to reduce outgoings.

There has also been a rise in the number of staff being paid more than 100,000 a year, despite pledges to balance out the number of redundant nursing posts with senior roles.

There was some cheer for health chiefs in the accounts, which will be formally submitted to the Scottish parliament next month.

The value of its land and buildings has swollen to 632m thanks to a recovery in the property market and the balance sheet has allowed 17m to be given to charity, 1m more than last year.

Susan Goldsmith, finance director for NHS Lothian, said: "It is important to note that these are draft accounts which have not yet been laid before parliament for final approval.

"Pay scales for all NHS staff are nationally agreed and rise incrementally year on year. As a result, three additional clinical consultants have reached the 100,000 band this year.

"Of those staff who earn over 100,000 per year, 99 per cent are highly-trained clinical staff.

"Annual increments also contribute to the rise in overall staff costs across the organisation. Ongoing work to reduce our workforce has helped to ensure this increase is much lower than it would previously have been."

In 2010-11, NHS Lothian spent 7.5m treating patients from other health boards, more than the previous year, although this cash is eventually reimbursed.

The accounts were briefly circulated at a special meeting in Craiglockhart yesterday, but they were taken back again after 15 minutes and will not be formally unveiled until later this year.

The overall cost of the NHS board of executives has remained much the same and some senior figures continue to collect thousands of pounds of perks, or "benefits in kind".

One health board source said: "The issue of pay rises is pretty much an impossible one to get on top of.

"It goes to show that cutting numbers doesn't necessarily have the impact it seems like it would on paper."

Lothians Conservative MSP Gavin Brown said: "NHS Lothian should state how much of this additional money was spent on the front line and how much was spent on backroom and administrative positions.

"We have to look very hard at where money can be saved, while still protecting our vital front-line services."

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