David Nicholson: You must not 'denigrate' health managers earning six-figure salaries Sir David Nicholson blames ministers for endless reorganisations Department of Health warns that nurses will be sacked to fund pay rises Health Secretary Jeremy Hunt says big salaries put public trust at risk Pay for chief executives rose by 121% 1997-2000, double rate for nurses Defence: NHS England chief Sir David Nicholson said six-figure salaries were needed to attract 'top drawer' managers Hospital bosses deserve their six-figure salaries because their jobs are some of the most complex in the world, the head of the NHS claimed today. Sir David Nicholson warned it was wrong to "denigrate" trust chief executives who can earn more than £200,000 -a-year. And he sought to blame ministers for the rising pay bill putting pressure on the health service, claiming endless reorganisations by successive governments created even more highly-paid roles. Health Secretary Jeremy Hunt has vowed to veto pay rises for senior staff at health quangos under his control, including NHS England, to set an example to the rest of the health service. But he does not have the power to intervene in pay deals offered by individual health trusts. Latest figures show that hospital chief executives saw their pay soar by 121 per cent between 1997 and 2010, almost twice the rate of increase enjoyed by nurses. Earlier today Sir Bruce Keogh, the medical director of NHS England, said managers deserve their the huge salaries needed to attract "the right calibre" of job applicants. Appearing before the health select committee today, Sir David was warned the remarks risked angering frontline doctors and nurses because it sounded like they did not deserve pay rises in the same way. Challenged over the remarks, Sir David said the NHS is going through "some of the biggest, most significant transformational change in the NHS and really do need top-drawer people to do that." The chief executive of NHS England, dubbed the "man with no shame" for his defiance in the face of criticism, called for an end to complaints about six-figure salaries in the health service. "If you constantly denigrate and criticise them, it's hardly surprising that they respond to that," he said. We all have a responsibility to support those people in incredibly difficult jobs. They absolutely are highly paid jobs. They are amongst the most complex and difficult jobs in the world. Those chief executive jobs - the complexity of those are on a scale managerially that most of us would have difficulty to understand. Warning: Labour MP Barbara Keeley said the spectacle of NHS bosses defending huge salaries because managers 'deserve' them would leave doctors and nurses facing pay freezes to think they do not He claimed the latest reorganisation ordered by the coalition - scrapping primary care trusts and replacing them with GP-led clinical commissioning groups - were in part to blame for the pay levels. I have been in the NHS for 35 years. I have only applied for a job once that was not associated with a reorganisation. If people would stop constant reorganisation the NHS would have less turbulence With major increases in NHS spending unlikely over the coming years, the total pay bill will have to be controlled, he said. There was a system set up by the government - not by me - signed off by ministers which appraised every job through an external evaluation and put a salary against and that's what people have got. We should not surprise by the salaries that people have got. People deserve the pay that the system that was set up identifies they should get. Labour MP Barbara Keeley repeatedly challenged him about the remarks, warning it sounds like "people at the very top on very significant salaries think they deserve it as if other people don't." Jobs: Frontline health staff will have be cut to fund pay rises for managers, the Department of Health has warned The government has warned that doctors and nurses will have to be axed to fund further pay rises for NHS managers. The quality of patient care would suffer as a result, the Department of Health claimed as ministers prepare to block salary hikes for senior officials. In a submission to a pay review body, the DoH said: "Any increase in pay costs above this level will risk unfeasible reductions in clinical staff which may harm the ability to maintain access to and quality of NHS services to the public." Warning: Health Secretary Jeremy Hunt says the NHS could lose public confidence if it does not curb pay rises The average salary of a hospital chief executive now £164,000 a year, compared to the Prime Minister's pay packet of £142,500. Even without a freeze in pay, salaries are still expected to "drift" upwards because managers are given automatic increase rises linked to length of service. Mr Hunt has warned the NHS risks losing public trust if it does not curb a BBC-style "culture of excessive pay and pay-offs." He added: "In this tough financial climate, I am determined to see real restraint on executive pay so that every penny possible can go on patient care. Sadly, the last government got their priorities completely wrong on NHS pay - giving managers far bigger rises than nurses. It comes after it emerged a husband and wife who worked as NHS managers were paid nearly £1million in redundancy money - only to be rehired by the health service within weeks. Jamie Reed, Labour's shadow health minister, said: 'Under David Cameron, many NHS managers have seen their salaries soar. Meanwhile, nurses have had theirs frozen and six thousands nursing jobs have been axed. 'David Cameron's NHS re-organisation siphoned £3 billion from patient care budgets. He ignored the warnings and wasted millions on redundancy payments for managers, many still in the NHS. Ministers have placed the NHS on the brink of its worst winter in a decade and posturing like this does nothing to help. Analysis of Primary Care Trusts and Strategic Health Authorities" final accounts, published last week, suggests payouts in excess of £100,000 were made to more than 50 staff. More than a dozen of these well-paid chiefs have since found work in the public sector. At the time, the NAO said that 44 very senior managers were made redundant at an average cost of £277,273 Labour has accused the Government of wasting hundreds of millions of pounds by replacing the statutory bodies with 211 new Clinical Commissioning Groups.