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November 2007

Friday, November 30, 2007

Daily Express: Cocaine on the NHS

By Tom Whitehead

Cocaine is being handed free to addicts on the NHS, it was revealed yesterday.

And the Government's key drug advisers want access to it made even easier – with nurses and pharmacists getting the power to hand it out.

Currently only doctors at licensed clinics are allowed to do this.

The practice was yesterday criticised as yet another insult for other NHS patients, such as Alzheimer's and cancer sufferers, who face a postcode lottery to get the drugs they desperately need.

Matthew Elliott, chief executive of the Taxpayers' Alliance, said:"Taxpayers are being mugged either way by drug users, either directly for their wallet, or indirectly by the taxman. The NHS should not be providing cocaine at our expense, especially when thousands of law-abiding patients are being denied life-saving treatment." More than 10,000 people receive treatment for cocaine addiction, with three clinics licensed to offer the drug in the most difficult cases.

But the Government would not say yesterday how many receive the drug or how it is administered.

The practice emerged yesterday after the Advisory Council on the Misuse of Drugs (ACMD) called for the licensing regime to be relaxed, so that nurses and pharmacists, as well as doctors, can hand out the drug.

At the first public meeting of the council since it was set up 36 years ago, chairman Professor Sir Michael Rawlins told members he wrote to Home Office minister Vernon Coaker earlier this month to propose the changes.

He said cocaine was a growing concern both among addicts and recreational users such as City workers.

He said there would have to be "robust" arrangements to ensure the substances were managed properly.

But Shadow Home Secretary David Davis said: "If Gordon Brown signs up to this it would show yet again that Labour merely seek to manage drug addiction rather than end it.

"The Conservative approach is different. We would stop – not swap – addiction by focussing the drugs budget on expanding the use of abstinence-based rehabilitation programmes.

"This method has proved far more successful at getting people off drugs than the Government's white flag approach." Heroin addicts can already get their drug free as part of their treatment. It emerged earlier this month that they have received £2.5million of free heroin and nursing care in NHS "shooting galleries".

Addicts inject themselves under supervision – but many are still going on to commit more crimes.

A spokeswoman for the National Treatment Agency, which treats addicts, said: "Cocaine prescribing is legally possible in England if licensed to do so by the Home Office, although it is not advocated as an effective treatment for drug addiction within clinical guidelines." And a Home Office spokesman insisted it had no intention of allowing nurse and pharmacist prescribers to apply for licences to treat drug users with cocaine.

He added: "The ultimate aim is to cut drug use and so cut drug-related crime, and the harm caused by illegal substances to individuals, families and communities.

"On 22 March 2007 we issued a consultation on nurses and pharmacists prescribing controlled drugs to make patient care more flexible.

"However, we made it clear then that we were not in favour of allowing nurses and pharmacists to prescribe diamorphine, cocaine or dipipanone [a substitute opiate]. Our position is unchanged."

Daily Mail: Let nurses give free cocaine to addicts, experts tell Labour

By James Slack and Simon Cable

Nurses should be given powers to prescribe cocaine on the Health Service to addicts, Government drug experts ruled yesterday.

A small number of doctors have already been quietly licensed to give the Class-A drug - which costs £50 per gramme at street prices - to chronic users.

Now the Advisory Council on the Misuse of Drugs wants to go further by giving NHS nurses and pharmacists permission to hand out cocaine.

The user has to take the drug in front of a doctor or nurse - raising the prospect of a medical professional having to watch an addict snort a line of the powder.

There are currently 10,000 individuals receiving treatment in the UK for cocaine use, though not all will be classed as addicts. The justificationfor giving an addict free cocaine - paid for by the taxpayer - is that it will help to reduce crime, as they will not have to steal to pay for the drug.

But this is likely to cause controversy because cocaine problems are often associated with high-earners.

Yesterday, advisory council chairman Professor Sir Michael Rawlins said city workers were snorting lines of the drug.

It comes only a week after the revelation that addicts were receiving free heroin on the NHS in a £2.5million pilot scheme.

Critics have questioned the decision to plough so much money into treating drug addicts when law-abiding citizens were being denied much-needed drugs for a range of illnesses. Alzheimer's patients newly diagnosed and with mild symptoms no longer qualify for medication - despite a cost of only £2.50 each day.

Drugs for some types of cancer, arthritis, bone disease and the prevention of blindness in older people are also being restricted, leading to claims of postcode prescribing and bitter court challenges.

Shadow Home Secretary David Davis said: 'If Gordon Brown signs up to this it would show yet again that Labour merely seek to manage drug addiction rather than end it.

'We would stop - not swap - drug addiction by focusing the drugs budget on expanding the use of abstilicencesnence-based drug rehabilitation programmes. This method has proved far more successful at getting people off drugs than the Government's white flag approach.'

Matthew Elliott, chief executive of the Taxpayers' Alliance, said: ' Taxpayers are being mugged either way by drug users, either directly for their wallet, or indirectly by the taxman.

'The NHS should not be providing cocaine at our expense, especially when thousands of law-abiding patients are denied life-saving treatment. This madness should stop.'

Michael Summers, vice chairman of the Patients' Association, said that the move could send out the wrong messages to drug addicts.

'It should not be possible for nurses to have this power,' he said. 'It could lead to more nurses being put in vulnerable positions where addicts are putting pressure on them to give them drugs.'

Currently, three UK doctors have to give cocaine to addicts. It is available in extreme cases, where other treatments have failed.

A spokesman for the advisory council said: 'We were invited by the Home Office to give a view on the prescribing of controlled drugs - specifically diamorphine, cocaine and dipipanone - for addicts for the management of their addiction.

'Under current legislation, these can only be prescribed for addicts for the management of their addiction by doctors under licence from the Home Office.

'Following consideration, the council's view is that the Misuse of Drugs (Supply to Addicts) Regulations 1997 should be amended to allow Nurse and Pharmacist Supplementary Prescribers to apply for a Home Office licence to prescribe diamorphine, cocaine or dipipanone for addicts for the management of addiction.'

A Home Office spokesman said: 'We have no intention of allowing nurse and pharmacist prescribers to apply for licences to treat drug users with cocaine.'

Ministers have the power to overrule the advisory council, which is an agency of the Home Office, but have sided with the organisation over a number of controversial matters - including the original decision to downgrade cannabis to Class C in January 2004.

Thursday, November 29, 2007

The Business: Hitting Rock Bottom

by Matthew Lynn

Whatever other epitaphs are eventually delivered on the Premiership of Gordon Brown, and on the Chancellorship of Alistair Darling, “decisive” is not likely to be among them. We are now into the third month since the crisis at Northern Rock erupted, causing the first run on a bank in a developed country in living memory and the greatest financial crisis in Britain since the fringe banking collapse of the early 1970s. Yet how much closer are we to a solution? Hardly so much as a step.

Between them, Brown and Darling have failed to provide the leadership the situation demands. They have not come up with a plan. They have failed to protect the reputation of the City, on which the prosperity of the whole economy crucially depends. Instead, they have fluffed around, while the failed bank sinks ever further into a financial swamp.

It was on 13 September that Northern Rock decided to seek emergency funding from the Bank of England; Lloyds TSB had been ready to take on the bank but talks with the Treasury broke down. Northern Rock had adopted what at the time was thought to be a clever business model: rather than relying on deposits to fund its loans and mortgages, it borrowed the funds on the money markets, regularly rolling the loans over as they expired.

As the global credit crunch intensified, the Rock found itself no longer able to roll over its loans, even though its collateral – its mortgage book – was robust. Northern Rock was forced to ask the authorities for help. As the news broke, savers started rushing to withdraw their money, worsening the crisis.

In a panic move, the government rushed to guarantee deposits above the current limit (at present, the first £2,000 ($4,127, E2,791) worth of deposits are entirely guaranteed, and then 90% of the next £32,000, a very low sum). It also agreed to lend what amounts to limitless funds to the Rock to make sure it could pay off its loans. Brown had decided to bail out Northern Rock, putting it on life support.

More than two months later, the situation has barely moved on. Bids for the bank were finally received this week; but the potential costs are surging. Northern Rock has been lent £24bn from the Bank of England. Add in the guarantees to £20bn or so of accountholders’ money and the total exposure for the taxpayer could be well over £44bn. The Rock’s share price plummeted this week; but it remains greater than zero, buoyed by hedge funds hoping the bank will be rescued and that existing shareholders will eventually make money.

There was a decent case to be made for rescuing the bank: the impact on financial confidence and, potentially, on the housing market, had it gone bust, would have been horrendous. But there was an equally good case for letting the bank shut: it would certainly have been a useful reminder to bankers that lending money you don’t have is a risky business. Some savers could have lost a lot of money.

There is no case, however, for the confusion and indecision surrounding Northern Rock since the rescue in September. On Monday, the government took a bad situation and made it a lot worse. The Treasury announced that the £24bn loan was finite and wouldn’t necessarily stay in place beyond next February.

What it was hoping to achieve with that statement, other than to hammer the Rock’s share price, is hard to fathom; the excuse is that Darling still has to figure out whether he can give any aid to Northern Rock without falling foul of European Union rules. The sale documents sent out to possible buyers of Northern Rock contained financial projections in which it borrowed billions of pounds from the Bank of England until 2010.

This is clearly state aid: the rate of interest paid by the Rock to the Bank may be high but it is still lower than what it would have to pay in the marketplace, assuming it could find anybody to lend it the funds, which is another reason why this is state aid, of the kind supposedly banned by Brussels: right now, Northern Rock has zero chance of raising money in the money markets in the usual way. It can’t stage a rights issue: there is no business plan and, as of last Friday, no chief executive either. So, if the government loan was to be withdrawn, it would collapse.

In reality it doesn’t matter whether the government’s assistance falls foul of EU rules or not. Any case will take years to go to the courts; if it thinks it is doing the right thing today, a fine in five or even 10 years’ time should be seen as a price worth paying.

There are many potential buyers for Northern Rock. Richard Branson’s Virgin Group has put together one consortium; another is led by the American buyout firm J.C. Flowers; a third is headed by the former boss of Abbey National, Luqman Arnold. Ten expressions of interest have been received, not all of them serious; one of the potential bidders, Cerberus, a private equity firm, pulled out this week.

Darling has set out the principle that the costs of a rescue should be borne “to the greatest extent possible” by the buyers and the bank itself. That is a shift from the previous position, which was that there should be no cost to the taxpayer. Northern Rock is being charged a crippling rate of interest and has been forced to pledge a chunk of its mortgage book as collateral. But this might be worth less than face value, even though few of its mortgages are thought to be bad; if the Bank of England begins to auction off the loan book, it would have to sell them at a discount.

A new analysis from Mike Denham, an accountant for the TaxPayers’ Alliance, explains why taxpayers are right to worry. If Northern Rock goes into liquidation, taxpayers will be waiting in line with other creditors, at least for part of their liabilities, hoping liquidators can raise enough from selling assets.

At the top of the Rock’s claims tree are the secured creditors. They lent money specifically secured against mortgage loans. Darling tried hard this week to give the impression that all his exposure is of this kind. But that’s not really the case, Denham argues cogently.

Because of the way the Rock funded itself in the wholesale money markets, a large chunk of its mortgage loans have already been pledged as security. Those mortgages have been ring-fenced, most via an offshore financing vehicle called Granite, for the benefit of investors in medium-term notes. Others have been assigned to a presciently constructed “bankruptcy remote special purpose vehicle” as security for its covered bond programme.

In its mid-year report, Northern Rock said that around £54bn of its loan book has been pledged to wholesale creditors. Another £24bn or so will since have been pledged to the Bank of England (if not, taxpayers really are in trouble). The total size of the balance sheet was £113bn mid-year. This must be much lower today, which means that there won’t be that many unpledged assets left.

Next in line come senior unsecured creditors. They get first dibs on any fire sale proceeds left over after the pledged assets have been stripped away. Taxpayers have exposure to this unsecured senior debt via the guarantee to depositors, including all wholesale deposits. As at mid-year, such deposits were somewhere between £33bn and £48bn (including £24bn of retail deposits). This is significantly lower today, which is lucky for taxpayers given how little unpledged collateral there remains.

Subordinated creditors come last; this debt is getting riskier by the day. It is thought that the penal element of the interest charged by the Bank of England on loans to Northern Rock is being rolled up as subordinated debt, not to be repaid for five years. The penal element has been defined as not merely the 0.5 percentage point excess over the normal market interbank rate, but as the one percentage point excess over the Bank rate. This could amount to £500m; Darling denied it is as much as that, but not its existence.

As Denham of the TaxPayers’ Alliance puts it: “It’s increasingly obvious that taxpayers are exposed to all layers of Northern Rock’s financial structure. We can take no comfort at all in all those official assurances that our lending is all fully secured. We are at risk all the way down to junk rated subordinated debt.”

Both Brown are Darling are now paying the price for their earlier indecisiveness. As soon as Northern Rock ran into trouble there were three realistic options; they haven’t changed since then.

One, let it go into administration. It would have been a rough solution, but so long as depositors were protected it might have avoided the worst damage. Shareholders would have lost everything; but such must regrettably be the fate of anybody who invests in a failed company. It would certainly have served as a warning to the markets that the government doesn’t bail-out companies that make a mess of their finances.

Two, Northern Rock could have been nationalised. Again, that has the virtue of honesty, though it would have meant buying out the shareholders and handing over to them more than they really deserved. A combination of the first solution – administration – and the second – nationalisation – could have avoided this. A hard-headed banker could then be appointed gradually to wind up the bank in an orderly fashion.

Three, the board could have been told to auction the bank off as a going concern to the highest bidder. To do that, the government would have had to spell out exactly how long the Bank of England loan would remain in place, and terms and conditions. This solution might have amounted to giving the bank away for a symbolic £1, or even for the government to pay somebody to buy it. This would have been the best solution; a version of it is still what the government hopes to achieve.

Any of those options could have been chosen at the end of September. All have different costs and benefits, but each of them would have been better than drifting aimlessly. Instead, it is close to the end of November and the government doesn’t appear to be any closer to making a decision.

That is ridiculous. It is not doing anything for the reputation of the London Stock Exchange that what is still – bizarrely – a FTSE 100 Index company has been turned into little more than a casino chip for the hedge funds. There can no meaningful market in the shares of a company with a future this uncertain.

The best we can now hope for is that the bill for taxpayers will not turn out to be too high, and that one of the financial institutions currently bidding will come up with a workable plan, recapitalise the business, line up new borrowing facilities and pay back the borrowing to the Bank.

Two months ago, the Northern Rock disaster could have still been described as an accident: an unfortunate combination of reckless management and a credit crunch in the markets conspiring to bring the bank down. Now, it can only be described as a fiasco, one entirely of the British government’s own making.

Wednesday, November 28, 2007

Daily Express: Sienna dumps law...by text

By John Twomey

Actress Sienna Miller left the taxpayer with a £10,000 bill yesterday after cancelling a court appearance by text message.

She was due to give evidence for rock singer Bryan Ferry's son, Otis, who is on trial for causing criminal damage.

But the former girlfriend of movie star Jude Law sent a text to Ferry's legal team saying she would not be able to attend the hearing in West London. Miller was in the capital last week but jetted to Mexico City accompanied by her boyfriend, actor Rhys Ifans. It means the case will only be part-heard and another day will have to be found in the busy court schedule.

Matthew Elliott, chief executive of the TaxPayers' Alliance, said: "Treating people like this is an insult – she should not take taxpayers' money for granted." A spokeswoman for Miller said: "She was never intended to be there and is on business overseas. She has provided a witness statement." Ferry, 25, of Eaton, Shrewsbury, Shropshire, is accused of causing £680 of damage to the cars of two photographers outside the Boujis club in Kensington in February.

He denies two counts of criminal damage. The case continues.

Daily Express: Cop shop for babies

By Martyn Brown

A police force has been rapped for spending £10,000 on setting up an online gift shop ­selling baby clothes bearing prison slogans.

Among the goods are bodysuits inscribed with the words “Out at last” and a bib which reads “I’ve been inside for nine months”.

Kent Police is also offering items which criminals could use to impersonate officers such as official-looking ties, cufflinks and pens. And the force, which deals with thousands of drink-­related incidents a year, is selling hip flasks bearing its logo.

Matthew Elliott, of the Taxpayers’ Alliance, branded the scheme a waste of money. “Kent Police is out of touch if it thinks ­merchandising is more important than crime-fighting,” he said.

Playgroup volunteer Sarah Newman, 47, from Ash­ford, said: “Old folk could be taken in by some­one with these accessories. They look authentic.”

The force said the shop would “help boost funds for crime prevention while meeting a growing demand for police-themed products”.

Tuesday, November 27, 2007

Daily Express: Former MSPs get £26,500 pay-offs

Politicians who stood down or lost their seats at the Holyrood elections have received more than £1.1million in pay-offs.

The "resettlement" grants, which came out of the Scottish Parliament contingency funds, are intended to ease MSPs back into everyday life.

Each of the 42 claiming members was entitled to £26,545 - half the final annual salary.

But critics have questioned the payments, claiming they were an unjustified drain on the public purse.

Mark Wallace, campaigns director for the Taxpayers Alliance, said:

"This is a disgraceful waste of taxpayers' money and many would question whether these payments are justified.

"MSPs enjoy good salaries, generous allowances, and of course all the trappings of power. If they choose to step down or are thrown out by voters, why on earth should they receive a further lump sum?"

Colin Fox, who lost his seat as a Scottish Socialist MSP for Lothians, said the £26,000 resettlement grant could be seen as a redundancy payment but was more than the average wage.

He added: "The four SSP former MSPs gave half their resettlement to the party, in line with taking half the wages while we were there."

In the private sector, workers are entitled to two weeks' pay if they have worked for their employer for two years, with another week's pay for each further whole year. This would work at out at £4,000 for MSPs.

Monday, November 26, 2007

The York Press: Councillors’ pay row erupts again

By Gavin Aitchison

Proposals for a massive pay rise for City of York councillors have drawn further criticism.

York Green Party leader Andy D'Agorne says the pay for Labour's shadow executive members should be cut, to fund any increase in councillors' basic allowance.

The Labour group was condemned after the May elections for blocking moves for a "rainbow coalition" - a cross-party alliance - to run the city.

Coun D'Agorne said: "If they (Labour allowances) were removed altogether there would be more incentive for Labour to take part in an all-party executive for the city, rather than just opposing difficult choices made by the ruling group."

His comments directly contrast those by Labour leader David Scott, who said the shadow executive payments should more closely match those of the executive, to reflect the hung nature of the council.

As reported in The Press on Thursday, an independent remuneration panel has proposed a 41 per cent increase in councillors' basic allowance, with further increases for those with special responsibilities.

The recommendations were condemned by council employees' trade union Unison, and by the TaxPayers' Alliance.

Council leader Steve Galloway said he would not take any rise in pay, but said younger councillors with family commitments were entitled to an increase.

Coun D'Agorne said: "I have an issue with the inflated rates payable to chairs of committees - why should a chair of an ad hoc scrutiny committee be paid as much as the Conservative leader and more than double that of the Green group leader?"

He also voiced concern over proposals to make allowances pensionable, saying: "By reducing my college hours by one day a week to give me time to attend council meetings, I currently lose out on 20 per cent of my pension contribution.

"I don't think it helps anyone for councillors to have to sacrifice part of their pension or their career to be an effective councillor."

He said shadow executive allowances should be cut to pay for at least some of the proposed increase in basic allowances, and said scrapping them altogether would encourage Labour to join an all-party coalition.

He said: "It is important to stress these recommendations will have to be subject to debate as part of the budget process if any additional amount is to be made available from council tax to pay for any increases."

Coun D'Agorne's Conservative counterpart, Coun Ian Gillies, said: "The council has a statutory duty to look at allowances every four years and it's out for consultation at the moment.

"We will be commenting accordingly in due course. I cannot say if we will be supporting it."

Daily Telegraph: Exam watchdog's £4.2m hotel bill

By Graeme Paton

EDUCATION officials spent more than £1.6 million of taxpayers' money on top hotels and conference centres in just six months, it has emerged.

The five-star Park Lane and Le Meridien hotels were both among the venues used by the Qualifications and Curriculum Authority (QCA).

The Government's examinations watchdog used the hotels to host meetings in the course of a recent review it was carrying out into the secondary school curriculum.

The full extent of the spending only emerged after a whistleblower within the organisation raised concerns.

Matthew Elliott, the chief executive of the Taxpayers' Alliance, said: "The QCA's focus should be on improving the qualifications and exams for children in this country, not living the high life at taxpayers' expense.

"If their offices are not large enough for a conference and they need outside accommodation, they should pick cheaper locations rather than frittering away other people's hard-earned cash.

"The QCA should show a bit more humility and respect for taxpayers' money.''

It was disclosed that in the 2006/07 financial year, the QCA spent pounds 2.65 million on meetings around the country. Between April and October this year it spent a further pounds 1.62 million.

A "significant number'' of the venues were booked to prepare the Government's flagship diplomas - being developed as an alternative to A-levels and GCSEs - and its new senior school curriculum.

David Laws, the Liberal Democrat children's spokesman, said the pounds 4.2 million total figure - equivalent to the annual salary of almost 150 fully-qualified teachers - could have been better spent.

"We need to know why this agency cannot use school halls and other public buildings to hold meetings,'' he said.

The QCA booked venues including Rubens At The Palace, a luxurious four-star hotel next to Buckingham Palace, the Radisson Edwardian

Marlborough, a deluxe hotel in Bloomsbury, and the five-star Le Meridien, just yards from its offices in Piccadilly.

The disclosure comes as the Government prepares to split up the QCA and create an independent body, answerable directly to Parliament.

A QCA spokesman insisted that the secondary review was a "major national undertaking'' and the choice of conference venues were justified.

"As part of the consultations, the QCA talked with over 4,500 teachers and head teachers, approximately 1,000 officers from local authorities and more than 3,000 other parties including parents, governors and pupils,'' he said.

"There are some financial costs connected with any exercise of this type, however, the work is now complete and the new curriculum will start being taught from next September.''

Sunday Mail: Tory Flatcat

By MARK AITKEN Political editor

EXCLUSIVE MSP gets £60k selling property funded by public And he's now charging us £625 a month to rent

A TORY politician has pocketed £60,000 from the controversial free-homes-for-MSPs scheme.

And wealthy farmer Alex Johnstone is now charging the public more in rent than he did in mortgage payments.

Johnstone made the profit from selling his taxpayer-funded flat in Edinburgh. He is now living in the capital in a rented flat financed with more public cash.

Johnstone, 46, is claiming £150 a month more in rent than he did in mortgage payments.

And the North East Scotland listMSP is also a member of the committee reviewing politicians' accommodation claims.

Last night campaigners slated the move and urged Johnstone to "put the public first".

Earlier this year, the Sunday Mail revealed how MSPs were amassing millions in profits from second homes under the Edinburgh Accommodation Allowance.

The scheme allows MSPs who live beyond commuting distance of Holyrood to claim up to £11,000 a year for overnight stays. It can be used to pay hotel bills, rent or mortgage payments.

MSPs can even claim back council tax, heating bills and TV licence costs. But it has been condemned as a property scam that has let politicians profit from the booming housing market.

Johnstone, from Stonehaven, bought his Edinburgh flat in McDonald Road in 2000 for £92,000.

He then sold it last year for £152,000.

When he lived in the flat, he claimed £468 a month in mortgage payments. He is now claiming £625-a-month in rent.

Johnstone is a member of the Scottish Parliament Corporate Body, which is examining the accommodation scheme. In May this year, it was revealed his family firm, A&K Johnstone, claimed £76,000 in EU subsidies between 2000 and 2004.

Yesterday, a Conservative spokesman said: "Alex recognised public concern about MSPs owning properties. He now rents a property, which people argued was a better way, and the costs are the consequences of that."

Johnstone declined to comment.

But Mark Wallace, of the Taxpayers' Alliance, said: "The public are uneasy about the size of MSPs' allowances.

"Those struggling to pay taxes will not be impressed to see that some are making a tidy profit from their hard-earned money.

"Any system that allows this kind of profiteering is in urgent need of reform.

"Behaviour like this undermines people's faith in our institutions and contributes to huge apathy and resentment amongst people who see their taxes are spent frivolously.

"The MSP in question should start putting the public first and try to focus on minimising the burden on the taxpayer."

Burnham Times: Salary shock on NHS rich list

The acting chief executive of the trust running Musgrove Park Hospital in Taunton is paid more than the Prime Minister.

According to a public sector rich list Dr Peter Cavanagh earns £190,400 per year compared with Gordon Brown who earns £188, 849.

On a list of people receiving top NHS remuneration packages Dr Cavanagh, of Taunton and Somerset NHS Trust, is ranked 22nd below people from large city and London hospitals.

The average earnings on the NHS list was £181,956 and the highest was Norman Lindsay, director of Turnaround at Whipps Cross University NHS Trust who received £395,000 a year.

This compares with a nurse's starting salary of just £21,985.

The rich list was the second one produced by the TaxPayers' Alliance which lists the 300 most highly paid people in the public sector.

It was compiled so taxpayers can judge for themselves whether the remuneration of senior officials represents good value for money.

TaxPayers Alliance chief executive Matthew Elliott said: "Taxpayers have a right to know how much senior public sector officials are being paid."

In response to Dr Cavanagh's name appearing on the list a spokesman for Taunton and Somerset NHS Trust said as acting chief executive he is responsible for more than 4,000 staff, an annual budget of £180m, and all the activity of a busy district general hospital.

He is a working consultant radiologist and his total remuneration package in 2006-07 was made up of a number of elements.

They were:

Standard NHS consultant's salary;

A national Clinical Excellence award of £45,000, paid centrally and not by Musgrove Park, for his contribution to excellence in the delivery, development and management of health care;

Responsibility payment for being medical director and acting chief executive; and

Pension contribution and allowable expenses such as mileage.

The spokesman said: "As the survey shows, it is usual for senior medical directors to receive remuneration packages similar to this - with 16 other medical directors of NHS Trusts in broadly the same range."

But a union official claimed NHS workers would feel undermined by the size of some salaries.

Unison regional health manager Joanne Kaye-Smith said: "The lowest paid staff, who run the NHS day in and day out, are on less than £6 an hour and it's beyond belief that someone else working in the same organisation is worth so much more. It is of immense concern to us that the NHS is paying enormous salaries to those at the top while those at the bottom, cleaning hospitals and cooking for patients, are paid so little.

"The majority of staff within the NHS have clear and transparent pay scales and are presently subject to Government pay policy resulting in below inflation pay awards.

"The news that different rules apply to those at the top is a slap in the face for staff, who ultimately are those people most likely to make a difference to patient care."