The chief executive of West Hertfordshire Hospitals NHS Trust, which runs Watford General Hospital, has been revealed as one of the highest paid NHS managers in the country.

Jan Filochowski collected a salary of £246,000, including a ten per cent bonus, in 2008/09.

This makes him the fifth highest earner in the health service, according to figures compiled by the Sunday Telegraph.

Since being appointed as interim chief executive in 2007, Mr Filochowski has overseen a remarkable turnaround in fortunes for the trust, which also includes Hemel Hempstead and St Albans hospitals.

He has also presided over the centralisation of many services at Watford's Vicarage Road campus and the opening of the new acute admissions unit last year.

Mr Filochowski was then formally appointed to the position, but this decision has come under fire from the Dacorum Hospital Action Group (DHAG) following an independent report by the East of England Strategic Health Authority (SHA) published last month.

The report found that although the trust acted in its best interests and those of its patients by appointing Mr Filochowski, more should have been done to ensure the process met the expected standards.

In a letter to all NHS organisations in the eastern region, SHA chairman Keith Pearson wrote: “I do believe that a formal appointment panel should have been convened, even if it was the case that there was only one credible candidate for the role.

Betty Harris, DHAG chairman, said: “The public would be astonished if such an abject failure of proper procedures in the appointment of a key and very highly-paid local health official were allowed to pass without serious consequences. It cannot be just ‘business as usual’.

“DHAG believes that the honourable thing for the chief executive to do would be to stand down, given that the appointment was flawed and so has no legitimacy. He came as an interim manager for a specified period and that is how things should have stayed.”

David McNeil, director of communications at the trust, said: “Patients would expect an organisation the size of West Hertfordshire Hospitals NHS Trust to have the very best leadership and in Jan Filochowski the report confirms that it has the right man for the job.”

In the same Sunday Times report, Caroline Tapster, the chief executive of Hertfordshire County Council, was named among the top earning local authority bosses in the country, with an annual salary of £203,427 and a car allowance worth £3,659.