The boss of the region’s ambulance service has been urged to consider paying back some of his wage after it emerged that he was being paid almost £100,000 a year more than his contemporaries.

Anthony Marsh, the CEO of the East of England Ambulance Service Trust (EEAST) and West Midlands Ambulance Service, has come under criticism over the last two weeks after it emerged that he was on a salary of more than £232,000. Government officials said this week that they would not tolerate a culture of excessive executive pay in the NHS.

However, a spokesman from the Department of Health revealed that the department gave no guidelines to NHS trusts on the upper limits for CEO wages.

Dr Marsh, who conducted a damning review into the management of EEAST last year, was appointed as interim CEO of the beleaguered ambulance service in January where he pledged to put more paramedics on the front-line and increase double staffed ambulance numbers.

However, an MP branded the dual role as “unsustainable” last night after junior health minister Dan Poulter said the chief executive’s wage as “obscene.”

NHS bosses yesterday said that Dr Marsh had achieved a lot in his first eight months in charge of EEAST and was putting the trust on the right track after years of failings.

However, Tom Watson, MP for West Bromwich East, said there were still questions that needed to be answered over the appointment. He added that there were already concerns about the West Midlands trust not hitting some response targets.

“I agree with the health minister that said it was too much money. It is highly irregular and there is a distinct lack of transparency and the arrangement does not work for anyone.”

“As a person looking at it from the outside, the arrangement looks completely unsustainable. Who gave the instruction to suspend the recruitment by open competition at the East of England and was it a result of ministerial pressure?”

The average wage for an ambulance trust chief executive in England is £145,000.

Dr Marsh, who works around 70 hours a week in his two chief executive roles and is also chairman of the Association of Ambulance Chief Executives, earns £232,226 a year. He also gets added on benefits of a car allowance of £9,400 and a pension of £33,672. An NHS Trust Development Authority (TDA) spokesman said Dr Marsh’s appointment was made in collaboration between the TDA and the East of England and West Midlands ambulance trusts.

They added that NHS trusts are responsible for administering the work-related expenses as well as travel and accommodation arrangements of their staff. The spokesman added that number of local MPs were aware and supportive of the plans to second Dr Marsh. A Department of Health spokesperson said: “It is right that senior managers are properly rewarded as long as they are accountable for their performance.

“However, we want executive staff to exercise greater pay restraint than staff working on the front line, and won’t tolerate a culture of excessive executive pay in the NHS. NHS organisations should always use taxpayers’ money responsibly.”

EEAST has so far made offers of employment to 352 of the 400 student paramedics it aims to hire by the end of March.

A spokesperson for the trust said: “Since his appointment, Dr Marsh has saved taxpayers approximately £8m of back office functions and management savings to help fund the recruitment of 400 new staff.

“The joint role does in fact save the tax payer approximately £130,000 on the cost of a having a substantive chief executive in each ambulance trust. It’s ludicrous to suggest the tax payer is getting poor value for money when taking everything into account - the organisation has turned a corner thanks to the actions Dr Marsh has put in place.”

How does Anthony Marsh’s salary compare?

• Simon Stevens, the chief executive of NHS England, earns £189,000 a year after he opted to take a 10pc pay cut when he started the job in April.

• Prime Minister David Cameron is on a salary of £142,000.

• The chief executive of Yorkshire Ambulance Service was paid £125,000 to £130,000 in 2012/13.

• The boss of the North West Ambulance Service is on a salary of up to £150,000.

• North East Ambulance Service pays its chief executive between £130,000 and £135,000 a year.

• The CEO of the South Central Ambulance Service has a salary of between £140,000 and £145,000.

• The South East Coast Ambulance Service boss earns £160,000 to £165,000 a year.

• The salaries of the London Ambulance Service, South Western Ambulance Service, and East Midlands Ambulance Service CEOs were not available last night.