Anthony Marsh’s salary is now £232,000-a-year, almost £90,000 more than the Prime Minister’s £142,500 pay.
He splits his time between West Midlands Ambulance Service (WMAS) and East of England Ambulance Service.
Bosses defended the increase saying it was cheaper than hiring another boss to run one of the organisations full-time.
But Tom Watson, Labour MP for West Bromwich East, accused the Government of authorising “banker style” increases. Hesaid: “This man is probably the highest paid public servant in the West Midlands and nobody has ever heard of him.”