Salary: £41,000

Philip Burton,43, joined the Hertfordshire-based PCG in February 1999. A former concert pianist with a masters degree in 17th century Italian opera, he was a hospital porter before joining the NHS management training scheme in 1980. After more than 10 years at acute and community units in North West Thames, the region funded him through an MBA. From 1994 he worked in health authority commissioning.

What was your career path?

I studied music at Liverpool University and piano at the Royal Northern College of Music, then moved to London to carry on my studies, paying for my education by taking professional work as an accompanist and working part-time as a care assistant in a nursing home.

I decided I didn't want to stay in music, which would mean a lonely life of staying in hotels and reading dusty books in the British Library, so I returned to Liverpool and ran a community arts project in Toxteth.

I then went back to London and got a job as a hospital porter in Greenwich, in a predominantly Afro-Caribbean team. I learned a lot about management there, and decided to go for the South East Thames trainee scheme. After working my way up in an acute trust in Watford, I moved to a community unit which then merged with an acute unit. I became director of marketing and business development, and unwittingly coined the phrase 'two-tier service' to describe GP fundholding.

I was one of five managers selected by North West Thames region to be funded for the Warwick Business School MBA, which was brilliant. I decided I needed to work on the other side of the fence, and got the job of assistant director of commissioning at Hertfordshire health agency, then at West Hertfordshire HA. Heading up a PCG seemed like a logical next step.

Describe your current job

At the moment I'm the only full-time manager at the PCG, and my key role is setting up the group, making appointments and establishing systems. In the short term, I'm getting to know the patch and all the relevant people. In the middle ground, we'll be working on the health improvement programme and clinical governance agendas and tackling all the ex-fundholding issues, ensuring everyone across the group has access to the same levels of service. For the longer term the group wants to become a first-wave trust, and there are frightening amounts of work to be done, especially while we are second-guessing the guidance.

How many hours a week do you work?

It should be 37, but it's more like 50 to 55 - the same as any other NHS manager.

What do you see as your biggest challenge for the coming year?

Unravelling fundholding and rolling out the benefits, getting over the split between management and primary care cultures, and involving the public in what we do.

What aspects of your job do you most enjoy?

Being part of a new world. Having a great board.

Which parts would you be happy to do without?

Bureaucracy. I hate rules and procedures and break out in a sweat if people ask me to sit on a steering group or produce an action plan.

How do you unwind?

I go running, reflect over a quick early evening pint on the way home and follow the downs and very rare ups of Blackburn Rovers. I'm also choirmaster for a choir which now has 35 members.

What has been the high point of your career?

Getting this job and finding out what a good board I've got.

What has been the low point of your career?

In the very early days of fundholding, a memo I wrote to a consultant colleague which acknowledged on paper, for the first time, the existence of a 'two-tier' service, was leaked to the press and appeared on the Nine O'Clock News and News at Ten. The hospital was crawling with TV crews and reporters. The ramifications opened doors for me, but at the time I felt like a liability.

What has been the hardest thing you've had to do at work?

Making staff redundant is never easy, nor is making decisions where you know they will detrimentally hit patient services.

What would you like to do in the future?

I don't really have a long-term strategy, but I'd like to run a primary care trust, even though it's a whole new ball game. When I retire I've thought about opening a bed and breakfast.

What other career might you have pursued?

I suppose realistically if I'd carried on in music I would have ended up teaching - which is awful if you don't really want to do it.

Could you ever see yourself managing an NHS Direct site?

At the HA I led on emergency services, so I started to understand about ambulance services and the like. I can see how NHS Direct and all the different out-of-hours systems in health and social care should coincide, and it should be used as a catalyst to bring all these disparate people together. But the change management to bring it all about is staggering. I feel PCGs will play a key role in all that, and I've got a lot to do here already.