Laura Donnelly interviews the new chief executive of Yorkshire and the Humber SHA
Margaret Edwards laughs now about the careful phraseology used by her school when she was thrown out for bad behaviour at the age of 15. After five years at the Department of Health as director of access, she has become accustomed to the language of diplomacy.
But back to her school days: 'My dad was headmaster of a neighbouring school so it was all very embarrassing for him ... rather than expel me they asked me not to carry on.' At the same age she left home after falling out with her parents, and became self-supporting. She started off selling pictures door to door and built up a business successful enough for her to buy her first home.
Determination is a continuing theme. Her early start did not stop her from going to university, by which time she had realised she was suffering from dyslexia. Surely a disadvantage for someone with a senior role implementing heavy policy. What about all those reports?
'I think it's an advantage. I can skim read quickly, I've got a good memory and good oral skills: I learned from an early age to pick things up quickly.'
After a degree in economics, at 21 she decided to 'become conventional' as she puts it, and got a job working in finance at a family practitioner committee in Norwich, for a 'lovely gentleman called Mr Pig'. Within six months she found herself standing on public platforms in order to close the local maternity unit: 'Pretty scary, really.'
There followed a succession of jobs in health authorities, children's services and community and acute trusts until she joined Heatherwood and Wexham Park Hospitals trust, where she spent six years, first as deputy, then chief executive before joining the DoH in 2001. Ms Edwards became director of performance, before the expanding role was split with director of delivery John Bacon, leaving her in charge of access - leading on the four-hour accident and emergency waits, primary care access and patient choice.
While A&E and primary care were seen as relative successes, Ms Edwards became better known for her work on choice, and in some respects best known for e-mail correspondence leaked to the press, in which IT czar Richard Granger accused the DoH of being 'in great danger of derailing' the NHS IT programme as the demands of choose and book increased.
Does she expect the NHS in Yorkshire to take well to the installation of a 'Department woman' in its midst? She winces at the description. 'I'm not getting that [from them] at all. As soon as I start talking to people they see that I know the NHS and they know this stuff is core to me ... as far as I'm concerned I'm coming home.'
What's more, people recognise the advantage of her knowledge of how the 'amazingly different' and 'much more opaque' culture of the DoH works.
What did she find most difficult? 'A lot of my leadership style has been about a charismatic, persuasive style; influencing and bringing people with me. As a civil servant you have to be completely neutral and objective - it's an interesting balance with passion and that's something I struggled with at times because I really believed in some of the things we were doing. But if a new minister comes along and wants to do something completely different then the assumption is you have no ownership of the agenda. That's quite difficult.'
She speaks highly of some 'fantastic' moments there ? discussing waiting lists with the prime minister, who 'completely got' the issues in hand. She recalls the 'odd moment in the headlights' less fondly ? 'you might think that when you do your first public accounts committee you would gradually learn by slowly accompanying someone ? but no'. Overall, time at the DoH taught her 'a lot about democracy ... and I think that will affect the way I run the strategic health authority'.