Pocket profile Jovial, mercurial civil servant turned NHS policy wonk and patients' champion. Private secretary to the late Sir Roy Griffiths.

Became trusts manager at the old National Association of Health Authorities and Trusts, then head of policy at the Institute of Health Services Management, and short-lived chief executive of the Patients Association.

What is he famous for?

Dreamed up 'Re-inventing Healthcare' for NAHAT in 1993, a plan to cut the number of district general hospitals in the UK to 30.

Formed a rent-a-quote double act at PA with former chair John Spiers.

What happened?

PA finances got tight. In January 1997 Mr Howland left after just over a year in the job. 'They could no longer afford me, ' he says.

Where is he now?

Running a PR/government relations outfit. Clients include a mental health charity, Mental Health Matters, and a home care firm, Healthcare at Home.

Regrets? Invokes the old Edith Piaf standard.

Adds: 'I remain an outsider and a radical.'

Remaining ambitions Would like to see NHS services 'more patient-focused' and would consider returning to the NHS if he could pursue this ambition. 'I'm really happy running my own company but if someone made me a good offer I would never say never.'