Parliamentary under secretary of state for quality, Department of Health (2010 ranking: 19)

It is difficult to find anyone with a bad word to say about Lord Howe. He is “Freddie” to all (partly to differentiate him from Lord Geoffrey Howe - a very different beast). His straightforward and cheerful manner has endeared him to all sides of the upper house and the DH.

During the Conservative years in opposition Lord Howe shadowed health in the Lords and earned himself a name as someone who could foster cross-party consensus against government proposals, partly achieved by giving a fair wind to those proposals he thought had merit. It would be wrong, however, to mistake his easy way with fellow peers for an absence of politics.

His first year as a coalition minister marked him out as an able operator, recognised in his 19th place in last year’s HSJ100. His rise for the year ahead can be put down to two things: the tricky task of seeing government legislation through the Lords and his role as the conscience of the Conservative party in the health ministerial team.

The Lansley reforms were always going to have a tough time in the Lords. Some details were in neither parties’ manifestos, nor did they feature in the coalition agreement. This gives the green light for the disaffected on all sides, especially the crossbenchers, to make the passage of legislation as difficult as possible. It will need all of Lord Howe’s guile and charm to see the business through. Few would bet against him doing it.

As the coalition becomes less comfortable and eyes look to the next general election, the blue part of Number 10 is increasingly asking: “How does this help the Conservatives to a majority at the next election?” A role unsuited to the technocratic health secretary, but ably filled by the politically astute Freddie.