NHS deputy chief executive (2010 ranking: 6)

A testament to Mr Flory’s standing is that his combined finance and operations job was to be transferred to the new NHS Commissioning Board. When, apparently, he decided not to join the board, the role was split. No one else was deemed skilled or reliable enough to hold such power.

The question of what Mr Flory will do next is hard to answer - he is, after all, a big fish. Some are linking him to one of the two chief executive posts that may be created if Monitor forms separate boards to tackle its, possibly conflicting, roles of foundation trust authoriser and sector regulator. But Mr Flory’s DH post is so pivotal that, even if he occupies it for only half of 2012, his influence will be enormous. This will be especially so as Sir David Nicholson focuses attention on establishing the commissioning board.

Mr Flory’s remit includes: the financial performance of the most challenged acute trusts; the new focus on tackling long and hidden waits; the review of 75,000 provider contracts and the fate of the billion-pound estate used to deliver community services.