Managing director responsible for establishing the NHS Commissioning Board (2010 ranking: 43)

Sir David Nicholson appointed Mr McCarthy to lead NHS Yorkshire and the Humber in 2009 and has clearly not lost faith, entrusting him with the design of the NHS Commissioning Board. The former DH director general for strategy, system reform and policy is well placed to work out how the board will be run. He will influence how tens of billions of pounds are spent by the board and the new commissioning groups.

His in-tray includes many critical questions: How will the board relate to clinical commissioning groups and the major specialist and teaching trusts that will rely on the board for most of their income? How will the board wield its direct control of 8,000 GP contracts?

That in-tray will also involve tackling how to negotiate the annual mandate with the health secretary; how to protect and use the board’s independence; and what calls to make on choice and competition. Moreover, his work will influence the fate of the thousands of DH, SHA and PCT staff liable to be transferred into the board.