Prime Minister’s Advisers including Steve Hilton, Paul Kirby and Paul Bate (New entry)

The advisers’ position shows the importance of 10 Downing Street in healthcare policy. David Cameron has had to acquire an understanding of healthcare earlier than most PMs and has strengthened his team accordingly.

Mr Kirby heads the policy team. a former KPMg partner who worked with george Osborne before the election, he believes in liberalised public services delivered by a range of providers. Mr Bate works on health and social care, having served in Tony Blair’s delivery unit, and he is thoughtful and highly regarded. He faces a challenge similar to that of predecessors such as Simon Stevens (96).

As well as developing visions for commissioning, hospital reconfiguration and financing, the advisers have the political challenge of creating a narrative that breaks out of a national echo chamber resounding with the cries of “Tories”, “nHS” and “cuts”. Both Pauls will work closely with Mr Hilton, Cameron’s lieutenant, who championed the original nHS reforms and has been evangelical about the Open Public Services white paper. Mr Hilton has clout and could push the PM back on a more reforming course.