Bill Morgan (2010 ranking: 32), Sean Worth (2010 ranking: 16), Paul Stephenson (new entry) and Jenny Jackson (new entry)

The trouble the NHS reforms are in can be measured by the number of advisers that now cluster around Mr Lansley. Mr Worth has been brought in from Number 10 to assist good friend Mr Morgan with implementation of the reforms. Mr Stephenson - as media adviser - has strict instructions to get the NHS off the front pages. The view is the public are drawing negative connotations from almost any NHS story, regardless of its subject. He has replaced Ms Jackson, who now acts as Mr Lansley’s gatekeeper in his private office.