His earlier career was spent as an administrator and manager in the National Health Service (NHS).
He studied at the University of Manchester, graduating with a Bachelor of Science (BSc) degree.
[2] He was a general manager of the Royal Free Hospital from 1986 to 1991, and the chief executive of St George's Healthcare NHS Trust from 1991 to 1999.
[3] In September 2013 he wrote an open letter to The Times in which he said companies should be sure that all expenses spent on research were necessary in order justify the high prices demanded for new products assessed by health technology assessment (HTA) bodies such as NICE: "If it really does cost £1.2bn to develop a new drug, the question the pharmaceutical industry must be able to answer is this: are you absolutely confident that it needs to?".
[4] He was said by the Health Service Journal to be the 34th most powerful person in the English NHS in December 2013.