My decision should be seen in the context of the changing role of the center of the NHS, said Granger in a statement, and the fact that when I took on this challenge [in October 2002] I said I would give this job five years. Granger plans to return to work in the private sector next year and is currently considering a number of approaches from unnamed companies.

In an interview with the Financial Times, Granger described his time at the NHS as quite simply relentless. He added that his decision to leave was a very personal one, motivated by a desire to spend more time with his three children.

Prior to joining the NHS, Granger was a partner at Deloitte Consulting. He had experience of working in the public sector, having overseen a number of major projects including the introduction of the congestion charge in London. Granger was often described as the UK’s highest-paid civil servant, with reports suggesting he earned 280,000 pounds ($555,000) a year for his work with the NHS.

During his time overseeing the NHS IT upgrade known as the National Programme for IT, or NPfIT, Granger has earned a reputation as an outspoken personality. Infamously, he once compared the main contractors in the NHS project to huskies pulling a sled.

When one of the dogs goes lame, and begins to slow the others down, they are shot, he said. They are then chopped up and fed to the other dogs. The survivors work harder, not only because they’ve had a meal, but also because they have seen what will happen should they themselves go lame.

For much of Granger’s tenure, the NPfIT has been mired in controversy. The cost of the project has spiraled to an estimated 12.4bn pounds ($24.6bn) and has been beset by delays. At public events, Granger regularly joked that the stress of his job had resulted in his premature hair loss.

Despite the numerous setbacks, Granger has always insisted that the NPfIT would eventually succeed in delivering improved services to UK citizens. This certainty was still evident in the statement announcing his departure.

I am proud of what has been achieved by the team I established, he said. I passionately believe that the program will deliver ever greater levels of benefit to patients over the coming years. There remain a number of challenges ahead, but I firmly believe that the leadership of the program…will ensure these hurdles are overcome.