He is the man who told the NHS it had to find savings of £20 billion over four years and his name was given to the task: the Nicholson Challenge.
But Sir David Nicholson, the chief executive of the Health Service in England, is facing questions about his own ability to find savings after details of his latest travel costs were published by the Department of Health. They reveal the NHS is spending £5,000 a month on his travel and hotel accommodation expenses. In the three months to September last year, the Department of Health spent £4,329 on his rail fares, £3,188 on hotel accommodation and £8,000 on an official car and driver.
The scale of the costs dwarfs that of the other 12 most senior officials in the Department, who between them spent £5,000 less over the same period.
Sir David has a basic salary of more than £200,000. But despite his job being primarily based in London, under a deal struck with the Department several years ago, he is allowed to live in Birmingham and have his journeys to London paid for by the taxpayer.
The Department also paid for the cost of a London flat where he stayed during the week until last year. That arrangement has now ended but, as a consequence, the Department has started paying for London hotel accommodation and more first class rail journeys to and from Birmingham.
Sir David is in charge of delivering drastic efficiency savings in order to meet budget restraints at a time of growing demand for services.
Sources in the Department of Health said Sir David had to travel around the whole country for his job – in particular Leeds where the Commissioning Board will be based.
A spokeswoman for the Department of Health said it did all it could to ensure good value for money: "The nature and responsibilities of the role of NHS chief executive necessitate travel across the country, in keeping with a national public role at the head of the largest organisation in Europe.
"All travel is booked in advance wherever possible and journeys are predominantly conducted by rail. Travel by car may be used for journeys at short notice or in anti-social hours, or to locations not accessible by rail."