He will take over one of the toughest management jobs in Britain, with responsibility for a pounds 30bn budget, at a time when the NHS in England is facing the biggest upheaval in its central administration since its foundation in 1948.
The announcement that Mr Langlands, deputy chief executive since October 1992, has been appointed to succeed Sir Duncan Nichol on a salary of about pounds 88,000, is expected today. Sir Duncan leaves in April after five years to become a professor of health care management in Manchester.
Mr Langlands has collected plaudits and apparently made no enemies since joining the health service in Scotland in 1974 as a graduate trainee with a pure science degree from Glasgow University.
Spells in Scottish hospitals were followed by a move to London at 29 to manage the merger of University College Hospital and the Middlesex hospital. He spent almost five years running Harrow health authority, north-west London, in the 1980s, followed by a spell in the private sector running the health care business of the management consultants, Towers Perrin, before being brought back into the NHS to run North-west Thames after its general manager, David Kenny, suffered a stroke in 1990.
Friends describe him as having a fine intellect and a strategic view of the NHS as well as having impressed as a practical manager at every level of the service. One colleague said: 'The faster the flak flies, the cooler he gets.' Another said he was 'solid, very balanced, with a considerable brain'.
He is said to favour much in the NHS changes, to be non-ideological but to want to see the NHS market well regulated. 'He has very strong public sector values and principles and he wants to make things work,' one colleague said.
With Sir Duncan having helped devise and deliver the reforms, some see advantage in Mr Langlands being able to take them on without having been directly involved in their creation.
Although describing himself as apolitical, some suspect he might have been happier if the post had become available under a Labour government and the highly political aspects of the job are said to be the area where he is least happy. But his performance has impressed ministers, not least in his handling of last year's difficult, complex and politically charged review of NHS functions and manpower which as deputy chief executive he undertook with Kate Jenkins, former head of the Downing Street efficiency unit.
That review led to the decisions to abolish regional health authorities and slim down central management of the health service. He will have to introduce that programme when money for the service - in spite of its favourable treatment in the spending round - is tight and when widespread hospital closures are being canvassed as medical technology is sharply changing the pattern of health care.
One colleague said: 'He will have to implement the biggest changes to central management the NHS has ever seen while keeping the show on the road at a time when resources are tight, the impact of the NHS reforms are really beginning to be felt, and when almost every senior person in the service is going to be looking for another job and worrying about their futures. It's an enormous challenge.'
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