Mr Fox's predecessors have been everything from fervent nationalists to bean-counting economists, but none has been what he is, a businessman to the core.
Even in conventional bean-counting terms, radical management turns out to be two- to four-times more productive than traditional management with its focus on scalable efficiency and treating customers and employees as things to be manipulated.
Mr Gapes said the quality of care was becoming secondary to "deficit-reducing bean-counting", telling MPs he was "extremely angry at the betrayal of my constituents" and pointing out that the current government had spoken out against the closure of hospital services whilst in opposition.