Time will judge whether the former health secretary becomes the man who destroyed the NHS or saved it, but there is no disputing that Andrew Lansley's fingerprints are all over the health service and will stay there.
His main achievement was somehow managing to steer the Health and Social Care Bill through Parliament. Although his new replacement at the Department of Health - Jeremy Hunt - will have the difficult job of working through what the detail of the incredibly complex legislation means.
The BMA's ‘no confidence' vote in the former health secretary – held at its annual representative meeting in June – was carried by 158 votes to 124, despite BMA chair Dr Hamish Meldrum calling on the conference to reject the motion.
‘I've got to negotiate with him, and it's awkward to say "here's your P45 – let's talk",' he pleaded.
Mr Lansley was elected as MP for South Cambridgeshire in May 1997 and served as shadow minister for health for seven years before being appointed health secretary after the general election in 2010. He was no rookie, but had been criticised as being too much of a technician and not able to explain the rationale for the reforms clearly enough.
In nominating Mr Lansley, one member of our panel said he was probably the most influential non-GP on the NHS ‘for all the wrong reasons', while another said the politician had ‘survived a turbulent year' although the full extent of his reforms ‘perhaps did not'.
He has certainly made history by becoming the first health secretary for decades to drive doctors to take industrial action over his planned changes to the NHS Pension Scheme.
His intransigence over pensions is probably motivated by not wanting to upset the Treasury, but it comes at an awkward time if he wants GPs to start delivering on his reforms over the next year.
Others said he has managed to do what many other BMA leaders wished they could and ‘created unity' within the profession, although he might not have welcomed the manner in which this was achieved.