Outgoing NHS IT director general Richard Granger says the job his successor faces is not for the faint-hearted.

Granger, who has run the £12bn National Programme for five years, announced this week that he will leave in the next few months.

Despite being billed as the UK’s highest-paid civil servant, he says that the time he puts in brings his pay down to ‘considerably less than £50 per hour’.

‘One of the big challenges is that there are three moving parts to deal with: the political and stakeholder machine; the vast quantities of IT; and a whole bunch of new-build activity,’ he said.

‘You are continuously trading those three things in an environment with a high degree of scrutiny and scale.’

Granger is bullish about his successes, and continues to refute criticism of the programme’s central control. ‘We have delivered the best part of 20,000 applications and put in place a messaging architecture that will support the ever-changing structure of the NHS,’ he said.

‘There are now more than 100 applications that are NPfIT-compliant. This isn’t a monolithic approach, it is a messaging architecture that supports heterogeneous software in a heterogeneous environment.’

He also denies claims of cost overruns. ‘Despite all the twaddle written about costs, the programme is under-budget,’ said Granger.

‘None of the spin from people who want to kick the government, with silly numbers about NPfIT costing £30bn, has any substance.’