''Oh, yes, I couldn't deny that'', Sir Malcolm Grant airily admits, when pressed on whether he is a member of the English establishment.
A desire to be at the ''absolute centre of things'' prompted his departure from Dunedin in 1972 to forge a career in England.
The young University of Otago law graduate, who grew up in Oamaru, was then an outsider, his New Zealand qualifications not sufficient for admission to the legal bar there.
''There's a big advantage in being different, not being part of the English establishment, being classless, and not being characterised by where you went to school.
''People used to tease me about my accent - they still will.''
Unable to work commercially, he entered academia, and is best known for a stellar university career that included a decade as vice-chancellor of University College London (UCL).
''That was the real job of a lifetime. I just absolutely loved that job.''
He has since been admitted to the bar, acquiring arcane legal honours such as Bencher of Middle Temple, whose members are drawn from the ranks of the ancient legal inn.
More significantly, Sir Malcolm has been entrusted with a quintessentially English institution - the National Health Service.
''The NHS has been running for about as long as I have. It started in 1948,'' the 67-year-old says.
Knighted in 2013 for services to higher education, Sir Malcolm was appointed chairman of NHS England in 2011.
Its inaugural head, Sir Malcolm was recently reappointed for three years.
A first in NHS history, the independent board was set up to better manage its $NZ232billion annual budget and chart a future course for the health service behemoth.
He is also on the board of Genomics England, which is experimenting with whole genome sequencing.
''This is the beginning of a new era of molecular medicine.''
He is excited by its potential and says such innovation is essential if Western health systems are to be affordable in the long term.
Sir Malcolm lives in London with his wife Chris, and the couple have three children and three grandchildren.
He visits New Zealand once a year - the last trip was for just four days, during which he gave an academic paper in Auckland.
He usually spends longer, and a priority is visiting siblings in Wellington and Christchurch.
The youngest of four, Sir Malcolm left Oamaru in 1966 to study in Dunedin.
''For 17 years, Oamaru was my whole life.''
He says he did not appreciate it at the time, but Waitaki Boys' High School provided a remarkably broad education, from high-level calculus to animal husbandry.
''Teaching quality varied from the truly outstanding - I had teachers who did inspire me - to those who were absolutely awful.''
Dunedin seemed ''absolutely huge'', he says, and even now, the ''great spread'' when entering the city impresses.
When he started his degree, the law school was based in the historic Dunedin courthouse in Stuart St.
He is aware of the recent row between the Government and the city over earthquake-strengthening the building.
''It's a lovely building - I heard about the fight.''
Otago University was ''good for law'', he says with certainty, and a teaching fellowship while he undertook his master's degree was ''one of the best things that ever happened to me''.
As well as providing an income, it no doubt helped him secure a mainstream academic job in England at Southampton University, where a temporary lectureship turned into a 15-year stay.
From there, he moved to UCL, before 12 years at Cambridge University, where he was appointed to the Chair of Land Economy.
In 2001 he was appointed as one of two pro-vice-chancellors at Cambridge, before returning to UCL in 2003 as vice-chancellor.
Running the London university allowed him to lead change that made more of it being part of a large city, he says.
He loved the hands-on nature of that job, and says in his NHS England role he is a step removed from day-to-day issues.
''I have an outstanding chief executive ... but he's the guy in charge.''
NHS England's yearly budget is about the same as New Zealand's gross domestic product, he points out.
As part of controversial Tory health reforms, the independent board was established to minimise potential for political whim to alter its course every few years.
''The Government wanted to have a more stable governance regime, but it was a huge step for them to take. They simply assigned to us the entire budget [for NHS England].''
Like many health systems, the NHS is trying to remove barriers between GP care and hospitals. Sir Malcolm says the best New Zealand examples of that approach are in Counties Manukau and Canterbury.
He has championed openness of decision-making, and board meetings are live-streamed on the internet.
''I believe the decisions are so important that the English public have a right to see who makes them and how we make them.
''That's been a bit controversial.''
His reappointment was ''something of a vote of confidence in what we're doing''.
While it was a ''completely different world'', he was familiar with health as UCL housed the United Kingdom's biggest medical school.
Chris, to whom he has been married for 41 years, is a doctor and so he also receives ''strong advice'' on health sector matters at home.
Sir Malcolm has recently accepted a new, largely honorific, role as chancellor of the University of York in north England.
He is also a former chairman of the Russell Group, which is an association of the UK's 20 leading research universities, and the Local Government Commission for England.
''Working in this country you really are at the very heart of things in the delivery of health care, in the leadership of research and medicine.''
