He becomes agitated when discussing a Harvard Business Review article from 2008 by Jean-Pierre Garnier, the former chief executive of GlaxoSmithKline, on the future of drug development. He agrees with the prognosis, but is fundamentally at odds over the prescription for change.

"In this time of gloom, the pharmaceutical companies ought to be doing extremely well," he says in his Scottish lilt. "There is no market as unique as drugs; when people are distressed, their desire for relief pre-empts all others; and the industry has a reputation for being good at development. The trouble is that it keeps making promises."

Still working, debating and writing in his 83rd year, long after most of his peers have quietly retired, Sir James has plenty of recommendations for improvement in an industry that has suffered from a flagging product pipeline, and still more thoughts on what has gone wrong.