She is renowned for hosting boozy karaoke nights in her Parliamentary office and for chomping on a cigar, but now Therese Coffey faces one of the biggest challenges in government.
She has long been a divisive figure - in June she said she would "prefer that people didn't have abortions" and voted against same-sex marriage in 2013.
The Liz Truss ally and close friend was branded "utterly heartless" by Piers Morgan when she hit out at school meal campaigner Marcus Rashford on Twitter, before being silenced by the footballer's classy reply.
Tonight she was confirmed as the minister in charge of the nation's health, with the mammoth task of slashing waiting times and tackling possible strikes by NHS workers.
She will balance her role as Health Secretary with serving as Ms Truss's deputy Prime Minister.
Controversy has followed Ms Coffey since she was first elected 12 years ago.
The 50-year-old sparked fury last year during her tenure as Work and Pensions Secretary when she suggested Brits should work longer hours to make up for her £20-a-week Universal Credit cut.
She was also heavily criticised in 2016 when it emerged she had received free trips to horse racing events paid for by betting firm Ladbrokes - having defending the use of fixed odds betting machines in deprived areas.
In June 2020 she was branded "heartless" after a blunt response to Manchester United and England star Marcus Rashford, who shone a light on child poverty during the pandemic.
The footballer tweeted: “When you wake up this morning and run your shower, take a second to think about parents who have had their water turned off during lockdown.”
Ms Coffey replied: “Water cannot be disconnected though.”
The footballer posted in response: “I’m concerned this is the only tweet of mine you acknowledged. Please, put rivalries aside for a second, and make a difference.”
Following the exchange former Piers Morgan fumed: "Unbelievable. The tone deafness of that response just about epitomises this government.
"Heartless, utterly heartless. Devoid of empathy. Devoid of any ability to see through any of their job-saving nonsense. Therese Coffey, shame on you."
Before the pandemic, Ms Coffey was reportedly the host of notorious late night "karaoke sessions" in the Houses of Parliament, which would regularly take place in her Commons office.
Footage emerged of her and welfare minister Will Quince belting out a version of “(I’ve Had) The Time Of My Life” at the Tory Party Conference - a day after the Universal Credit uplift was scrapped.
Her voting record since becoming an MP in 2010 is controversial.
Ms Coffey opposed same-sex marriage in 2013, as well as in Northern Ireland in 2019, and also voted against the Assisted Dying Bill in 2015.
In March this year she was one of 174 Tory MPs who opposed extending access to abortion pills at home.
But she is well regarded in Tory circles, with Nadine Dorries claiming "nothing goes wrong'" in her departments, and earning a reputation as a workaholic.
Before being elected to Parliament she studied chemistry at Oxford and worked for chocolate giant Mars before becoming a finance manager at the BBC.
She made two failed attempts to enter the European Parliament before securing the safe Tory Suffolk Coastal seat in 2010.
Ms Coffey landed her first government role two years later, holding various posts including junior minister in the Department for Environment, Food and Rural Affairs.
She joined the Cabinet when she was appointed work and pensions secretary by Mr Johnson in September 2019.
At the time, she celebrated the moment by tweeting a photo of herself and Ms Truss, saying: "I was delighted to attend my first Cabinet meeting at No 10 with my mate @trussliz showing me the ropes".
Replacing Dominic Raab as Deputy PM, Ms Coffey's primary duties are to stand in at Prime Minister's Questions and chair the Cabinet if Ms Truss is absent.
As Health Secretary, she will face the challenge of sorting a plan for the NHS without the guarantee of extra funds from the soon-to-be-canned national insurance hike.
Moments after taking the health portfolio she said her priorities were ABCD - ambulances, backlogs, care and doctors and dentists.
