Lord Darzi's interim report for his review of the NHS clears the way for private sector providers to break the logjam over GP access.
The 54-page document is long on aspiration and short on detail, but the commitments on primary care are concrete progress. The junior health minister sets a benchmark of at least 100 new GP practices, whether traditional independent contractors or private operators, opening up in the communities where they are most needed, beginning with the 25 per cent of primary care trusts with the worst services.
The rationale for this is simple: there is a strong correlation between poor primary care and early death.
Meanwhile, health centres in easy-to-reach locations such as shopping centres will provide a wide range of services without the need to register with a GP there.
In a third strand of the access campaign, the government is leaning on PCTs to redouble pressure on existing GPs to adopt 21st century opening hours. To this end Lord Darzi has set a target of half of all practices to offer out-of-hours services - with a clear instruction for PCTs to find someone who will if existing providers won't. While the GP contract is still a route for reform that needs to be pursued, the government is right to take the shortcut of simply setting up competing practices where local GPs won't budge.
Recent primary care announcements - including the long-awaited framework for external support for commissioners - reveal that Gordon Brown's government still sees a significant role for the private sector in health, albeit with a little less zealotry than under Tony Blair.
Elsewhere in Lord Darzi's report, the proposed Health Innovation Council, a gathering of good and great to promote the take-up of new techniques and technologies, is a centralised waste of time.
The systems the NHS should be adopting are well known, and the NHS Institute for Innovation and Improvement, its National Innovation Centre and the regional innovation hubs are already in place to drive change. What is needed is regional and local action to bring change on stream, not yet another committee.
But although the solution offered is misguided, Lord Darzi's analysis of the impact of the failure of clinicians, managers and politicians to ensure new techniques are adopted is hard-hitting.
From heart attacks to diabetes to surgery, the message is stark - quality and length of life are suffering because the NHS is too slow to modernise.