Scotland's health minister, Susan Deacon, has been replaced by her deputy, Malcolm Chisholm, as new first minister Jack McConnell loses no time in signalling that health is at the top of his agenda.
Ms Deacon, who is pregnant, was offered the post of social justice minister, but turned it down.
Her departure is part of a major shake-up of Scottish government in the wake of the appointment of a new first minister - Scotland's third.
Even before he was officially elected to the post last Thursday, Mr McConnell announced that he wanted a report on the state of Scotland's health services.
The first anniversary of publication of Scotland's health plan, Our National Health, falls on December 14. Mr McConnell says this will give him an 'ideal opportunity' to find out which targets have been met. He also plans a summit of NHS leaders to discuss improvements in the service. In addition, Mr McConnell has created a new minister of public services to push through reform and delivery, especially in the NHS.
Details have already begun to emerge indicating divergences from the previous regime.
While Mr McConnell's predecessor, Henry McLeish, had made it clear that Scotland would not be following health secretary Alan Milburn into a 'concordat' with the private sector, Mr McConnell, in an interview with The Scotsman, said: 'I do not have strong views one way or the other.
What I am interested in doing is making sure operations are carried out as quickly as possible and that we have an efficient use of all available resources.'
Scotland already uses private sector spare capacity for NHS operations.
It is clear that Mr McConnell wants to see rapid improvements in Scotland's health services, particularly in view of the extra resources it has been awarded.Ms Deacon had also expressed frustration with the slow pace of change.
A Scottish Executive spokesperson said that Mr McConnell had discussed with Ms Deacon the need for an urgent assessment of the performance of the NHS in Scotland.
The Scottish National Party had already seized on this as evidence that Mr McConnell had no faith in Ms Deacon, who was appointed by Scotland's original first minister, the late Donald Dewar. SNP health spokeswoman Nicola Sturgeon said: 'This is a public humiliation for Ms Deacon. It is clear that Mr McConnell has no confidence in her stewardship of the NHS.'
Mr McConnell and Ms Deacon have crossed swords before. After the first year of devolution, Ms Deacon fought for the return of£34m which had been clawed from her department. Though Mr McConnell, then finance minister, eventually agreed, it caused a split in the party.