The appointment of Peter Bradley as chief executive of the London Ambulance Service is less of a bombshell than the arrival - and abrupt departure - of its former leader, Michael Honey.
Mr Bradley was headhunted from New Zealand to become the trust's director of operational development in 1996 and looks like the natural man for the top job, despite the six-strong short list.
The unions seem quietly pleased. London Health Emergency, another thorn in the side of the trust, is at least pleased to see a chief executive in place, six months after Mr Honey left.
Mr Bradley also seems to have made a good start. He has defused a row over holiday leave that threatened to mar the summer. And he is in the middle of talking to staff about an improvement programme that should be finalised by October.
Difficult days, however, lie ahead. And the key to getting through them will be money.
Mr Honey was criticised, after he left, for failing to attract additional funding to his troubled organisation. The new improvement programme sets out a stall for an extra£26m.
Getting that money, as Mr Bradley is well aware, will be essential. But the new chief executive also acknowledges that money alone will not turn around LAS's response times.
In June, its ambulances reached just 35 per cent of urgent calls within eight minutes, against a target of 95 per cent.
Even allowing for the impact of Euro 2000 - 300 additional emergency calls flooded in every time England played - this shows the size of the task facing LAS.
Changes in working methods, as well as new staff, equipment and technology, will be needed to tackle it. It will be interesting to see how long the unions keep quiet as the changes come on stream.
In the end, though, LAS cannot tackle its problems in isolation from others in the capital.
Solutions to over-use of emergency services and London's choking traffic lie elsewhere. Coping with congestion, indeed, is the job of the new mayor.
Over to Peter Bradley - but also to Red Ken.