After 11 years of public service reform, the government's record is still dogged by poor performance. The failure regime unveiled last week shows ministers are running out of patience.
But will it work? Coming just days before the government threatened the weakest schools with closure, the underperformance plan has the feel of a government that fears it will soon pay an electoral price for failing to get all parts of the public sector to an acceptable standard.
The intervention plan is based on takeovers by the private sector or other NHS organisations, or parachuting in talented managers. But it is far from clear whether many high-flying staff will find the idea appealing.
Unions immediately attacked the plan as creeping privatisation. This hostility means any firm that sends in a team which then fails will have its reputation shredded by those anxious to prove the private sector has no place in the NHS. But it is hardly a more attractive option for mainstream health service managers. Someone who is leading a successful trust may well baulk at sending the cream of their team to a failing organisation while the trust they should be working for is neglected.
Ministers' preferred option is for a weak trust to be taken over by a strong one. The only example so far - Heart of England taking over Good Hope - is a success story, but there is no reason to assume that will be repeated.
In the private sector, evidence for takeovers turning around ailing companies is hard to find. Foundation trusts, mindful of the rough handling they can expect from Monitor if their finances are derailed, are going to want a compelling business case to convince them. And if they are willing to take the plunge they will be in a strong position to demand substantial, continuing financial support from the Department of Health.
But even if all these hurdles are surmounted, a trust may still fail. Sacking managers may win a few headlines but will not tackle wider issues such as oversupply. The government has been stalling for months on producing a plan for winding up a failing hospital; it needs to admit that in a market system a small number of providers may go to the wall - no matter how many management teams they consume.