The Healthcare Commission's State of Healthcare report, published on Tuesday, reveals much to celebrate (for more background, click here).

Waiting times are plummeting, safety standards are edging up, progress is being made on the big killers of cancer and circulatory and respiratory diseases, and we are living longer.

The waiting time improvements are staggering. At the end of March, 352 patients had been waiting longer than 26 weeks for a hospital appointment. Seven years earlier it was 264,000. Put another way, the figures are 754 times better - an amazing achievement which demolishes any suggestion that services have not improved under Labour.

As HSJ's news analysis reveals this week, waiting time reductions are won on the back of formidable efforts by clinicians and managers, from rigorous analysis of clinical pathways to the sheer slog of clearing backlogs.

The problem areas the report discusses are, in the main, well known. They include the disparity in life expectancy between the wealthiest and the poorest, lack of leadership by trust boards on tackling patient safety, and poor inpatient facilities for the mentally ill.

But the findings on primary care are a serious jolt for PCTs that fancy themselves as 'world class commissioners'.

The report accuses many PCTs of simply not understanding local health needs, rendering them incapable of buying the right services.

Examples include an estimated 140,000 people with undiagnosed heart failure, 60,000 fewer people getting care from community matrons than planned, and 5,000 severely mentally ill people unable to access crisis services.

Barely one in seven PCTs has educational programmes for diabetes sufferers, while endemic shortcomings were uncovered in monitoring by GPs of obesity, smoking and chronic conditions.

Huge improvements are still needed if the health service is to tackle inequalities and deliver world class services.

But the waiting list improvements are still amazing.