Sir Liam Donaldson's review of the health service in Northern Ireland was ordered by Edwin Poots last year, published under his successor Jim Wells in January and now the latest DUP health minister has announced the first big change arising from this process.
The Donaldson report made a series of recommendations, including the closure of local hospitals and simplifying the system for commissioning, as well as other proposals.
Current health minister Simon Hamilton has opted to tackle administrative structures first, announcing that the health and social care board, which commissions services for the six health trusts, is to close down.
Mr Hamilton said the current set up ``has not worked'' and the structures ``blur the lines of accountability and weaken authority.''
This is quite an admission of failure with regard to a system that was only established a few years ago following the last attempt at streamlining services and improving efficiency in the NHS.
In political terms, a minister announcing he is sweeping away a layer of bureaucracy always sounds bold and decisive and Mr Hamilton could do with positive headlines after taking a battering over his party's in-out policy.
It also allows him to address a key question raised in the Donaldson report, namely, who is in charge of the health service in Northern Ireland?
Mr Hamilton is saying he is in charge and the trusts are accountable to the minister and the Department of Health.
However, the public will find it hard to understand how a layer of bureaucracy can be removed yet there will not be significant savings to the public purse.
Of course, the real issue which is not being fully addressed is the number of hospitals serving a population of 1.8 million.
Mr Hamilton has signalled this could be a long process which sounds as though he is not planning to grasp this particular nettle any time soon.
But it is a nettle that will have to be grasped if we are to get to grips with the serious problems in our health service.
