Among the many papers competing for the attention of Alan Johnson, the new secretary of state for health, the one that calls out for priority is the report of a Cabinet Office team on the “capability” of the Department of Health.1 The report, one of a series of reviews ranging across Whitehall, is highly critical. The DH is not alone in attracting criticism; unsurprisingly the review of the Home Office was more scathing still, and no government department has emerged from the reviews as a flawless instrument for framing and executing ministerial policy. But the timing of the report's publication poses a challenge for Mr Johnson as he takes over as health secretary. The challenge is to decide just what kind of competence he wants his department to develop, and in turn what the department's role should be.

In a foreword to the capability review, the trio of officials at the top …