England’s health secretary has been putting flesh on the bones of his strategy for the NHS with almost indecent speed. After six years shadowing the role Andrew Lansley is a man in a hurry, and he seems to have transmitted some of that urgency to the department he now runs. Consultation papers are pouring out, and Mr Lansley himself is ever present, selling the story to any audience that will listen.

He does it well. When he’s in full flow you can see how the reform is meant to work and you begin to believe in it, just a little. It’s an unusual and even uplifting experience to see a politician who really wants to convince the doubters by the force of argument. Under the previous government these discussions often took place elsewhere to avoid parading differences in public, and policies appeared unrehearsed and at unexpected moments, such as Tony Blair’s promise in a television interview to match European levels of spending on health.

Mr Lansley’s basic pitch is that general practitioners provide an unexploited talent pool that, properly harnessed, will make the system work better. It’s an act of faith, like …