Leading article: A new prescription that may be too late

Gordon Brown will try again to seize the initiative when he announces a package of eye-catching reforms to the public sector today. The core idea of "Building Britain's Future" is to get away from that pre-eminent symbol of Blair-era government, the micro-management of myriad targets, in exchange for the delivery of few, more manageable, consumer "entitlements".

What this means in the health service, for example, as the Health Secretary, Andy Burnham, tells The Independent today, is that if a Primary Care Trust is unable to give cancer patients a specialist appointment within a fortnight of referral, it will be obliged to fund their private consultation. This all marks a change of gear on Mr Brown's part, a philosophical shift away from the centralising trend that he inherited from Tony Blair and has perpetuated. If the changes cut the amount of form-filling in the NHS, they are welcome. Targets may have had some use at first but were a blunt instrument, and doctors rightly complained that their use distorted NHS priorities and accentuated an unhealthy top-down management culture.

Whether any of these initiatives are sufficiently radical to reform the gargantuan NHS, or transform Labour's standing, is another matter. With no more than a year to go before an election, the success of this package is critical to Mr Brown's political fight-back. Long vulnerable to the charge of lacking vision, this is his riposte.

The great problem for Mr Brown is that these reforms come almost two years to the day since he became Prime Minister – two years marked by drift and incrementalism. His problem is compounded by the fact that many people have stopped listening to MPs altogether in the wave of the revelations about parliamentarians' expenses. The timing is doubly infelicitous in that they are being pushed forward in a recession.

Even the best reforms require the investment of some money up front. But the public is now more sceptical about the value it is getting from public services than it was two years ago. In other words, Mr Brown may benefit little from his latest proposals unless he can persuade the public that he is plotting a path to a more efficient health service.