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The Prime Minister has strengthened his team in Downing Street. He now needs to change the team in the Cabinet

It is an unfortunate fact of British politics that power is far too centralised. But, however unfortunate it may be, it is still a fact. That is why, pending a radical dispersal of power, it was always unwise of David Cameron to suppose that he could run his Government as a chairman, overseeing the chief executives of the various business outposts. Political authority flows upwards and does not stop until it reaches the top.

After a series of minor tangles and a major mess in the making in the National Health Service, the Prime Minister realised that his administration lacked crucial political intelligence. He acted decisively to rectify this, putting in place a bigger and much improved operation in Downing Street to plan and assess the political impact of bright ideas that had their origins elsewhere in Whitehall.

The work of the new team is already visible in the wise decision to reopen consultation on the Health and Social Care Bill. If and when crime or prisons policy starts to cause difficulties, Mr Cameron should, at least, have an early warning system. That does not mean, however, that all the personnel issues have been dealt with. Indeed, now that Mr Cameron has fixed his kitchen cabinet, he needs to turn his attention to the actual Cabinet itself.

The Prime Minister is known not to be a fan of unnecessary reshuffles. He has good reason. Ministers do move too frequently and most unforced changes have little positive impact on the public. If they have any effect at all, they usually succeed only in disappointing the vanquished and the never-to-be-called upon. Prime ministerial patronage used badly can be worse than patronage not used at all. The intricacies of coalition politics make reshuffles even more tricky than usual.

But, with that caveat, Mr Cameron ought to be thinking about shuffling the deck. If he waits too long, the summer recess will intervene, and then the restart of the political season runs straight into the annual party conferences. So, if the Prime Minister is going to freshen his team at all, the only opportunity he has is in early May, straight after the referendum on the alternative vote and the local election results. He may, of course, be glad of something to shift attention from either, or both, of those outcomes. But even if he does not need a diversion, there is ample reason to use that moment well.

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Serious questions have to be asked about whether a number of Cabinet ministers are being deployed in the right place. Despite the brave face he put on the pause in his legislation, Andrew Lansley has lost the political argument at Health. Since he was caught speaking out of turn, Vince Cable’s future at Business has been in doubt; a move to Health could suit him well. Liam Fox, the Defence Secretary, was not distinguished in the Comprehensive Spending Review, but can he be moved during a war? Eric Pickles appears intent on starting fights with as many councils as he can; and, at the Ministry of Justice, Kenneth Clarke’s proposals for prisons are a disaster in the making.

Any reshuffle involves the juggling of both personal and political relationships, but it is not as if there is no talent available. Nick Herbert is proving impressive as Minister of State at the Home Office, as is Greg Clark at Communities. If David Laws is ever freed from the endless investigation into his expenses he would be welcomed back into Government. Distinguished politicians such as Stephen Dorrell, Lord Ashdown of Norton-sub-Hamdon and Sir Malcolm Rifkind still have a lot to offer.

With the first anniversary of the coalition approaching it is clear that, when the eyes of the Prime Minister and George Osborne, the Chancellor, stray, policy is liable to go wrong. A better team in Downing Street has strengthened their grip but they will need to change the faces they see every Tuesday morning around the Cabinet table.