One of the latest remedies for poor quality services is seen as being redesign of the health care system. Redesign is charged with political meaning, representing a radical challenge to practitioners and managers. But is it really a new approach? Although it draws on theories of re-engineering and total quality management, it is a pragmatic blend of components of both. Early findings suggest that quality improvement has been achieved but this has not been as extensive as anticipated. Redesign is in danger of being seen as the new magic bullet and thus may be being set up to fail. It may prove to be one more in a succession of discarded change management fads.