Health Secretary Jeremy Hunt had a landmark year in 2004.
Not because of events in his personal life or career but because that was the year the way the NHS pays GPs changed. It meant a big pay rise for the doctors who make up the backbone of the NHS. It also meant that they could opt out of providing 24/7 care for patients on their lists.
The old system was awful - it meant GPs could be called out in the middle of the night or at weekends while trying to maintain daytime surgeries, sometimes dog-tired and not at their best.
The new system opened up out of hours services to private companies who could bid for contracts.
Jeremy Hunt thinks it hasn't worked well. People don't trust doctors who come to treat them when the GPs surgery is closed.
So they vote with their feet and go to A&E departments. That, he believes, has been a major factor in building up the pressure on emergency departments and creating what everyone agrees is a real crisis.
In a letter leaked to the Independent newspaper today, 20 senior A&E doctors from the Midlands say their departments suffer from "toxic overcrowding" that threatens patient safety.
Later this week, Hunt is expected to launch a series of reforms to the way GPs work.
A summary of those proposals, seen by ITV News, shows he wants to revive the idea of the "family GP". Every patient should have a named doctor who is responsible for their care 24/7.
That doesn't mean that they have to go back to the old system of turning out themselves in the middle of the night to visit sick patients. It does mean they are responsible for making sure that there is a proper system of out of hours cover.
There would also be a new Chief Inspector of General Practice to run a tough regime of inspections to ensure GP surgeries are focussing on their patients.
GPs we've spoken to seem to be happy to talk to the government about ways of improving services like out of hours cover. But they don't want to go back to the old debilitating system.
There is room for compromise - how much remains to be seen.
For the Labour opposition this is all a diversion. The Shadow Health Secretary Andy Burnham says the government is wrong to blame GPs for the A&E crisis.
That, he claims, is the result of cuts in the number of nurses, the closure of walk-in centres, and the failings of the 111 emergency telephone system, all of which happened on David Cameron's watch.
As usual in the divisive world of health politics, they're probably both right to a certain extent.
And at least people are now talking about how to sort out the A&E crisis and the mess of out of hours cover.