It was a bit of shock as earlier in the day his boss Andrew Lansley had repeated his pledge to confine 'Labour's political targets' to the dustbin of history and move to a regime based on outcomes.
Admittedly Mr O'Brien's praise for targets was limited – he thought they could be useful to 'jump start' change but added that they had had their day. The interesting point is that this is not a million miles from Labour's acceptance that targets may be subject to a law of diminishing return and that targets for providers should become entitlements for patients.
It was a brave performance from Mr O'Brien – he also acknowledged that moving from targets to outcomes was not going to be easy. Outcomes, he admitted, often can be measured only over the long term and may not fit in with political timescales.
It must be right for the politicians to find better ways of measuring NHS performance and in principle outcomes are better than process measures. But even process targets can still have a place, especially where we cannot establish clear outcomes or when the process itself matters. Speed of access will still be important for patients – the NHS needs to be responsive as well as efficient and effective.
Oh and there was one more piece of O'Brien courage – he suggested that the Conservatives would welcome an opportunity to meet with the social care minister Phil Hope, even at this late stage, to see if they could achieve political consensus on social care funding reform. Over to you Phil.