CAPTAIN Cameron changed his crew aboard HM Government yesterday, including some of the most senior officers on the bridge, but without any indication of the major change of course so badly needed.

Rather, the Prime Minister's first major reshuffle suggests that we can expect more of the same. With the exception of the transport portfolio which signals a possible U-turn over a third runway at Heathrow, the changes are more of style than substance, with the importation of competent communicators and administrators in an attempt to improve the presentation and delivery of government policy.

So out goes Andrew Lansley, who has managed to antagonise the medical profession, in favour of the smooth-talking Jeremy Hunt. But will the English NHS be any safer in the hands of the man who bent over backwards to promote private sector interests in his last job?

Politically, this reshuffle illustrates how little room David Cameron has for manoeuvre in an increasingly uneasy coalition that has to accommodate restless backbenchers from both the Eurosceptic Tory right and the social liberal-inclined Liberal Democrats. Mass mutiny would be politically suicidal. At the same time, as the next General Election approaches, if the UK economy remains in the doldrums, Coalition MPs in marginal constituencies will become increasingly rebellious. With further reshuffles unlikely, even the hypothetical carrot of a minor government post will not be available to help lure MPs through the lobbies.

If anything, yesterday's comings and goings mark a slight shift to the right, most obviously in Chris Grayling taking the justice brief. He is more likely to favour replacing the Human Rights Act with a weaker British Bill of Rights than Ken Clarke who remains in the Cabinet, thanks to a clever soft shoe shuffle. As Minister without Portfolio, Mr Clarke, one of the most effective Chancellors of the last 20 years, will be charged with making Coalition economic policy more palatable. Mr Cameron clearly feared the havoc this outspoken old stager could have wrought from the backbenches.

The gap between rhetoric and reality on the subject of promoting women is widening. The cabinet is even "maler and paler" now, with just four women, down from five, and no non-white faces, following the demotion of Baroness Warsi (who continues to attend Cabinet but not as a full member). France and Sweden have equal numbers of men and women at cabinet level. The further marginalisation of women at the political top table sends out the wrong message.

All five LibDems retain their positions, including Scottish Secretary Michael Moore, which emphasises how little this reshuffle has to do with Scotland.

Significantly, the four main players in government – Iain Duncan Smith, Theresa May, William Hague and George Osborne – remain in post. For most of the electorate yesterday, the fact that the Chancellor was booed at the Paralympics on Monday night was more of a talker than the reshuffle. That sums up the problem. The economy is in the mire and the prospects are dire. The UK needs changes in not just personnel but policies.