The terms practice development (PD) and health care governance (HG) have become synonymous with quality and modernization. However, limited activity has been devoted to deciphering why this is the case and what the potential benefits of PD and HG are in supporting the National Health Service modernization agenda. The paper attempts to demystify this issue by providing an insight into the drivers for modernization and through outlining the emerging debates associated with how and why PD and HG may provide the recipe for modernization.