Mr Cameron has moved Justine Greening from Transport to International Development, and replaced her with Patrick McLoughlin, who was formerly the Tories' chief whip.
Miss Greening, MP for Putney in south west London, was strongly opposed to any expansion to Heathrow, and has even marched publicly against it.
By contrast, Mr McLoughlin is a Midlander with a constituency in Derbyshire. That, of course, is nowhere near the third busiest airport in the world, and therefore he is an ideal MP to lead a change of tack.
Nevertheless, such a change of policy - still unconfirmed at this stage - would represent yet another major U-turn by Mr Cameron's government.
The Tories' 2010 manifesto, which helped the likes of Ms Greening to be re-elected, said its aim was to "make Heathrow airport better, not bigger".
It is no surprise, therefore, to see London mayor Boris Johnson angrily reinstating his long-held opposition, considering the obvious inference to be made from today's activity.
"There can be only one reason to move her - and that is to expand Heathrow Airport," said Mr Johnson, who added that the idea was "mad".
Now, on this issue, Mr Cameron needs to be careful. Once contemporaries of the infamous posh boys Bullingdon club, the Prime Minister and the mayor have increasingly been seen as political rivals.
Indeed, following Mr Johnson's successful re-election in May - and poor results elsewhere for the Tories in the local polls on the same night - the headline on the front-page of the Times was "Boris wins, Tories lose".
Ever since then, Mr Johnson has been seriously touted as the next Conservative leader, rather than Mr Cameron's friend George Osborne after the Chancellor oversaw a disastrously-presented Budget.
Yes - while it has been a glorious summer at the Olympics and Paralympics for British athletes - this has been another tough few months for the government... and making life hard for themselves has become somewhat of a speciality.
Mr Osborne's budget was criticised for freezing pensioners' personal allowances to pay for a cut to the top rate of income tax.
And, subsequently, there was a series of U-turns over VAT on pasty tax and caravans, charity tax relief, and a planned 3p per litre fuel duty rise.
Meanwhile, then-Culture secretary Jeremy Hunt came under pressure following a nervous appearance at the Leveson Inquiry into press ethics which revealed his close links to the Rupert Murdoch media empire.
Mr Hunt, who was considering Mr Murdoch's BSkyB takeover bid, even faced a vote of no confidence in which the Tories' coalition partners, the Liberal Democrats, abstained.
Fortunately for Mr Hunt, though, he retained the backing of the PM, and somehow gained a promotion to Health secretary in this reshuffle, replacing Andrew Lansley.
Mr Lansley had made himself deeply unpopular with a large amount of healthcare professionals after forcing through the government's controversial reforms.
It remains to be seen whether Mr Hunt will use better judgement as Health secretary than he did over the BSkyB debacle - though that seems doubtful considering he believes homoeopathy works.
It also remains to be seen if this reshuffle will actually improve the perception of government among the wider public, but most of them have little effect, and this will probably be the same.
For a start, the other three newsworthy Great Offices of State, outwith the premiership - the Chancellor, the Home secretary, and the Foreign secretary - have all remained unchanged.
Similarly, none of the five Lib Dem Cabinet ministers - Deputy Prime Minister Nick Clegg, Vince Cable, Ed Davey, Michael Moore, and Danny Alexander - moved from their positions either.
However, David Laws did get back into government as a minister in the Education department.
Mr Laws, of course, began life in the Cameron Ministry as Chief Secretary to the Treasury but he had to resign that position within just three weeks after being badly exposed in the Daily Telegraph expenses scandal.
Despite this, it was always likely that Mr Laws would find his way back into the government in some form as he is a close friend of Lib Dem leader Mr Clegg.
And, having endured yet another wave of internal dissent from the party ranks, it will come as no surprise that the Lib Dem leader once again needs all the friends he can get.
Perhaps the worst of the latest bout of criticism came from peer Lord Smith of Clifton, who told BBC Five Live: "We are currently being governed by young boys in small trousers.
"If we put Vince Cable in we'll have our poll rating soar because he is economically literate - unlike Nick Clegg. And he is clearly a leader of the future. We don't need all these young kids running the government."
Lord Smith was joined on the attack by Adrian Sanders, MP for Torbay, who accused Mr Clegg of "just bumbling along".
And it did not help Mr Clegg's battered image, of course, that his first task in the new parliamentary term was to announce to the Commons the withdrawal of reform to the House of Lords after Conservative backbench opposition scuppered the bill.
Similarly, his latest attempt to distinguish the Lib Dems from the Tories - by once again bringing up the idea of a wealth tax - fell flat after he was reminded that he had only just months ago voted through a cut to the top rate of income tax in the Budget.
Yes, it has been clear for some time now that Mr Clegg is the very definition of a busted flush. Quite frankly right now, though, the Conservatives do not look much more competent either.
Certainly, Armando Ianucci cannot have struggled for material from the coalition government for the fourth series of his superb political satire, the Thick Of It.
The Thick Of It returns on Saturday at 9.45pm on BBC2 - but Ianucci is well aware that truth can be stranger than fiction when it comes to modern-day politics...
CAMERON'S CABINET RESHUFFLE
| Minister | Party | From | To |
| Jeremy Hunt | CON | Culture | Health |
| Andrew Lansley | CON | Health | Leader of the Commons |
| Justine Greening | CON | Transport | International development |
| Patrick McLoughlin | CON | Chief whip | Transport |
| Andrew Mitchell | CON | International development | Chief whip |
| Ken Clarke | CON | Justice | Minister without portfolio |
| Chris Grayling | CON | Employment minister | Justice |
| Lady Warsi | CON | Party chairman | Foreign Office minister |
| Maria Miller | CON | Disabilities minister | Culture |
| Caroline Spelman | CON | Environment | TBC |
| Owen Paterson | CON | Northern Ireland | Environment |
| Theresa Villiers | CON | Transport minister | Northern Ireland |
| Grant Shapps | CON | Housing minister | Minister without portfolio |
| David Jones | CON | Minister in Wales office | Welsh secretary |
| Michael Fallon | CON | Party co-chairman | Minister in business department |
| David Laws | LD | Backbencher | Education minister |
| Cheryl Gillian | CON | Welsh secretary | TBC |
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