So as the summer breezes blows through the ever-greying tresses of the post-pause ministerial locks, what does the landscape around us foretell ofthe autumn and winter to come?

From my position two feet above the water line and holding steady it depends on which way you look. As our chums across the channel would have it, looking up it’s pretty much plus ça change, plus c’est la même chose. Tankie Dave at the helm, Cynthia on the ropes, some bloke with a beard running Monitor trying to get his foot out of his mouth and still believing in GP commissioning with the same passion that Peter believes in fairies.

The boy Britnell is keeping his head down until people forget (they never will) and the dust is being gently blown off the turnaround proposals that generated the famous gold rush of 2007.

Meanwhile in the land of PCTs/I mean clusters/I mean consortia/I mean Tankie Dave’s Stormtroopers things look, well, they look, well frankly, I haven’t got a clue what’s going on. I’m sure it makes sense if you’re in the film but watching it as a series of stills I’m not sure if it’s a tragedy, a thriller or a farce. Whatever it is, it sure is an epic.

But god bless the staff and let us wish them all a wonderful summer holiday. For we forget or underestimate at our peril their stoic ability to look after the patients while all around them others do whatever it is Kipling says you shouldn’t do. Because I hereby confidently predict that there will be a demand for NHS services this winter. Remember where you heard it first.

And most importantly, what of our dear patients? It seems like things are quietening down a bit. Except for that hospital in Cornwall which is chock-a-block with the fallout of post-exam result madness and multiple cases of surfer’s knee. So what the hell, I’m going on holiday too. Somewhere cheap. Like Cornwall. Save me a bed…