Never have so many said so much about so little for so long.

All power to the cluster’s elbow;  at least the contract negotiations are a little bit different this year. The agenda says it all, really - £250m up for grabs and direct access physiotherapy given star billing as agenda item number one. 

And good to see phlebotomy services making a surprise entry as runner up, pushing discharge letters down to an all-time low of agenda item three. I guess we’ll deal with the other £249m under any other business.

To be fair, the last meeting might have put them off the meaty stuff. If I may paraphrase: “You’re making too many consultant-to-consultant referrals.” “Fine, we’ll send them back.” “Hang on a minute, that’ll mean more work for us.”… “Your first-to-follow-up ratios are too high.” “Fine, we’ll send them back.” “Hang on a minute, that’ll mean more work for us.” Etc, etc, etc.

Although it might get a bit different now that the cabal of wives - I mean practice managers - and assorted offspring have managed to bury the hatchet long enough to offer interim commissioning support (at least until the completion of the expensive procurement exercise to reappoint the ex-PCT staff to their old jobs at a lower salary).

Personally, I can think of no finer way for little Johnnie to fund his gap year than by putting his A-level maths to work in procuring healthcare on behalf of the masses. I mean if those idiots at the PCT can do it, who can’t? And hey, I’m sure he’ll be happy to take calls in Goa should there be any post-contract cock-ups.

But all mere bagatelle compared to the kick-ass at the shadow Health and Wellbeing Board where its standing room only as the flotilla of empty vessels slug it out for a seat at the bridge of the only port in the  storm. And agenda item one? Car parking for the direct access physiotherapy service. Never have so many said so much about so little for so long.   

But it’ll all be all right in the end because we’ve had another letter from Tankie Dave on managing the transition. Trouble is, I’m still only on page 147…