So much has happened over the last month. The banks have toppled into the abyss. Iceland, Hungary and the Ukraine have admitted to going bust. By comparison, our quest for new GP premises seems small fry.

It’s all gone extremely quiet on that front and I for one am not too disappointed by that. This does not seem the time to go into that sort of venture, so for the foreseeable future, to my mind, we’ll stick with our three converted detached Victorian buildings. I now almost skip between the three, such is my relief that, with a new build, we haven’t committed ourselves to an Iceland-like debt.

I am sure most GPs are bracing themselves for the gathering storm of adverse publicity that will herald a complete renegotiation of the GP contract, as the government tries to recoup some of its public spending. I doubt there’s much public support for GPs to rely upon. The British Medical Association (BMA) does not appear to be a great defender of primary care, so l think it might be time for a trip to the Canadian jobs fair!

On a more positive note, we’ve agreed to revamp our management structure. We held our definitive “Day of Judgment” Away Day. After negotiations over bacon a few Saturdays ago, we identified a need to refocus.

Two of our partners (out of a total of 10) will now be released for at least a morning a week to tackle our practice manager over such thorny issues as the salaried doctors, reception and innumerous other issues.

I produced a Venn Diagram at the meeting summarising who I thought ought to be in the Super Management group. I’ve waited 19 years, since my Maths A level, to produce this. It went down a storm (in my mind).

We do, however, seem very short now at surgery. Our lunchtime extras number, on average, more than 25. Last week, while on call, I did 12 visits in one day. Things seems tight.

Half-term has begun badly. The flu struck one of my partners down. I’ll strike him, if he’s away tomorrow. Another partner limped in with a bad back. Much respect is due there – the poor man can’t even tie his shoes up. I’ve offered him some slip-ons, so there’s no excuse tomorrow. I can’t be accused of lacking heart.

The children are off to Devon with my wife this week, leaving me to fend for myself. I’ve lined up a couple of therapeutic meetings at the local pub in the evenings. I see this as purely medicinal!

Is it a tough time for your practice? Your comments: (Terms and conditions apply)

“Yes, but it would be tougher if my partners used phrases like ‘to tackle our practice manager over such thorny issues….” Surely not a GP who thinks he’s superior and who doesn’t see his practice manager as part of the team?” – Name and address withheld

The latest Management in Practice survey has been extended until tomorrow! Recent news stories have meant the survey, on healthcare finance topics, is more pertinent than ever. So we’d love to know your thoughts on top-up payments, prescription charges, practice income issues and more. Completing the survey will take just 5 minutes and the results will be reported in the Winter 2008 issue of Management in Practice magazine. There will also be a prize draw where four lucky winners will win £50 worth of Marks & Spencer vouchers. Simply click here to take part