The ready-reckoner for the viability of clinical commissioning groups (CCG) was released this week. It’s a useful bit of kit, a bit like a mirror.

You can look up whether your beautifully handcrafted CCG, made with hundreds of person-hours of meetings, is actually viable in the post-reformist Health Bill world.

The trouble is that in some places CCGs will be suffering from dysmorphic syndrome: the CCG they see reflected in the mirror may be fatter or fitter than the body they actually represent.

If you are in such an organisation, either one which is struggling to fit into a tight-fitting council boundary or a waif-like orphan jostling with siblings and believing itself to be big enough to cope on its own, you will soon be facing a painful choice.

The choice will be either to swallow lots and lots of practices to achieve the size required for viability, or to throw up a few thousand patients who are tipping the scales.

Of course, there is no guarantee that you will be happier or fitter in the authorisation Olympics after all this bulking up or slimming down. Clinical experience tells us all that drastic attempts to lose or gain weight are often risk factors for other illnesses.

The part of my brain prone to wishful thinking cannot help but wonder if the Silver Fox should have mentioned this right back at the start.

Of course that’s foolish of me, he couldn’t have done that – he didn’t know! He’s just been making it up as he goes along.