Martin Ellingham's plans to resume his career as a consultant in London are put on hold following the birth of the (as yet, un-named) son he fathered with his now estranged partner, Louisa Glasson. When he returns, he is given the news that Auntie Joan had a heart attack and died at the wheel of her parked car.*New doctor Diana Dibbs (Joanna Scanlan) has her husband replace Pauline, who has moved on to a job in Bristol. PC Joe Penhale discovers a cyst on his body, and goes to see Martin at Louisa's home for a consultation, rather than being examined by a woman. Dr. Dibbs' qualifications as a doctor are questionable, considering that she even mis-diagnosed her own Type 2 diabetes. When the first patient arrives, she gives him a prescription, but also hands him pills from her handbag, her own personal diabetes pills, rather than his having to wait for Mrs. Tishell to fill the prescription at the pharmacy. She tells him that if he finds no relief, to just take more of the pills. The patient later collapses in Mrs. Tishell's pharmacy. When Martin shows up to confront her, she blocks her door with a chair, and crawls out a window to get away from him. A pursuit ensues, and she collapses on the pavement. To serve the community, Martin resumes his old practice.

Determined to get to grips with fatherhood, Martin asks Louisa to move into his house so he can help to raise their son. He even suggests that Louisa and 'baby' could move to London with him. Louisa is none too sure about the move to London. Meanwhile, Aunt Joan's sister Ruth Ellingham (Eileen Atkins) turns up at Portwenn for Joan's funeral. Aunt Ruth is a doctor like Ellingham and his father Christopher, but she is a psychiatrist. Aunt Ruth, Aunt Joan, and Ellingham's father Chris were all siblings. Ellingham turns Joan's funeral into a medical warning. PC Penhale takes a mobile call in the middle of the service, and leaves, returning to interrupt with an announcement of a parked car outside. Martin injures a patient by falling on him, after the patient has bent over in the office. At the home of patient Harry Pote, he diagnoses him with brittle bones from taking too many protein shakes and spending time basking under a sun lamp. Aunt Ruth has no intentions of staying, until Martin reveals that Aunt Joan's farm was bequeathed to her. Al Large has been managing the farm until someone else takes over. Ruth reveals that she is dying, having diagnosed herself with Lupus. Martin disagrees and diagnoses her with a simple autoimmune disease. She decides to keep Joan's farm and have Al Large run it for her.[32]

Ellingham has a new receptionist, Morwenna Newcross (Jessica Ransom), an attractive teenage girl to replace Pauline. Morwenna fails to make a good impression on the doc by arriving late on her first day. Her grandfather William Newcross (Peter Vaughan) shares his stash of methamphetamines with her, to make sure she is on time, and bright as a button at work. Sleepless nights are taking their toll on Martin and Louisa, who have not yet chosen a name for their new son. Tempers are frayed as they try to find ways to comfort their constantly wailing baby. Meanwhile, Aunt Ruth is dealing with intruder Michael Dunwich (Andrew-Lee Potts), who has stolen the hub caps from her car for his artistic display. His mother Shirley (Miriam Margolyes) is having abdominal and mental problems, and also believes her son is trying to poison her. Dr. Ellingham's test finds a large amount of arsenic in her system, and alerts Constable Penhale that her son might be trying to harm her. Ellingham determines the arsenic is coming from the old wallpaper in the Dunwich home, and sends her to the hospital. At the end of the day, Ellingham reads a medical magazine to his newborn son.[33]

It's Portwenn Fun Day and the village is buzzing with excitement about this major fund raising event. PC Penhale is in his element rallying the runners and whipping up support. The event sparks culinary rivalry between Bert Large who runs Large's restaurant with son Al. and Mark Briggs the landlord of the Crab and Lobster pub. They are both keen to take advantage of the day to boost their takings by providing food for the runners and spectators. Also, Louisa's mother Eleanor (played by Louise Jameson) arrives unexpectedly. Eleanor is a combative personality who finds fault with Louisa, Martin, and everyone else. Martin and Louisa find their son is sleeping through usual feeds until they find out her mother gave him some of her brew to calm him down. Louisa is not comfortable having her mother around, but Eleanor indicates she'll be in town for a while. Louisa and she have an argument about Eleanor's leaving her behind and moving to Spain when Louisa was 11 years old. Mrs. Tishell and Eleanor have a fight over Martin, with Eleanor complaining about Martin and belittling Mrs. Tishell's pharmacy business. Louisa finally throws her mother out of the home she shares with Martin, and tells her she wants her out of Portwenn. Aunt Ruth hires Al full-time as her farm manager.[34]

PC Joe Penhale has an unexpected visitor: his ex-wife Maggie Reid (Julie Graham), who appears to have completely forgotten that they split up a couple of years ago. He asks her if she knows the current date, and she says it's the year 2008 (not the current 2011). Maggie's boyfriend telephones Penhale trying to find her, and Maggie says she doesn't know him. Penhale is torn between being with her, since he still loves her, or straightening out her seeming lapse of memory of the past few years. He takes her to Large's restaurant, where fellow diner Martin quickly spots that Maggie is showing symptoms of transient global amnesia. Bert and Al Large argue over unpaid bills, and Bert tries unsuccessfully to get Martin to invest in the restaurant. He also visits loan sharks and tries to hock some of his personal possessions to raise needed funds. After they refuse, he borrows money from them, and lies to Al about straightening out the finances. Louisa's mother Eleanor (Louise Jameson) catches up with her old school friend Paul Hale (John Duttine), a local fisherman, who takes her out on a date. When addison's disease causes Paul to collapse on his boat, and Martin has to rush to his rescue, Eleanor laughs about his collapse. Morwenna arrives at the surgery with an injured foot and the doctor grimaces at the sight of the blood as he treats the wound. Ellingham notices that Morwenna avoids having a tetanus vaccine and realises she is frightened of needles. PC Penhale warns Martin and Louisa that if they do not register a name for their son soon, the state will be forced to step in. In the end they name their son James Henry Ellingham, after both their grandfathers. Martin registers the name without telling Louisa.[35]

In an effort to get Maggie to stay in Portwenn after she gets the all-clear, PC Joe Penhale tries to prove that he is the man for her ? and even engineers situations where he can show off his macho side to impress her. Maggie does eventually leave but she and PC Penhale part on good terms, after he realizes her departure is better for both of them. Aunt Ruth finds old photos of Martin as a child. Martin steps in when school caretaker Mr Coley (Brian Pettifer) becomes confused after breathing carbon monoxide and puts the children of the school at risk. Tensions mount between Martin and Louisa as they find themselves unable to agree on anything, including his making decisions about James Henry without discussing with her. Louisa and James move in with her mother.[36]

Mrs. Tishell's infatuation for Martin increases, encouraged by his continued separation from Louisa. Bert Large's restaurant business is in financial trouble. He can't even afford the food and drink for a charity event to raise money for Florence Dingle's (Anne Reid) cat sanctuary. Mrs Dingle is distraught. She desperately needs the money to continue to look after the cats and kittens in her care. Bert is also being chased by loan sharks Alastair Tonken (Alan Williams) and his son Norman (Marcus Cunningham) for the repayment of ?1,000 they gave him to clear his debts, warning of repercussions if he doesn't pay up. Unknown to Louisa, her mother Eleanor prefers to help Bert with his restaurant, so she drops baby James Henry off with teenager Angie Grappy (Angela Terence).*After Ruth gives Al ?800 to pay for fencing on her farm, he instead uses the money to get Bert out of the clutches of the loan sharks. Together with the ?200 Bert already had, they can repay the ?1,000 to the loan sharks. However, the sharks say he still owes another ?350 for interest and late payment charge. Ruth is upset when Al tells her what he did with her ?800, but Al later offers her a percentage of the restaurant profits to repay his debt to her. After Mrs. Dingley collapses, Penhale tends to her while waiting for Martin to arrive. While Martin is tending Mrs. Dingley, Penhale hears Al, Bert and the loan sharks arguing, and orders the Tonkens to leave town and never return.*Martin finds out Angie Grappy is tending James Henry when she shows for her own medical care, pushing the baby's pram. He confronts Louisa about Eleanor's being their son's caretaker. Martin, assisted by Morwenna, performs an emergency hernia operation on Louisa's mother Eleanor and saves her life when the ambulance's arrival is delayed.*

Mrs. Tishell discovers that she can no longer hide her infatuation with Dr. Ellingham and she decides that she must take drastic action, fuelled by a cocktail of drugs that are affecting her judgment. Her husband Clive (Malcolm Storry) shows up and announces his retirement. After a check-up with Martin, Clive learns he has to inject himself everyday, to keep his blood from clotting. Louisa's mother Eleanor says she's leaving town for a while. Mrs. Tishell mis-dispenses eyedrops to PC Penhale causing him to crash his Land Rover.*Martin asks Mrs. Tishell to look after James for the day, and to otherwise give her husband Clive his daily injections. Clive Tishell thinks Martin and his wife have been having an affair during his long absence, the thought of which is abhorrent to Martin. She mistakenly thinks that Martin has sent her a covert message through a young couple he has treated, and she vanishes with James to a nearby holiday home. The drugs, for a few hours, cause her to think that James is hers and Ellingham's son. Martin, Louisa, Aunt Ruth and PC Penhale chase after her. To coax her out of the locked house, Martin pretends to profess his love for Mrs Tishell and a desire to stay in Portwenn, while actually aiming his remarks at Louisa. James Henry is rescued, Martin and Louisa profess their love, kiss and reconcile.