Cull

by Tanvir Bush

‘Don’t worry,’ he says gently to the man. ‘It doesn’t look like a stroke to me.’

  At this, and delivered by such a man as The Good Doctor, both the patient and the gathered stewards visibly relax.

  The doctor smiles, asks the man to raise his arms, then to grimace, wink, raise an eyebrow. He asks a few more questions – has he had a recent virus, yes; any dizziness or discomfort, no – and gives a probable diagnosis of a form of facial palsy, possibly Bell’s palsy. He recommends seeing the GP back home for a full check-up and a course of steroids. ‘But I don’t think we need to divert the plane,’ he says and all around him are happy grins, half grins from the man, of course, and sighs of relief.

  Back in his seat and now wide awake, The Good Doctor Binding is once again staring at the papers on his lap.

  ‘Ah excuse me … Doctor?’

  He looks up to find the same stern stewardess, now looking a little less tight-lipped.

  ‘Is he all right?’

  ‘Oh yes, sir. We just wanted to thank you very much from all the crew. The captain has said I may offer you some of his personal stash of malt whisky. It’s a fifteen-year-old Glenfiddich. May I get you a glass or two?’

  ‘That’s very kind,’ says The Good Doctor Binding. ‘I would be most grateful.

  An Invisible Committee

  ‘Could you wear one of these, please, sir?’

  The Good Doctor Binding has not yet been home to read his post or kiss his wife. He still has post-flight flatulence and that tight little headache between his eyes, but he doesn’t complain. He is being paid more than even he feels comfortable with for this particular jaunt, and so he will suck in his gut and stick on the yellow hard hat and follow the young man through the building site and over the muddy ground to the single Portakabin in the middle of the mess of concrete and scaffolding.

  ‘Up there, sir,’ says the young man, pointing to the steps of the cabin. ‘They’re waiting for you.’

  ‘Thanks,’ says The Good Doctor, hefting his briefcase and clambering up.

  There are six men and one woman inside the Portakabin already, all seated around a large plastic trestle table and still with their jackets and coats on, although the cabin is warm and smells of glue and coffee. They turn, words clamped behind tight lips, and stare at him as he enters. He doffs his hard hat, impressed by the turnout.

  ‘At last, Dr Binding!’ A bald, wide-cheeked man in a blue bow tie comes forward, arms outstretched. The Good Doctor shakes his hand.

  ‘Afternoon, John,’ he says. ‘Apologies for being a little late. I had a minor medical emergency to deal with on the flight and just needed to ensure the patient was offloaded safely.’

  ‘Not to worry, not to worry.’ The Right Honourable John Thorpe-Sinclair MP wipes his shiny pate with a large blue hanky. ‘Let me introduce you to the others. An unnecessary formality in some ways as none of you are “really here”.’ He uses his pudgy fingers to apostrophise the air. ‘And this meeting is not actually happening.’

  The Good Doctor Binding recognises many of the figures around the table already. The tall string bean of a fellow is Professor Erwin Bore, Chair of Botany at the South-West Agricultural College Research Centre.

  The silver-haired woman in the Chanel suit is Dr Maxine de Crinis, Infectious Diseases Unit, London Institute.

  The oafish Julian Hallywooden, an ophthalmologist and brainstem specialist, is new to him. The man’s eyeballs bulge slightly and The Good Doctor guesses Graves’ disease. Oddly appropriate for an ophthalmologist.

  The baby-faced man in black is his colleague, Professor Fred Pansy: Psychiatry, Royal Manchester Hospital. He smiles and winks too often, thinks The Good Doctor. He finds the man a mite sinister. Then there is his close friend, the handsome and warm Warren Hyde, Professor of Law at Ruskin.

  ‘And of course, you know Monsieur Henri Rennes from TOSA,’ says John, concluding the introductions.

  The Good Doctor shakes hands; some are hot and slightly sticky, others cool and soft. One, Julian Hallywooden’s, is a competitive squeeze and grind. The Good Doctor suppresses a wince. The Monsieur with the thick black hair and manicured fingernails gives him a knowing nod.

  ‘Right, all present and correct. Please take a seat and let’s begin this extraordinary meeting of the … well, what shall we call ourselves?’ says Thorpe-Sinclair, as the men and woman settle into their plastic seats.

  ‘Do we need a name at all?’ asks Maxine.

  ‘I think it helps us with focus. I had jotted one down earlier … hold on. Yes, here.’ The minister pulls a scrap of paper from his waistcoat. ‘How about the UK Co-operative for Hospitals and Nursing Homes, or UKCHNH?’

  ‘Does that cover my rehabilitation centre?’ asks Pansy with a wink and a smile.

  ‘Yes, of course.’

  ‘I like it.’

  ‘Just for the moment, then.’

  And that is that. The bundle of eminents are ‘officially’ named. As there will be no records of this meeting, no minutes, no texts, no invoices for expenses, no imprints of lipstick on coffee cups or muddy smears from Italian loafers, it matters little to them what they are called. But the Rt Hon. MP is right. It does help with focus … and focus they do.

  As a specialist in liver disease and alcohol-related cancer, The Good Doctor Binding has treated hundreds of men and women and even, traumatically, children as young as eleven. For the past three years he has been working on the dilemma of providing medical care to chronic alcoholics, many of whom have become homeless, in part due to their addiction. Things have escalated for the ‘chronics’ with the welfare cuts. There has been a spout, a gush, a torrent, now, of people falling into impossible debt, being evicted and made homeless. The new lot of street people are different from the human detritus of the past thirty years. Now the newly evicted are couples and families with different needs requiring different responses from the beleaguered government and councils. The old guard of rotting-livered hobos were finding their patches invaded by hungry, confused people who needed – demanded – greater attention. The Good Doctor Binding had been tasked with separating the old guard of repeat-offender alcoholic homeless and ‘solving their particular problems’. He, in collaboration with Fred Pansy, had started by setting up the first experimental ‘therapy’ unit at the Royal Manchester Hospital. They had called it ‘Homeless Action!’.

  ‘And these are the results of my research,’ he says proudly, and lays down the folder with ‘CDD’ written in black on the cover. ‘The “CDD” on this file cover stands for “Clearance, Disinfection and Disposal”, which will soon become clear. The local trials have been successful, and we are ready to move forward, to widen coverage. In short, we can escalate, and quickly.’ There is a pause as the copies of the file are circulated, shuffled and pages turned.

  John Thorpe-Sinclair clears his throat. ‘I am sure I don’t have to remind you all that these files do not leave this room … there is a shredding machine in the corner.’

  Does The Good Doctor truly understand the consequences of his actions? He had purported to be morally outraged when TOSA and the Department for Work and Pensions conspired to ‘delay’ medicals for the new and repeat Chronic Condition Benefit applicants. ‘I am morally outraged,’ he had blustered, and yet …

  And yet he had understood the basic economic argument. The argument ran thus: the European Union quoted thirteen weeks as being a fair time between application and medical assessment for the Chronic Condition Benefit. During the time they were waiting to be medically assessed, applicants, or ‘malingerers’ as John Thorpe-Sinclair called them, would be on the lowest level of Job Strivers’ Benefit. If the medical went in the applicant’s favour, they could end up receiving nearly triple the Job Strivers’ Benefit by being moved into the Chronic Condition Benefit category, and this was very costly. Too costly.

  TOSA has already, and quite deliberately, developed an almost incoherent tick-box system of which Monsieur Rennes, its CEO, is very proud – insisting it ensures t
hat over 70 per cent of applicants fail at the first hurdle: the form-filling. The form is indeed a masterpiece of waspish misinformation, running to at least fifty pages of questions ranging from such banalities as ‘Can you lift a cup?’ and ‘Can you wash yourself?’ to ‘Given the choice to work, even from your own bed, would you do so?’ As many people could lift a cup occasionally and wash themselves a little and would love to work, even if their illness or disability caused them to be unable, they would tick ‘yes’. A ‘yes’, even just one, on any part of the monstrous form would guarantee an immediate FAIL. And yet, still some people were managing to find a way through the red tape and wangle themselves onto the higher amount of benefit. And worse even than that, almost 90 per cent of the FAILs went to their doctors and appealed, and in court TOSA decisions were usually ruled as ‘unfair’ and overturned.

  Appeals cost. Chronic Condition Benefit costs. These useless, economically unviable scroungers cost.

  John Thorpe-Sinclair and Henri Rennes had put to a panel – very similar to this one – that they could save money and minimise the irritating issue of appeals by extending the time between application and assessment indefinitely, say eleven months or twelve, by which time the applicant would either die – depending on the severity of their condition or disability – or be forced to find other sources of income. No one, especially someone with extra care needs, could really survive on the basic Job Strivers’ Benefit … especially with children, not in the long term.

  This ‘extension’ between application and medical had been approved and had indeed saved hundreds of thousands of pounds already. Malingerers died naturally, or by suicide, by the dozen, and many more just disappeared out of the system entirely. Thorpe-Sinclair was extremely proud of himself, but it wasn’t enough. Not by a long shot. And so they had approached The Good Doctor.

  The Good Doctor had searched his soul. He had taken the Hippocratic Oath and felt he had a firm grasp of medical ethics. What Thorpe-Sinclair and Rennes were suggesting meant that many people with genuine medical needs would potentially die before receiving the benefit they were entitled to. On the other hand, The Good Doctor had seen hundreds of his patients commit virtual suicide by refusing to take his advice or the advice of any health professional. Time after time, the same patient would stagger in to his surgery, a little more yellow, still smoking, still obese, still moaning about how the medication made them queasy when in reality it was the ghastly diet and the litres of cheap vodka they were guzzling. He found their deliberate ignorance interesting but exhausting and perhaps, he thought, Rennes and the idiot Thorpe-Sinclair had a point. It couldn’t hurt, anyway. Not really. These people were unlikely to be much missed.

  ‘The CDD initiative seems to me to be both kind and practical,’ says The Good Doctor Binding to the faces around the table. And the faces blink and nod. ‘Ward B in Grassybanks Residential Home is already welcoming new clients, and we open Ward C this summer.’

  Switch Gets Fed, and Alex

  Gets Suspicious

  The underpass connects several main roads by a series of concrete tunnels beneath the main Newtonmarket Road roundabout. The tunnels converge on a central hexagon, open to the sky, and at the centre of this is a raised flowerbed and an enormous street light. More raised beds with thick bushes line its edges and there has been an attempt to make it slightly less of an eyesore, with tiled murals in the tunnels and several benches nailed down for weary commuters to sit on and eat their lunch. Up above, traffic booms in endless thundering circles, round and round, but down below – in an interesting quirk of acoustics – it is relatively quiet. Alex uses the underpass several times a day, and it can be a little disorienting as each tunnel entrance looks exactly the same as the others, but comes out at a different road junction. She is reliant on Chris remembering which is which … although, strangely, they often end up on the park side and not the town side. Wicked dog.

  Today, Chris has frozen right in the middle and is not moving.

  ‘What is it, boy?’ asks Alex, scanning around with her tunnel of sight for movement or blurry shapes. She can’t see anyone else down here. Opposite them something in the bushes makes a small whining noise. Chris’s tail had flattened but now it is up and waving. He makes a low growl in the back of his throat; warning, and yet calling. Another dog, thinks Alex. And she is right.

  ‘What’s wrong with you?’ Chris is asking, because although he knows the other dog, her scent is somehow wrong. She usually carries the scents of road tar, alcohol, cigarette smoke and vomit on her coat – none of which are her smells but those of her feeder, Phil. Her own deeper smell is an orangey brown, warm and sunny with iron blue running through it. She is a very loyal dog, but fierce. But today the orange is greyer, and the iron blue of her is thin and faded. She smells like half of the dog she was. Chris barks for her to come out of the bushes and feels Alex jump.

  ‘Shit … Chris!’

  ‘I don’t want to be seen,’ says the other dog. ‘Oh, but I am hungry, hungry, hungry. Afeared. I quake.’

  Chris, being a dog, must bare his teeth at weakness. It is essential because weak is close to mad and must be dominated or it will bite. He draws his lips back and flattens his tail again. ‘Come out!’ he demands.

  And she does, fast, slinking from underneath the bushes and running across their path, pausing for a single moment to show deference to Chris and then dashing over to the far side of the hexagon, tail tucked beneath her legs, ears and muzzle flat almost to the ground. She cowers and whines. ‘So sad, so hungry, so empty.’

  ‘Switch? Is that you?’ Alex has recognised the German shepherd bitch. ‘Oh my God, you poor old girl!’

  She signals Chris into a down and stay, laying his lead across his back, then moves slowly over to the shivering dog. She knows that Switch belongs to Phil, one of the homeless men who use the underpass to drink, brawl and sleep in. Alex likes Phil. He is a good-natured drunk with a quick wit and he loves his dog. Alex likes Switch too, but is wary of her. Switch has always seemed a gregarious, sweet-natured beast. She played with Chris with no trouble, but life on the street is tough, and the dogs are often protection as well as companionship. Phil and Switch are a good team, and Alex has never seen Switch looking scrawny or dirty, but now, as she gets closer, she can see the dog is filthy and her ribs are obvious through her ragged coat.

  ‘Switch?’ she says in a low voice and kneels close to the dog, extending her hand with one of Chris’s disgusting fishy treats. It doesn’t take long before Switch has taken the bait, and Alex is able to catch hold of the string around her neck. Switch is still shivering as Alex gently moves her hands over the dog’s legs, back, head and abdomen. She can feel no breaks, finds no blood, but the dog is malnourished and terrified. How could Phil leave you like this? she thinks, but Alex knows that Phil would never have left Switch like this. Something is very wrong here.

  It isn’t hard to get Switch to follow them, although by the time they are back at Alex’s flat there are almost no treats left. Alex wonders if Switch will come inside, but the dog doesn’t hesitate, following on Chris’s tail. She heads straight to Chris’s water bowl and drinks and drinks until it is almost empty.

  ‘Don’t make yourself sick, Switch,’ says Alex. She looks over at Chris who is sitting very upright, holding his sheep toy, Myrtle, in his gob and watching Switch quite calmly. OK then. Two dogs.

  She thinks What the hell happened to Phil?

  Homeless Action!

  The night shelter, more commonly known as The Station, is wreathed in scaffolding like the rest of the city. It used to be a huge old church and still hulks over the main West Road as if about to slam a Bible down upon the city in evangelical pique. The land and buildings are owned by the Church and a group of wealthy trustees who, for over thirty years, have been providing a sanctuary for the homeless of Cambright. Last time Alex visited she was following up a story about a group of trafficked Romanian men who had been conned into believing they would be part of a wo
rk team and had instead ended up abandoned and passport-less, living in the graveyard behind Turton Street. That had been over four years ago, and of course by now those men would have been rounded up and sent to the offshore holding rigs. Cheaper than trying to repatriate them. They had been better off in the graveyard.

  Back then, The Station had offered the Romanians and the other assorted transient folk an evening meal and a spare bed when one became free. Then, they had room for thirty people and three dogs based on the level of the emergency. There was also access to legal help, advice and information services, and various useful workshops, mostly based around self-esteem and CV writing. There was a regular GP/care assistant (and vet), and access to clean needles, condoms and more.

  That was back then. Four years is a long time in politics.

  No longer would that have been an option for the Romanians, or for any other immigrants, illegal or otherwise. ‘Foreigners’ were no longer allowed access to charity. This was made very clear by the ban on any published leaflet or general information offered in any language other than English. If you cannot read it, write it or speak it, then you shouldn’t be here. And so say all of us, quoth, in effect, the Lord Chancellor. The Believe in Better campaigners now made regular sweeps of all the shelter- and food-based charities for this seditious literature, or for anyone with a foreign accent mooching around looking like they were freeloading. Men, women and children ‘hanging around’ food banks and emergency shelters who couldn’t respond appropriately to the question ‘Where are you from?’ were usually roughed up a little and then handed over to the new private H5 police force with their exceptionally silly sci-fi uniforms. The H5 police force had made a request that the campaigners listen carefully to the accents before embarking on these so-called ‘shakedowns’. Every week they were having to apologise to the Welsh.

  ‘Even leaving migrants out of the picture, the housing situation is hopeless,’ says Glenda, the on-duty manager. It is three days since Alex and Chris took in Switch and now they are all looking for more answers at The Station. Glenda is giving Alex the tour, accompanying it with a stream of facts from the front line. ‘Most of the country’s council accommodation tenants are in rent arrears, and the eviction rate is running at over five hundred a week in Cambright alone. Ironically, many of the desperate find occasional work as bailiffs. There is money to be made in repossession.’