by Penny Jordan
‘I’m sorry to say this, but on your present showing I’m afraid that you’re beginning to fall very much behind the Northern’s figures.’
Richard had heard enough.
‘This unit is about saving lives, not money,’ he told David sharply. ‘Any good surgeon will tell you about the risks you take with people’s lives once you start treating them like conveyor-belt products; they are each and every one of them individuals with individual needs.’
‘Yes, I’m sure,’ David stopped him angrily. ‘But the days of surgeons playing God are, I’m afraid, Richard, gone forever. We are a public service and as such we are financially accountable to the public, a public who have every right to demand to know for instance why one hospital manages to perform almost twice as many hip replacements in a given period as another, and why that same one is somehow managing to reduce its drugs bill in addition to increasing its number of operations…’
‘I judge the success-rate of my work not on how many operations I perform or how cheaply I deal with my patients’ aftercare, but on providing the best chance of recovery and a good quality of life,’ Richard told him quietly.
Inwardly he was seething with anger at the injustice and ignorance of David’s criticisms. He might not be an accountant, but when it came to his own field of surgery…
‘And I could ask you why, if this other hospital is doing as well as you think, GPs and their patients appear to prefer to come to us… ?’
The tense, uncomfortable silence which followed his outburst left Richard wishing he had not allowed David to provoke him.
‘Not every patient prefers the General, Richard,’ David contradicted him silkily. ‘In fact I received a letter only this morning from one of your patients complaining about the fact that you have postponed her operation on two successive occasions and asking that she be referred to another hospital. I didn’t mean to bring this up in public, but since you yourself have focused the meeting on more personal issues I feel that in defence of the Northern’s surgical unit I owe it to them to mention this complaint.’
The last time he had been humiliated so publicly had been when he was still a raw medical student but his reaction to David’s comment was much the same now as it had been then: the sense of shock and discomfort, the awareness of other people’s attention being focused on him with varying degrees of pity and amusement, the ear-burning sense of shame and the immediate and fierce desire to vindicate himself.
Only he wasn’t a student any more, and the thought of having to justify himself to David Howarth of all men met with such a wall of resistance from his pride that he was powerless to do anything other than simply sit there.
It was left to Brian to say uncomfortably, ‘I’m sure there’s some logical explanation for delaying this patient’s operation, David… Sometimes these things happen with nonurgent surgery… It’s unfortunate, I know, that it should have happened more than once, but…’
‘Are you telling me that it’s common practice at the General to delay non-urgent operations more than once? You know how the Minister feels about this sort of thing, Brian, and it certainly doesn’t augur well for the General’s claims that it is the better choice for the new unit… I’m not sure too many accident victims would be happy to be told that their surgery had to be delayed,’ he added sarcastically.
‘Everyone at the General has worked very hard to help raise the extra cash for this new unit,’ Brian began desperately. ‘You know that——’
‘I’m sorry, Brian,’ David interrupted him smoothly, standing up, ‘but we really must leave it there. I’ve got a meeting this afternoon.’ He was halfway to the door before he stopped and turned round, the cold pale blue eyes surveying Richard triumphantiy.
‘Richard, a word in my office before you leave if you please… and I’d like you there as well, Brian…’
* * *
‘Now, this complaint… the first thing we need to establish is that Mrs Jennings is correct when she claims that her operation has been delayed on two occasions.’
David smiled coldly at Richard, obviously already sure of the answer.
‘Yes, it has,’ Richard agreed tersely. He was damned if he was going to explain or excuse himself to this jumped-up, undersized accountant, who didn’t know the first thing about surgery anyway.
‘I’m sure that Richard had a perfectly good reason for delaying the woman’s operation, David,’ Brian was saying palliatingly next to him.
‘Yes, I’m sure he had,’ David agreed smoothly. ‘And since the surgery is non-urgent there is no question of any lack of surgical judgement… fortunately…’
Richard froze. He knew damned well what David was up to, trying to suggest that he had shown a lack of good judgement, trying to intimate that he was getting too old to stay on top of things.
‘However, I’m sure we all have to accept that there was a certain degree of lack of perception, shall we say? Of course, we all know it’s easily done,’ David continued, steepling his fingers and looking at Richard over the top of them. ‘Pressure of work, strain, stress. All of these things build up and tend to lead to such misjudgements… Fortunately, as I’ve already said, in this case no one’s life was put in danger, but I shall have to write and apologise and I suspect from the tone of this letter that we’ll be very fortunate if we can keep it out of the local Press—and you know how the Minister feels about that kind of thing. I’m sorry to say this, Richard, but it only takes one mistake like this to prejudice people’s minds against the efficiency of an entire hospital.
‘As Brian said, I’m sure you had a perfectly good reason for this postponement…’
Angrily Richard stayed silent. He wasn’t going to risk saying anything to David. He had already come dangerously, disastrously close to losing his temper with him once today, and there was no disguising the elation in David’s manner towards him, now that he believed he had him wrong-footed.
‘Can we assure Mrs Jennings that her operation will now receive priority?’ he asked Richard. ‘And an apology from you personally, Richard, might not be a bad idea.
‘Oh, I’d like a word with you in private if you don’t mind, Brian,’ he continued, giving Richard a dismissive look.
As calmly as he could, Richard left his office.
The Health Authority’s area offices, he decided bleakly as he went outside to wait for Brian, had as little to do with the saving of people’s lives, with healing them and helping them, as the head offices of a bank. Money—that was what this place was all about. Money… not people…
* * *
‘Brian, I wonder if you’ve given any more thought to suggesting to Richard that he take early retirement?’
Even though he had been semi-expecting it, Brian felt his heart sink.
‘I doubt that he’d be interested, David. He’s a first-rate surgeon. We’re lucky to have him.’
‘Are we?’ David asked him drily. ‘Mrs Jennings doesn’t appear to think so.’
‘We often have to alter operation times to make way for more urgent cases,’ Brian appeased uncomfortably.
‘This isn’t just a matter of placating one angry patient; there’s also the problems of the budgets and Richard’s refusal even to try to stick to them. Quite honestly, Brian, if he can’t move with the times and accept the way things are, then he is just going to have to make way for someone who can.
‘I don’t like to say this, but I really think you do need to keep a closer eye on him… for the patients’ sakes if nothing else. I understand your loyalty to him, but I have to warn you that he could quite easily cost the General the new accident unit.’
‘Richard’s worked hard to help raise money towards it…’
‘Yes… I know. Oh, by the way, your hospital’s got someone to take over your psychiatric post. If he accepts you’ll be very lucky. He’s a first-rate psychiatrist, very highly qualified—over-qualified for the post really, but it seems he’s anxious to come back over here for personal reasons… He
’s been working in the States for the last few years. I shall be writing to him later offering him the position.
‘Now, about Richard… remember what I said, Brian. Quite honestly I think that, of all your options, persuading him to take early retirement would be the best… for the hospital’s sake…’
The hospital’s, or yours? Brian wondered cynically as he left David’s office. It was obvious that the young man did not like Richard, but Richard unfortunately didn’t seem to realise his own danger and exacerbated the situation instead of easing it.
From his office window David had a clear view of where Richard was standing in the car park waiting for Brian. Tall and broad-shouldered, with a thick head of strong dark hair, touched with distinguished wings of grey at his forehead, he was perhaps the epitome of every woman’s fantasies of what a senior surgeon should look like, and the epitome of everything that he, David, most disliked and resented.
He could remember quite clearly the day he’d realised that he was never going to achieve such an enviable height, nor such almost film-star male good looks, and the bitterness that realisation had caused him, the jealousy and resentment.
But the tables were turned now and it was Richard and his type who were outsiders, doomed soon to be as extinct as dinosaurs, unable to adapt to fit into a world which had changed too fast for them.
Uncanny how much of a resemblance Richard bore to that long-ago schoolboy who had taunted him with his small stature and lack of macho maleness. He was smiling as he turned away from the window and went back to his desk to pick up Sophie Jennings’ letter of complaint.
CHAPTER ELEVEN
TODAY was the day she had her appointment with the Citizens Advice Bureau, and in preparation for it, and also in an attempt to exert some kind of control and order over the chaos of Andrew’s financial affairs, Philippa had spent the previous evening making lists of the positive and practical steps she could take to help herself.
It was a pitifully short list, but she still studied it with fierce concentration as she ate her breakfast. She had made herself a vow that she was no longer going to sit back and let life and other people make her decisions for her as she had done with Andrew; that she was going to grit her teeth and assert herself a little more, something she ought perhaps to have done years ago, she acknowledged self-critically now as she studied the list in front of her.
Her first priorities had to be: a) to find herself a job—any kind of job, just so long as it brought her in some income—and b) to do something about ensuring that both she and more importantly the boys had somewhere to live once the house was sold.
With half-term just over, the boys weren’t due any more holidays until Easter. How quickly would the bank want her out of the house and how soon would they be able to sell it?
She wished now that she had questioned Neville Wilson more closely on these points, but at the time she had been too shocked to do so…
If the worst came to the worst she would just have to go cap in hand to her parents and ask if they could stay with them. It was the last thing she wanted to do, especially in view of their attitude, but for the boys’ sakes she might finally have to do so. Where previously she had resented Andrew’s insistence on sending them away to school, now she was almost grateful for it. At least while they were at school their lives were protected and secure… for the time being.
Next year… but she couldn’t think as far ahead as next year at the moment—she dared not even think as far ahead as next week.
She looked at her list again… A job… She smiled wryly to herself. She wasn’t so naïve as to imagine she would find work easily.
There were training schemes, though, she told herself. She had spent the last few days studying the local papers and visiting the Job Centre, obtaining as much information as she could on what kind of training schemes might be available to her, and this was one of the things she hoped to discuss with the Citizens Advice Bureau counsellor.
She glanced at the kitchen clock. It was time for her to leave; she had made her appointment as early in the morning as she could, not wanting to spend all day worrying apprehensively about it.
She stood up, smoothing down the skirt of her suit. She had seen an advertisement in the local paper for a secondhand clothes shop; they must buy clothes as well as sell them, and what good was a wardrobe full of expensive clothes to her when she hadn’t really got enough money to eat?
Which was her own fault and no one else’s, she told herself firmly as she left the house, muttering under her breath, ‘I’m damned if I’m going to start wallowing in self-pity.’
She had two clear choices ahead of her now, two clearly diverging paths she could take: she could either succumb to the fear, misery and despair she could feel waiting to overwhelm her, to pounce on her like shadows lingering threateningly in the dark, or she could fight the situation just as hard as she could and look upon what had happened as an opportunity to prove to the world, and more importantly to herself, just how strong she could be. A chance to have a fresh start and make her life what she wanted it to be, to be answerable only to herself and her sons.
She had her health, mentally and physically; she had a good brain even if she had lazily allowed it to semi-atrophy, and, perhaps most important of all, she admitted to herself, she also now had the impetus to make use of them; they were after all the only assets she now had, and if when she was younger she had not been able to motivate herself to use them for her own benefit, when it came to protecting and nurturing her sons…
* * *
The offices of the Citizens Advice Bureau were housed in a building next to the town hall. As Philippa approached them a young woman came down the steps towards her; she had a baby in a buggy and a toddler by the hand and Philippa automatically hurried up the steps to help her with the buggy.
As she turned to thank her, Philippa saw how very young she was, barely out of her teens. Her face looked pinched and thin, her collarbone sticking out sharply beneath the baggy black clothes she was wearing.
The toddler had a runny nose and the baby was crying; despite the cold wind neither child was wearing mittens and nor was the mother, and as she watched them Philippa felt a surge of angry despair against a world which on the one hand sanctimoniously and sentimentally semi-worshipped the ideal of motherhood—a motherhood that was depicted by an idealistic image of a glowing, perfect young woman clutching an even more perfect, glowing child, the status of both of them enhanced by a wealth of material assets—and yet on the other hand seemed deliberately to ignore the fact that motherhood for so many meant nothing like that. This was the reality of modern motherhood, this young, tired-looking girl.
And she thought she had problems, Philippa acknowledged as she hurried back up the steps.
The girl behind the reception desk gave her a friendly smile and asked her her name. The waiting-room had a shabby and yet somehow comforting air about it, slightly reminiscent of a doctor’s surgery, with its faded notices and a pile of ancient out-of-date magazines.
Lost in studying her surroundings, Philippa started slightly when she heard someone saying her name, and focused on the elegant woman speaking to her.
‘I’m Elizabeth Humphries,’ the counsellor introduced herself as she showed Philippa into her office. ‘We spoke briefly on the telephone when you rang to make your appointment.’
How much did she already know about her? Philippa wondered uncomfortably as she took the chair she was offered. The news of Andrew’s suicide and the problems with the business had made headlines in the local paper and she suspected it would be naïve of her to think that this woman hadn’t guessed who she was.
How did she feel, having to offer the same help and advice to the woman whose husband was responsible for so many other people losing their jobs?
But just in case she hadn’t heard, Philippa gritted her teeth and briefly outlined her situation.
Elizabeth heard her out in silence, causing Philippa to grimace slightly
and ask, ‘You must feel that there are other people who need your help much more than I do. People…’
‘Is that what you think?’ Elizabeth asked her quietly. ‘Or are you really trying to say that you believe that only a certain social class needs to come somewhere like this for advice? You’d be surprised how many professional and apparently financially stable people do come to us for debt counselling.’
‘Yes, I understand that,’ Philippa acknowledged.
‘But you still don’t feel that you should be sitting here…?’ Elizabeth smiled at her. ‘We’re here to help and advise you,’ she told her gently. ‘Not to sit in judgement. Now, have you brought a list of your debts with you?’
Philippa handed the list over to her. ‘I have written to them all explaining the position, but…’
‘That’s good,’ Elizabeth told her approvingly. ‘You’ll find that most of them will be prepared to accept a minimal payment and…’
Philippa shook her head.
‘I can’t even afford that until I find some kind of work. I don’t know what, though. I don’t have any qualifications or training. My biggest worry at the moment apart from the debts is going to be finding somewhere to live. My husband bought the house in his own name with a legacy. He signed it over to the bank when he needed money for the company and, of course, the bank now want to call in their security.’
‘Do you have family who could perhaps help?’ Elizabeth asked her.
Philippa shook her head. ‘Not really… my parents… although I had thought if I could get a job I could perhaps rent somewhere…’
‘If you get accepted on a government training course, you will be paid a small amount while you’re on it,’ Elizabeth told her. ‘And then, of course, there are other benefits you can claim, but I’m afraid when it comes to rehousing you… The effects of the recession have meant that there’s been a tremendous backlog of people needing to be rehoused, many of whom have had to go into bed and breakfast accommodation in the meantime. Have you discussed with the bank when they will expect you to vacate the house?’