by Damien Boyd
‘And why are they doing that?’
‘Money. Pure and simple. Animal insulin is more expensive to produce and cheaper for the NHS to buy, so the same profit margin isn’t there for them, is it?’
‘Hang on a minute. If the human stuff is cheaper to produce and they charge the NHS more for it, how do they justify it?’ asked Dixon.
‘It’s the research and development costs. The old adage about the first pill costing four hundred million pounds and the second one costing four pence. They have to recover the R and D costs, don’t they?’
Dixon leaned forward, picked up Monty’s tennis ball and threw it along the beach.
‘Oh, they’ll tell you that synthetic insulin, I refuse to call it “human”, is better at controlling blood sugar levels,’ continued Perry, ‘but there’s a technical term for that.’
‘What?’
‘Bollocks. The only study done said there was no evidence whatsoever that it was better or worse than animal insulin.’
‘The Cochrane Review?’ asked Dixon.
‘You’ve done your homework,’ replied Perry.
‘Couldn’t sleep.’
‘And choice is a joke. Were you given a choice?’
‘No.’
‘Of course you weren’t. Money talks.’
‘What d’you mean by that?’
‘They incentivise the doctors and consultants to prescribe synthetic insulin.’
‘Incentivise?’
‘Pay.’
Dixon shook his head.
‘There are about thirty thousand diabetics on animal insulin at the moment,’ said Perry, ‘and some of them just can’t tolerate the synthetic stuff. Not to mention countless thousands on synthetic having all sorts of problems and thinking they’re being caused by something else entirely. Look at Lizzie. First they thought it was ME, then MS.’
‘What will happen to them if it’s withdrawn?’ asked Dixon.
‘They’ll die. Just like Lizzie would’ve done if I hadn’t seen that advert. But that’s a small price to pay for a profit margin.’
Chapter Twenty-Two
Dixon dropped Perry on the corner of St John’s Road, where a group of Conservative activists were waiting for him, huddled under two large umbrellas. Then he sped south on the M5 to Express Park, arriving just before midday. Jane was standing by the printers in the CID area.
‘Lewis was looking for you.’
‘I sent him a text,’ replied Dixon. ‘What’ve you got?’
‘A full company search on Betalin UK and anything else I can find on the directors and shareholders. There’s only two of them, though. That Ann McConnell and Betalin AB. They’re based in Gothenburg, Sweden. I’m assuming that AB is the Swedish equivalent of our “limited”.’
‘Must be,’ replied Dixon. ‘See if any of its directors live in the UK.’
‘Will do,’ replied Jane. ‘Are we getting Dave and Mark back?’
‘That’s what I texted Lewis about.’
‘Thank God for that,’ said Jane, rolling her eyes. ‘How’d you get on with Tom Perry?’
‘Good. It’s just as we thought. She had a bad reaction to the human insulin and switched to the animal. She was fine after that. My impression is that he was going to make it his pet campaign if he got elected.’
‘And the money?’
‘Millions,’ replied Dixon. ‘Have we got Louise?’
‘Not till Monday.’
The meeting lasted a little over ten minutes. Jane watched through the windows of meeting room two as Dixon became more and more agitated. Then the door flew open.
‘And keep me posted,’ shouted DCI Lewis.
‘I’m assuming we’re not getting Dave and Mark back then,’ said Jane, as Dixon marched past her workstation towards the kettle.
‘No.’
‘Why not?’
‘Not enough to justify taking them off their current investigation,’ replied Dixon. ‘Coffee?’
‘Yes, please.’
‘He tried to soft soap me with some crap about having absolute confidence we can do it without them.’
‘He thinks you’re on the right track then?’
‘He does.’
‘You need to have a word with Tom Perry about police budget cuts, if he gets in.’
‘I might just do that,’ said Dixon, handing Jane a mug of coffee.
The hotel had ticked all the boxes; cheap, dog friendly, and just off the M1 at Northampton. But Monty was the only one who had slept well. Dixon had spent most of the night reading the file on Betalin UK and the sound of paper rustling at regular intervals had kept Jane awake too.
Dixon was sitting on the end of the bed, staring at his insulin pen.
‘What’s up?’ asked Jane.
‘I was just thinking about the side effects.’
‘Every drug has side effects.’
‘Yes, but they don’t usually include getting stabbed to death.’
‘I suppose not.’
Dixon dialled up ten units on the pen and then pushed the needle into the side of his thigh. He pressed the button and watched the dial turning, pumping the insulin into his leg. Without it he could look forward to rising blood sugar levels, a diabetic coma, organ failure and then death. With it he could lead a normal life.
He had never considered himself lucky when it came to his diabetes, not that he had wasted much time feeling sorry for himself either. His old climbing partner, Jake, hadn’t let him.
‘They’re letting me out tomorrow,’ Dixon had said, lying in his hospital bed after what had turned out to be a diabetic coma. ‘My blood sugar levels are OK now.’
‘Good,’ Jake had replied, grinning. ‘Pembroke on Friday, before some other bugger bags the first ascent of Suicide Wall.’
And that was that. No moping about at home for weeks; just straight out onto the sea cliffs as if nothing had happened, although it was only later that he realised the full extent of the favour that Jake had done him.
After that Dixon had just got on with it, having learned early on, and the hard way, that there was no alternative. Controlling his blood sugar levels had been easy, once he got the hang of it, and he had never suffered any side effects from his insulin. He was starting to realise just how lucky he had been after all.
‘You can have my orange juice,’ said Dixon, handing a tray to Jane in the restaurant. ‘It’s packed full of sugar.’
‘Did you download the satnav app for your phone?’ asked Jane.
Dixon winced.
‘Whatever happened to the art of map reading?’ he muttered, but it was lost in the noise of the coffee machine.
It took them ten minutes to find the Insulin Dependent Diabetes Trust office on a small business park on the edge of Northampton, although Dixon had checked the satellite image on Google Maps before they had left the hotel. He thought it best not to tell Jane.
The IDDT as it was known, according to the sign at the entrance to the business park, occupied the end of a terrace of modern two storey red brick offices set back from the service road. The block paved car park in front of the terrace was broken up into sections by box hedging, but the IDDT spaces were all occupied, as were all the visitors’ spaces, so Dixon parked in a space marked ‘Partridges Solicitors’.
‘You’ll get a ticket,’ said Jane.
Dixon took a business card out of his jacket pocket and left it on the dashboard. ‘That’ll have to do,’ he said, climbing out of the Land Rover. He stopped and looked up at the clear blue sky. ‘It only rains in Somerset these days.’
‘Seems like it,’ replied Jane.
The door to the IDDT office was locked so Dixon rang the bell and waited.
‘That’s Penny Thurstan,’ said Dixon, peering through the frosted glass window in the front door. ‘Her picture’s on the website.’
She was tall and slim, with very short grey hair.
‘Must be her.’
‘Inspector Dixon?’
‘Yes, and this is
Detective Constable Winter.’
‘Come in.’
‘We’ve parked in a space belonging to the solicitors, is that all right?’ asked Jane.
‘Hold the door a minute and I’ll just go and tell them where you are,’ replied Penny Thurstan, walking along the front of the terrace. ‘Don’t let go or we’ll be locked out.’ She disappeared into the office next door and reappeared a few moments later. ‘That’s fine.’
‘Thank you, Mrs Thurstan,’ said Dixon.
‘Penny, please. Now, anyone for coffee?’
‘Yes, please.’
Dixon and Jane waited in an interview room on the ground floor while Penny fetched three mugs of coffee.
‘We’re investigating the murder of Elizabeth Perry,’ said Dixon, when she reappeared.
‘You said that on the phone but I’m not sure I can help much. I’d met her a couple of times, and Tom, but I didn’t know them that well.’
‘When did you last see them?’
‘February last year. We went to the House of Commons. We do a lot of lobbying, as you might imagine, but Tom gave us direct access to the health minister. It was great for a small charity like us and we were all holding our breath to see if he got elected. Then this happens. My heart goes out to him. I can’t begin to imagine . . .’ Her voice tailed off.
‘So Tom was going to champion your cause?’
‘They both were. Tom and Lizzie. They had real personal experience. Tom said he was going to do everything he could if he got in. Even a private member’s bill, if he got lucky in the ballot.’
‘Saying what?’
‘That all diabetics must be given information about both types of insulin, alerting them to the risks, side effects, that sort of stuff. They’re supposed to now but it doesn’t happen. And guaranteeing the availability of animal insulin.’
‘How could you guarantee it?’
‘In 2002 the government bought a blood plasma supply company in America. It was when there was concern about Creutzfeldt–Jakob disease passing by blood transfusion. Tom’s argument was if they could do it then, they can do it now. And there are 30,000 people dependent on animal insulin.’
‘Would it have worked?’ asked Dixon.
‘I don’t know. There’s less money about these days, of course. But he was going to have a damned good go at it, I have no doubt about that.’
‘Which company would the government try to buy?’
‘Neither while the supply is still there, but it would have to be DK Pharma. Betalin’s too big.’
‘But Betalin are stopping production, aren’t they?’
‘It’s under consideration, apparently. It’s a very small part of their business, which is 90 per cent human insulin. That’s where the bigger profit is.’
‘Could DK Pharma cope with the extra demand?’
‘No. Not straight away, anyway.’
‘Why do the NHS put people on human insulin rather than animal if it’s more expensive?’
‘Is this on the record or off?’ asked Penny.
‘On,’ replied Dixon.
‘Then I’d best not speculate. But what I can say is that it’s not based on any clinical evidence that it’s any better. Have you looked at the 2004 Cochrane Review?’
‘Yes.’
‘Tom was going to do the speculating with the benefit of parliamentary privilege.’
‘I think he still might,’ said Dixon.
‘Forgive me for asking, but I thought Lizzie was killed when she disturbed a burglar?’
‘Is this on the record or off?’ asked Dixon.
‘Off.’
‘We’re looking at other possible motives for her murder.’
‘Like what?’
‘Tell me about Betalin.’
‘They’re a large Swedish pharmaceutical company. They produce 60 per cent of the world’s human insulin supply, and the associated stuff, like pens and blood testing kits. They’re aggressive in their marketing . . .’
‘What about in the UK?’ interrupted Dixon.
‘Their UK arm is really just a small distribution company. They use the pharmaceutical wholesalers to get it out there. The company itself is part owned by the Swedish parent and part by Dr McConnell, who calls herself the medical director. She used to sit on the board of the National Institute of Clinical Excellence,’ replied Penny.
‘Friends in high places,’ said Dixon.
‘Precisely.’
‘Is she medically qualified?’
‘Oh, yes.’
‘Let’s assume that Tom and Lizzie had been successful in helping you raise awareness then, and tens of thousands of people wanted to switch to animal insulin, how much would that cost Betalin?’
‘Millions,’ replied Penny. ‘It’s not just the lost profit but the cost of scaling up their animal insulin production to meet the demand. Not to mention the lost bonuses.’
‘Bonuses?’
‘I said I wouldn’t speculate, didn’t I?’ said Penny, slapping the back of her left hand with her right.
‘Reading between the lines is a speciality of mine,’ said Dixon.
Penny grimaced. ‘Are you saying that someone at Betalin had Lizzie killed to stop Tom?’
‘We’re looking at a number of possible motives.’
‘I never thought they’d go that far,’ said Penny, shaking her head.
‘It’s just one of a number of possible motives that we’re investigating and it is highly confidential . . .’
‘Of course it is,’ replied Penny. ‘And what about you? Are you on human insulin or animal?’
‘How on earth d’you . . . ?’
‘I’ve been around diabetics over thirty years, Inspector. And besides, there’s a tiny drop of blood on your shirt.’
‘Where to now?’ asked Jane, climbing into the passenger seat of Dixon’s Land Rover.
‘Bracknell.’
‘Betalin?’
Dixon nodded.
‘We haven’t got any evidence.’
‘Well spotted.’
‘But . . .’
‘We’re just making enquiries,’ said Dixon. ‘Besides, I want her to know we know. See what our precious Dr Ann McConnell does.’
‘And what if we’re wrong?’
‘Then we’ve lost nothing.’
‘What’s a private member’s bill?’ asked Jane.
‘Each year there’s a ballot and the successful MPs get to place their own bill before the House. A few even get it made into law but that usually only happens if the government agrees with it and allows the time.’
‘And Tom would’ve gone with the insulin thing?’
‘I get the feeling he still will,’ replied Dixon, nodding.
‘Betalin won’t like that.’
‘D’you want to ruffle her feathers, or shall I?’
‘You do it. You’re much better at it than me,’ replied Jane, smiling. She turned away when she heard the door being unlocked from the inside.
‘Yes.’
‘Detective Inspector Dixon and Detective Constable Winter to see Dr McConnell,’ said Dixon, holding his warrant card up.
The door opened just enough to reveal a woman in her late fifties, wearing a two piece tartan wool suit.
‘Do you have an appointment?’
‘No.’
‘You’ll need an appointment.’
‘Is Dr McConnell in?’
‘Not today, I’m afraid.’
‘And you are?’
‘I’m her secretary. Muriel Dummett.’
‘Well, Mrs Dummett, we have these marvellous little gadgets called automatic number plate recognition cameras. You may have heard of them?’
‘Yes.’
‘And mine tells me that’s Dr McConnell’s car,’ said Dixon, pointing to a white BMW parked behind his Land Rover.
‘Oh, yes . . . er . . . maybe she came back and didn’t tell me. I’ll just go and check.’ Mrs Dummett tried to shut the door but Dixon stepped forward.
Dixon looked at Jane and winked.
‘You’ll have to forgive Muriel, I’m afraid, Inspector,’ came a voice from behind him. ‘She’s ever so protective of me. Cold callers, salespeople, you know how it is.’
‘I do,’ said Dixon, spinning round.
Dr Ann McConnell was older than he had expected. Maybe it was an old photograph on Google Images? Long dyed hair tied up in a bun and sickly sweet perfume. A touch of Botox too, perhaps. She was dressed casually, in black trousers and a black pullover, and looked a little bit too much like an Albanian gangster for comfort. It was only when Dixon stepped forward to shake her hand that he noticed fingernails stained yellow and the smell of stale tobacco, which explained the perfume.
‘What can I do for you?’ she asked.
‘We’re investigating the murder of Elizabeth Perry,’ replied Dixon.
Dr McConnell was no poker player. Seldom had Dixon seen the blood drain from a face faster, but she did her best to compose herself with a loud cough and a shake of the head.
‘Do I know her?’
‘That was going to be my next question.’
‘I don’t think so,’ said Dr McConnell, thrusting her hands into her pockets.
‘Let me jog your memory. Her husband is the Tory candidate in the by-election. She was murdered on Christmas Eve.’
‘Oh, yes. I’ve seen it on the TV. Tragic.’
‘Three months pregnant,’ said Dixon.
Dr McConnell turned away.
‘And you gave a quote to the Surrey Comet last year.’
‘Did I?’
‘It was an investigation into the continued availability of animal insulin.’
‘I give lots of comments to journalists, Inspector.’
‘Mrs Perry suffered some very nasty side effects from human insulin. Does that ring any bells?’
‘No.’
‘And she went to see the health minister with her husband?’
‘No, sorry.’
‘Perhaps we could continue this in your office, Dr McConnell?’ asked Dixon.