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Savage Cuts
Ações de livro
Comece a lerDuração: 409 páginas5 horas
- Editora:
- Colin McIntosh
- Lançado em:
- May 22, 2017
- ISBN:
- 9780995597013
- Formato:
- Livro
Descrição
Savage Cuts is a contemporary story of a health service torn between political imperatives to close a local hospital, and a group of unlikely collaborators to keep it open.
Stella Savage, has been appointed as chief executive to the Royal Infirmary with the secret task of closing the hospital, which is considered to be too old and too small for a modern health service. Her plans are discovered by consultant physician William Judd who has very different views and becomes determined to keep it open. As both parties enlist their support and begin battle, they are surprised by two unexpected developments, the malicious claims of a so-called ‘whistle-blower,’ and the rapid spread of an infectious illness within the hospital affecting patients and staff and threatening the local community.
To deal with the emergency Savage and Judd are forced to work together. The experience tests their own beliefs about themselves and the future of the hospital.
Driven by an ensemble cast, the story is an illuminating window into a world hotly debated since the 1970s. It combines scabrous humour with brutal realism in facing the contradictions of a modern health service.
Ações de livro
Comece a lerDados do livro
Savage Cuts
Duração: 409 páginas5 horas
Descrição
Savage Cuts is a contemporary story of a health service torn between political imperatives to close a local hospital, and a group of unlikely collaborators to keep it open.
Stella Savage, has been appointed as chief executive to the Royal Infirmary with the secret task of closing the hospital, which is considered to be too old and too small for a modern health service. Her plans are discovered by consultant physician William Judd who has very different views and becomes determined to keep it open. As both parties enlist their support and begin battle, they are surprised by two unexpected developments, the malicious claims of a so-called ‘whistle-blower,’ and the rapid spread of an infectious illness within the hospital affecting patients and staff and threatening the local community.
To deal with the emergency Savage and Judd are forced to work together. The experience tests their own beliefs about themselves and the future of the hospital.
Driven by an ensemble cast, the story is an illuminating window into a world hotly debated since the 1970s. It combines scabrous humour with brutal realism in facing the contradictions of a modern health service.
- Editora:
- Colin McIntosh
- Lançado em:
- May 22, 2017
- ISBN:
- 9780995597013
- Formato:
- Livro
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Savage Cuts - Colin McIntosh
Majorca
1. Judd
Dr William Judd, Consultant Physician to the Royal Infirmary, towelled himself briskly and walked into the bedroom just as his girlfriend, Anne, finished applying her make-up. She looked up and smiled. ‘Monday morning blues?’
‘No, just a little bit unsettled.’
‘Why? Is it the new chief executive?’
‘Yes, partly. I haven’t yet met her, and she’s been at work while we’ve been away. But also because I’m chairing the Medical Staff Committee meeting for the first time this week. She’ll be there. She has a reputation for closing services.’
‘Don’t be so glum. You’ll make a great chairman. You really care about the service. Your colleagues know that and it’s why you took the job. And don’t worry about the new chief exec – they come and go, and she won’t be able to resist such a charming consultant physician.’ She rose and put her arms around him. ‘Cheer up. Haven’t we just had the loveliest break?’
‘Yes, yes we have.’ Judd smiled and returned her hug, glad that she had accepted his explanation. They had needed the holiday, the time – time away from their careers, time to spend together for a change. The vacation had been healing, yes, until their return late last night, when Anne had immediately sat at her desk to check her emails.
‘Can’t that wait until morning?’ he had asked.
‘No, darling. I need to know what’s on tomorrow, which papers to take. Go to bed. Don’t fuss. I won’t be long.’
But he had fallen asleep before she had finished and Anne was up and showering before their alarm had woken him.
Anne broke from their embrace and glanced at her watch. ‘I’ve got to go, darling, or I’ll miss my train. Keep smiling. It’s a lovely brisk day and I’ve chosen you a tie to suit. To suit your suit. Toodle-oo!’
She was right. It was a lovely day for November and feeling uplifted by Anne’s habitual optimism – curious how she always managed to do that – he checked his own emails before deciding to walk to the hospital. Happily, there were no urgent messages.
The Royal Infirmary was close to the Thames at the south end of the borough, now surrounded by many public buildings and offices, while its sister hospital, St Andrew’s was two miles further north, in an area that was mainly residential. The two hospitals worked together to serve the borough, sharing some of the staff and services. That is part of the problem, having to share, he thought as he crossed the river. At one time Judd could see the hospital from the bridge, but now it was hidden behind much taller structures of steel, glass and concrete.
Ten minutes later, Judd stopped and surveyed the Royal: five storeys of red brick, tall chimneys and narrow windows, built with classical symmetry, but now in need of repair and under constant threat of closure. Very high capital charges!
– he could just hear their last chief accountant’s wheedling voice.
He stepped back as a party of tourists scuttled past. Americans mostly, he decided, judging by the plaid clothes, running shoes and the rather tired, disdainful look of their guide.
‘This isn’t the oldest medical school in the capital,’ said the guide, his monotone revealing his boredom, ‘but it is usually regarded as the best. Doctors who trained here have gone to the far corners of the world.’
Hardly surprising, the way things are going, thought Judd.
The guide seemed to wake up and struck the wall with the flat of his hand. ‘Within these walls there is an air of dynamism that makes British medicine what it is today!’ he concluded impressively.
The tourists looked at the decaying walls with obliging awe. One manoeuvred his gum against his cheek and asked, ‘Say, did that dude Pastoor train here?’
Fearing the guide’s reply, Judd hurried inside – and bumped into a small boy lodged in the narrow entrance clutching a bloody rag to his nose.
‘Oops! Sorry, son. Got yourself a bleeder? Fighting?’ The boy removed the cloth and shook his head, adding an arc of flaming colour to the drab wall. ‘Want it fixed?’ The boy nodded. ‘What’s your name?’
‘Peter.’
‘Come with me then, Peter.’ Taking the boy’s arm, Judd led him across the entrance hall to A&E. ‘Here we go, through this door – Accident and Emergency Department – they’ll soon fix you up. No school today?’
The boy shook his head. Another spray. ‘Uh-uh. It’s half-term.’
Judd looked up as a nurse approached. ‘Ah, staff nurse, this is Peter, his nose needs some attention.’
‘OK, doctor.’ The nurse smiled kindly addressing Peter: ‘Nobody with you? Your mother?’
Judd stepped back, covering his tie with his hand as the boy shook his head again. ‘She’s working.’
‘Come with me then.’
‘Bye, Peter.’
The smile of encouragement slowly faded from Judd’s face as he watched the boy being led to the reception desk. Skinny little mite, he thought, he shouldn’t be here on his own.
Judd left the department and headed for his office, but stopped as he caught sight of the cleaner in a blue uniform scuttling towards the lift, obviously late for work. ‘Olga, Olga! Hold on a moment, I need to talk to you.’
As Olga stopped and looked around, her worried frown changed to a beam of pleasure. ‘Dr J-Ju-Judd.’ She bobbed up and down.
‘Hello, Olga. Are you OK?’
A nod and another bob.
‘Your psychiatrist, Dr Frew, sent me an email to ask if I’d seen you. He said that you hadn’t shown up for your injection again.’ Olga stared at the floor. ‘You haven’t been hearing voices again, have you, Olga?’
‘N-no, d-doctor.’
‘Or seeing things? No more hallucinations?’
She shook her head.
‘That’s good, but remember Olga …remember what happened the last time you forgot your medicines? You had to be admitted. We don’t want that to happen again, do we?’
‘N-no, Dr J-Judd.’
‘Good. Then as soon as you finish your shift, go to Psychiatry and have your injection. You’ll do that, won’t you?’
Olga nodded her head vigorously, bobbed again and set off for the lift. Judd watched her for a moment before he took the stairs to his office. He must remember to check with Dr Frew tomorrow that she had attended for her jab. He felt concerned, having assisted the psychiatrist in convincing Human Resources that Olga was employable, despite the obvious safety issues.
He checked his tie again. Good. None of Peter’s blood spray on Anne’s latest gift. Her gifts were regular, a habit, perhaps one a month. To show her love? Or an ongoing apology?
He shook his head. Booting his PC, he looked at the papers and correspondence awaiting his attention on the desk.
Not now. Time for some work.
2. Casualty
Like most A&E departments, the Royal Infirmary had a separate entrance for patients arriving by ambulance and another for the walking wounded. It was this latter entrance that Judd had used to deliver Peter, who was now lying on a trolley in a curtained cubicle awaiting the arrival of a doctor. His nostrils had been packed by a nurse but the bleeding continued, and as the department’s medical staff were involved with other patients, the sister in charge thought he might need cauterisation and took the opportunity to ask one of the junior surgeons, Dr Large, to see Peter. Large was tall, thin, with gangly limbs, and it wasn’t uncommon for people who met him to think that Long
would have been a more appropriate surname for him.
Large was always training. After entry to medical school he was inspired by one of the reruns of the movie Doctor in the House on television and had embarked on a strict programme on how to become a dedicated medical student, walking about with a weary face, hunched shoulders, stethoscope dangling carelessly from his pocket, a long woollen scarf wrapped four times around his neck and a large pile of books underneath each arm. He developed rapidly. By the time he graduated, he felt he had the longest arms in medical school.
Now, at the age of twenty-six, he was training to be a surgeon and had only recently achieved perfection in his code of conduct. Observing that all great surgeons lose their temper in the operating theatre and cover their technical slips by throwing their instruments about, he had successfully managed to spear the theatre sister’s foot with a scalpel. It had passed through the side of a plastic bucket, the top of her rubber boot, the skin, subcutaneous tissue and muscles of her foot, skilfully gliding between the metatarsal bones and only coming to a stop after traversing the boot’s sole and entering the thermoplastic tiles below. ‘The scalpel was blunt,’ he’d explained.
He would make a great surgeon.
After that incident, he was obliged to transfer from this previous hospital and arrived at the Royal, where he was now learning to improvise. He had noted that by improvising on existing instruments, many famous surgeons had ultimately developed new models and had achieved fame by having them named after themselves: the Spenser-Wells forceps, the Thomas’s splint, the Robert Jones bandage; so there was every opportunity for a Large something. But what…?
He was happily engaged on this train of thought when he was caught by sister to see a boy with a bleeding nose.
‘Why can’t Dr Patel deal with it?’ he asked as the sister beckoned him. A bleeding nose hardly warranted a surgeon.
‘She’s in an ambulance outside, dealing with a probable DOA,’ she explained. ‘We’re short-staffed and the boy’s bleeding won’t stop.’
Ah yes, he remembered, better to diagnose death in the ambulance when the body could be taken straight to the coroner’s mortuary, rather than be admitted to hospital causing a mountain of paperwork.
‘OK, sister, show me.’
He was led to the small boy holding a drenched, once-green surgical towel to his nose.
‘This is Peter. We’ve tried packing it,’ said sister, ‘but I think it’s going to need cauterisation.’
The boy’s eyes were wide, fixed on his saviour.
‘Wait! There must be another way. Improvise. Improvise.’ Desperately, Large wracked his brain. ‘I’ve got it! I’ve got it!’ he cried in excitement.
Sister rolled her eyes.
‘Get me a urinary catheter and a syringe.’
‘A urinary catheter?’
‘Yes, yes. A small one.’ Large turned to the boy and removed the soggy red pack from Peter’s nose. ‘Been picking it?’
The boy nodded proudly, spraying another cupful of fresh blood on the walls, while swinging his legs happily on the trolley.
‘You’re picking it and we’re packing it. We’ll soon have it stopped,’ said Large, taking the catheter from sister’s hand and threading it up boy’s nostril. The catheter was a double lumen rubber tube designed to drain urine from an obstructed bladder. One of the tubes acted as the drain, while the other was used to inflate a small balloon at its tip, preventing the catheter from slipping out. Using a syringe full of air, Large inflated the balloon in the boy’s nose. The flow of blood stopped. ‘There we are. Just leave it in place for half an hour.’
‘But shouldn’t you have used saline?’
‘Nah. Air is quicker. Improvise.’
Sister seemed unimpressed. ‘Hmmph. There’s another patient you could help with over there,’ she said. ‘Miss Gamble …again. This time with a head injury.’ And Peter was left with the rubber tube dangling from his nose as the emergency team went to deal with Miss Victoria Gamble.
Miss Gamble was one of the department’s recurrent visitors, usually in a state of advanced inebriation. Introduced to the horrors of life at puberty when the parson exposed himself during Bible class, Victoria Gamble had applied herself to the profession of cynical spinsterhood. Now, at eighty-seven, the only things left that she believed in were gin and her virginity. In a world of changing values, they had remained safe and constant.
She had a large bruise on her forehead, induced by contact with a gin bottle when she fell out of bed. She watched suspiciously as the tall young man approached and examined her injury.
Large started taking details of the accident, hoping against hope that she hadn’t lost consciousness, obliging him to follow the hospital policy of x-raying her skull – a rule in all cases of accident induced coma. Large hated looking at skull x-rays. They reminded him of his father. ‘You fell from bed and banged your head, Miss Gamble?’
‘Yes!’ she answered starchily, wondering at such a young whippersnapper being allowed to ask such indelicacies.
Large crossed his fingers. ‘Er, were you knocked out?’
‘Certainly NOT young man!’ she cried, outraged. ‘I FELL out!’
And to emphasise her indignation she swung her handbag against his head. The handbag was made of soft leather and crumpled quickly on impact; the gin bottle half-full, was made of thick glass and did not.
With scarce a moan, Large sank to the floor.
3. The Chief Executive
Stella Savage, the new chief executive officer to the Royal, sat at her desk awaiting the arrival of her finance director, Len Morris. She had been in post for two weeks, had undergone the ordeal of the orientation process – visiting departments and meeting staff – and she had done most of her homework, getting abreast of the current organisation and practices. Much of the paperwork was in the waste basket; the rest was neatly labelled awaiting filing. Now she had to carry out the task that she had been given by her boss, Lady Cynthia Winsone. It was not the first time she had been told to make cuts or closures, but it was the first time she was tasked with closing a hospital and keeping her role secret.
Lady Winsone was the deputy chair of NHS London, the strategic health authority responsible for implementing the department’s fiscal policy in the capital. Stella hadn’t liked her from the start when she’d chaired the committee appointing Stella to her new post.
After the appointment, she had called Stella to her office. ‘I’ve been watching you for some time, my girl,’ she had said. ‘You’ve done well, you’re ambitious.’
‘Yes, yes, I am,’ she’d replied.
‘How ambitious?’
‘I like to do a good job, to succeed in my role and advance my career.’
‘Good girl. You remind me of me at your age. Well, I have a task for you, a very important task, direct from the Department of Health, but it does require sensitive management.’
Stella snorted as she recalled the conversation. Sensitive? It was devious and made her role difficult to say the least. It was bad enough having to report to that odious woman. Like her indeed. I certainly hope I’m not.
She stood up and looked at herself in the full-length mirror she’d had installed as part of the improvements she had made on inheriting her office. No, I’m no girl, she thought as she studied her reflection, automatically running her hands down the grey wool suit. She turned to examine her profile. But not bad for a woman nearing thirty-four. She settled an errant blonde curl behind her ear before returning to her seat and the memory of her interview.
‘Remember, my girl,’ Lady Winsone had continued. ‘If the medical staff or the public get wind of this, they’ll mount a campaign – and that always makes things more difficult. Divide and conquer, that’s how to deal with them.’
My girl, my girl. Stella could still hear the patronising voice. Well, I’m certainly not that, even if she is my boss. And to behave like a dedicated efficient chief exec while secretly ensuring the demise of the hospital, that is going to be tough. But maybe, just maybe, I need that challenge.
A knock on her door and she returned to the present as a head appeared. It was the finance director who had been with her at her previous hospital.
‘Come in, Len, take a seat. Coffee?’
Morris shook his head. ‘No thanks. I’m OK.’ He dusted the chair carefully before he sat down.
Stella wasn’t surprised. Her question had been automatic. In the three years since she had known him, she hadn’t seen him drink anything but water, and he usually took care to dust wooden chairs. He hadn’t divulged a reason. Perhaps because he favoured wearing dark suits.
‘Are you sure? You look a bit troubled.’
‘Oh, it’s not that important, just that bloody suggestion box again.’
Stella smiled. On their arrival at the hospital, Morris, acting as Stella’s deputy, had placed a suggestion box in the staff dining room in an attempt to show that the new management team were open to ideas from the workplace. ‘What’s the problem then?’
‘We’re not getting any suggestions, just complaints – about the décor, the food, difficulty parking etc., etc. – and I’m pretty sure they are mostly from the same person.’
’Oh, it’ll settle down. Why not let it ride for a bit?’
‘Sure. Of course.’ Morris crossed his legs and gave her an apologetic smile.
‘Len, I wanted to see you because I’m going to a meeting this lunchtime with the Lady Winsone at St Andrews Hospital, and the chief exec from St Andrews will also be there,’ she explained.
Morris merely nodded.
‘Well, brief me. Is our job going to be easy or difficult?’
He shifted in his seat and Stella smiled inwardly. She knew he hated answering such direct questions. Morris was fully aware of their underlying mission.
‘Well, that depends …the hospital does have many weaknesses, as does St Andrews. Both are old. Both need modernisation or rebuilding. Both well over budget.’
‘Come on, Len, we knew all this before we came here. Neither hospital offers a full service. They share some departments and some staff. But what have you discovered in the last two weeks? Tell me about the staff. Where are the weak points? Who are the power brokers? Who do we have to be wary of?’
The finance director leaned forwards, placed his elbows on his knees and steepled his fingers. Stella was familiar with the faraway expression he adopted as he looked over her shoulder to the wall behind her. The first time she saw it she felt as if she had asked him to explain the string theory. She waited expectantly until he relaxed, sat back, smacked his lips twice and began. ‘The chief surgeon, Sir Oliver Mann, may be difficult, and Ray Wiseman, the professor of medicine and cardiology. These two are probably the most powerful individuals. Mann is desperate for a chair, but he’s now on his third wife while still flirting when he can – which has probably interfered with his chances of professorship – and the cardiologist, Wiseman, well …he is vying for a gong.’
Stella laughed. ‘Oh, these academics, don’t you just love them? But what’s their beef, why should we be wary?’
‘Both their departments are split. Mann’s emergency surgery is here at the Royal because we have an A&E department, but his day-case work and elective surgery is mostly carried out at St Andrew’s. Acute cardiology is here for the same reason, but much of the cardiac research and diagnostic procedures is at St Andrews, thus splitting Wiseman’s work.’
Stella pondered for a moment. Divide and conquer. ‘And the weak points? No, don’t tell me, let me guess.’ She laughed again. ‘It’s the split departments, Surgery and Cardiology. Of course. Well, we’ll promise to solve their difficulties.’
Morris gave a weak smile. He picked a piece of fluff from the sleeve of his jacket and glanced up at Stella. ‘You enjoy this, don’t you?’
‘I do. I enjoy doing a good job. But don’t tell me you aren’t enjoying it too?’
‘Yes, yes, I do. I am. But I’m coming at it from a financial perspective – very different.’
Stella stood up and stretched. It was true, her perspective was different, but Morris’s curiosity about her feelings was a new development. And she wasn’t sure she liked it.
‘Not that different,’ she said. ‘I’m a manager in healthcare, yes, and I have to manage its resources – which includes people as well as buildings, budgets and the rest – and if that means closing redundant and inefficient hospitals for the good of the service, I will, without regrets. The patients will ultimately get a better deal.’
Morris was watching her without comment.
‘If you’re asking me if I feel sorry for making people redundant, I do,’ she continued. ‘For the porters and cleaners and others who live locally and depend on the hospital for a job. But the professionals? No. The nurses, radiographers etc. will be OK. And the doctors? Huh.’ She had a brief mental picture of her father. ‘They worry more about losing their private practice, moving further away from Harley Street, but they won’t starve.’
Was that convincing, or did I just sound bitter? she thought. Len probably knows I originally trained as a nurse.
She took a deep breath, turned and gave Morris a small apologetic smile. She sat down again. ‘All right. And the others. What about the chief physician?’
Morris sneered. ‘Hunter-Harvey? No problem. Usual pompous consultant, arrogant to his juniors. Bit of a nincompoop, I thought.’
Having met Hunter-Harvey, Stella agreed. That had been her initial impression. ‘And Judd, the chairman of the Medical Staff Committee, will he be a stumbling block?’
‘I shouldn’t think so. He’s supposed to be a competent enough physician, but he’s had no management training or experience. I think he’ll have his hands full trying to chair the committee.’
‘Let’s put him to the test.’ Stella pushed a button on her phone. ’Belinda, do you have Dr Judd’s number? Yes? Put me through, thanks … Dr Judd? Hello, this is Stella Savage. No, not so formal. Stella will do. How do you want to be called – Bill? William? William, OK. Did you have a good break? Splendid. Your colleague, Dr Hunter-Harvey, has invited me to your Medical Staff Committee meeting tomorrow. I hope that’s all right? Good. I’m sorry, my diary is so full we won’t get a chance to meet before then, but I thought it only right to warn you that we shall probably have to close a ward … yes, one of the surgical ones, I’m afraid. Nurse shortages. We haven’t been able to recruit any, despite our best efforts. I’ll explain tomorrow. Sorry about that. All right. See you then.’
‘That should put the cat among the pigeons,’ said Morris with a smirk. ‘Pitting him against angry surgeons too.’
Stella smiled. ‘Yes, and I resisted adding best of luck. Now, tell me about the others.’
Over the next forty minutes they discussed the hospital and its staff, until they were interrupted by Stella’s secretary who reminded her of her forthcoming meeting at St Andrews.
‘Oh, right, Belinda. Thanks. Can you order me a taxi?’
Turning back to Len, she said, ‘Now, the meeting tomorrow. Just like last time we must make the medical staff feel that we are doing our best to improve services in the hospital. No hint of a different agenda.’
‘But maybe slip in something controversial?’ added Len.
‘Now would I do that?’ she asked.
4. HH: Senior Physician
The medical wards were on the first floor of the Royal. Two of them, Maple Ward (male medical) and Spruce Ward (female medical) were under the joint care of Judd and his senior colleague Dr WJ Hunter-Harvey. They were supported by two junior doctors: Scurr, a newly graduated houseman (or house officer), and Marsh, their registrar, now an experienced young doctor, training to become a consultant physician like his superiors. On a Monday morning, it was Hunter-Harvey’s turn to perform a teaching ward round.
Hunter-Harvey, or HH as he called himself (unaware of what the students called him), was about to do a round. He was a short and plump man, with gold-rimmed spectacles, a pinstriped suit and a rectal ache. By day, he maintained the dignity appropriate to that of senior consultant to the hospital – a position owing more to the fact that his brother had been chairman of the board of governors rather than to any meritorious service on his part – while by night, he maintained the humility that only those with severe haemorrhoids may know.
Every evening, he would bend over the kitchen table with his trousers about his ankles as his wife applied cold bread poultices to the grape-like cluster hanging from his buttocks. And each night, whilst smearing on the poultice with a silver teaspoon, his wife would reflect sadly that this was an intimacy unforeseen when she had whispered ‘Yes’ during that passionate night in her parent’s coal cellar. If only her husband could see it from her point of view. ‘Why don’t you let Ollie remove them for you?’ she had asked for the umpteenth time the evening before.
‘What?’ he had exploded. ‘Let that butcher and his gangly knife-happy idiot of a registrar get their hands on me? Not bloody likely.’
That butcher was his friend Sir Oliver Mann, the chief surgeon to the hospital and surgeon to the Queen; while his knife-happy idiot of a registrar was the gangly knife-happy idiot, Dr Nathaniel Large.
About to enter the ward, Hunter-Harvey was annoyed because the registrar he shared with Judd – Dr Marsh – was off duty, reported to be in bed recovering from yet another busy night on-call. Although his houseman was present, HH felt aggrieved that someone of his seniority was deprived of his registrar for a teaching ward round. It wasn’t good enough. He refused to admit, however, that his pangs of anxiety were because he relied on his registrar to cope with the difficult questions asked by the students. He felt the need to complain, and remembered that Judd must have returned from his holiday. He left his office, crossed the corridor and tapped on the door.
‘Come.’
‘Hello, Bill. I hope I’m not interrupting.’
‘No, not at all, HH. Have a seat. Just catching up on emails and correspondence.’
‘How was your holiday?’
‘Good thanks. Anne and I went to Cyprus. A nice break from our cold weather. We had a good time. Tell me, have you met the new chief exec? What’s she like?’
Hunter-Harvey hesitated. ‘Yes …I met her last week. Smart. Smartly dressed. Lots of questions – which I did my best to answer. I think I left her with a good impression of our services. Didn’t give much away herself. Said she’d like to come to our next Medical Staff Committee meeting, so I invited her. Said you wouldn’t mind. You don’t, do you?’
‘No, no, that seems appropriate. Let’s hope she doesn’t live up to her name. Savage, isn’t it?’
‘Yes, that’s right.’ Hunter-Harvey felt a flutter of anxiety. Should he complain?
He stood up and winced as the movement caused a momentary spasm. He forced a smile. ‘Well, I must do my ward round. Oh, these bloody juniors. You don’t happen to know where our registrar Marsh is this morning, do you? I only have a houseman and staff nurse with me on the ward round. Not good enough.’
‘No, I don’t know where Marsh is. But the houseman, Scurr, he’s pretty competent, don’t you think?’
‘Oh yes, yes. Indeed, he is. Very competent.’ Hunter- Harvey tried again: ‘But the junior staff …they work far fewer hours than we did at their stage, don’t they?’
‘Yes,’ Judd conceded. ‘The European Working Directive has seen to that. But you must admit their workload is also now very much heavier than it was in our day. I don’t envy them …’
He could see that Judd was waiting for an answer. ‘Oh yes, yes indeed, Bill, you’re quite right. They’re much busier. I’d best leave you to your work. See you later.’
His mood didn’t improve as he headed for Maple Ward.
While watching for Hunter-Harvey’s approach, Dr Christopher Scurr silently cursed himself again at his folly in spending yet another sleepless night in frenzied amours with Nurse Bends. It was too much. He must get some sleep. He straightened up as Hunter-Harvey arrived, ignoring Olga, the bobbing figure in blue who had just entered the ward corridor.
‘Are the students here, Scurr?’
‘Yes, sir,’ said his houseman, looking at his companion, Nurse Bends, as if for confirmation. Scurr had already spoken to the five students, reminding them of some of HH’s many eccentricities and old-fashioned ways. He
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