Next morning Steven drove straight to the flat in London and parked the Honda in the basement garage, taking his gear up in the lift. Only two journeys were required; he’d left as much as possible in Leicester in an effort to minimise the change. The heating gurgled and protested for a bit but finally sorted out its problems and settled down to a steady hum before he left for the Home Office. He had changed into a dark suit and tie, Macmillan’s stipulated dress code; he wouldn’t be there but somehow it seemed only right.
‘How nice to see you,’ exclaimed Jean Roberts when Steven appeared in her office. ‘I couldn’t believe it when I heard the rumours about your coming back; I’m so glad they were true.’
Steven and Jean had known each other a long time, and it was good to be exchanging pleasantries again. Jean asked to be brought up to date on Jenny and her life in Scotland, and Steven got the latest details about the Bach Choir, of which Jean was an enthusiastic member. When they reached a natural hiatus, Jean asked, ‘Will you be using Sir John’s office?’
Steven shook his head. ‘No I’ll use the small one for the time being. Let’s not give up on him yet. Apart from anything else, I’ve only agreed to take a look at the thing that’s been concerning him most. I take it you have some notes for me?’
‘Quite a lot, actually.’ Jean pulled out several files from her desk drawer. ‘In the absence of any specific requests from Sir John, I had to go for blanket cover.’
‘Wow,’ said Steven, surveying the pile. ‘Where do I begin?’
Jean smiled. ‘How much do you know?’
‘Let’s see. Almost twenty years ago, a journalist went up to Newcastle to cover a story and never came back. He, his editor and several others died. Officially the story he was covering was about an operation that went wrong in a hospital where a new health scheme was being introduced at the time — the very successful brainchild of the then health secretary, John Carlisle. The scheme was abandoned for some unknown reason, Carlisle dropped off the radar and ended up taking his own life last week. Someone else connected with the scheme was recently blown to bits in Paris. How am I doing?’
‘I think you’ve grasped the main points very well.’
‘But most of this was nearly twenty years ago,’ said Steven. ‘What triggered John’s interest?’
Jean appeared thoughtful. ‘Looking back, I think it was a lunch he had with Detective Chief Superintendent Malloy. He came back from that wanting details about the operation you mentioned. Apparently the surgeon’s wife was one of those who died in Paris too, and the name had rung a bell with Sir John. It just seemed to go on from there.’
‘Thanks, Jean. Maybe I’ll go see him again before I make a start on this.’
‘Give him my best.’
John Macmillan was resting with his eyes closed when Steven arrived at the hospital, causing him to pause at the door. He was wondering whether or not to just leave when Macmillan seemed to sense someone was there and opened his eyes. ‘Steven.’
‘How are you feeling?’
‘Like I have a brain tumour.’
‘Stupid question. Have they scheduled the operation?
‘Next week.’
Steven sat down beside him. ‘It’s going to take more than a clump of cells to fell the John Macmillan I know.’
Macmillan smiled serenely, as if he knew better. ‘Have you seen Jean?’
‘I’ve just come from the Home Office. She gave me what she thought were the relevant files — all of them.’
Macmillan managed a chuckle. ‘Sorry there are so many.’
‘So where should I start?’
‘Carlisle’s death. There was always something odd about the man. I think he could be the key to whatever’s going on.’
‘A dead man?’
Macmillan closed his eyes and gave a slight nod as if acknowledging the problem.
‘What do you mean by odd?’ Steven continued.
‘Meteoric rise, spectacular fall, something not quite right with either.’
‘Okay, I’ll run with that,’ said Steven gently, sensing that Macmillan had no heart for further talk. ‘We’ll talk after the op.’
He turned at the door to look back at the sleeping man. A lump came to his throat.
When he got back to the flat and had made himself some coffee, he took Macmillan’s advice and separated the material on John Carlisle from the files. It took about fifteen minutes to do this, followed by another hour of reading it, before he found himself agreeing with John Macmillan. There was something very odd about the man. He seemed to have appeared on the political landscape from nowhere. A poor lower second from Cambridge had been followed by several jobs in the City — none of which had lasted longer than a few months — and then he’d popped up as the Conservative candidate for Ryleigh in the Cotswolds, a safe Tory seat. Why was that? Why had he been gifted a safe seat when there must have been tremendous competition for such a prize?
It was much more usual for would-be MPs to cut their teeth fighting no-hope seats in their opponents’ heartlands, proving their resilience and commitment to the cause before being adopted by a constituency which afforded them at least a chance of winning. But not John Carlisle. He materialised from nowhere, a new, unknown candidate in a constituency where they’d elect a cardboard cut-out if it was wearing blue, and won the seat with a majority of over ten thousand.
Steven could see from contemporary press cuttings that Carlisle had been a strikingly good-looking man in a pretty-boy sort of way — all white teeth and floppy hair. He could imagine Tory matrons taking to him well enough but even so… it all seemed far too easy. The man said nothing in the House for the first year but then started to exhibit an interest in the National Health Service and produced over the course of the next eighteen months a string of suggestions as to how it could be modernised and improved — an interest and expertise that again appeared to have come from nowhere. A year later, after a cabinet shuffle, he was made health secretary, and launched an ambitious modernising scheme in the north of England to much acclaim.
Reading through yet more press cuttings from the time, Steven found that few had a bad word to say about the Northern Health Scheme, although one or two local GPs had expressed concern over a perceived lack of freedom to prescribe as they saw fit. Steven followed this up but there was little to support the GPs. Under the scheme, a computer made the final judgement about which drugs the patients were to be given, but it was clear that the computer did not just pick the cheapest option. A sophisticated software program examined the doctors’ recommendations, sought alternatives and examined the merits of all, based on published research, before making the final decision about what to give the patient. If two drugs had equal merit in the literature, it would supply the cheaper one.
The computer was unbiased, which was more than could be said for prescribing physicians who could be influenced by shiny advertising and pharmaceutical company hospitality. When the computer had made its choice, the drug was supplied from a central pharmacy quickly and efficiently, to be either administered in the hospital or collected by the patient. The need for bits of paper floating around the system and people interpreting them had been eliminated at a single stroke, as had the need for queuing at chemists while prescriptions were filled. Doctors in College Hospital and the surrounding GP practices simply punched in details of their patients and their recommended medicines, and the computer did the rest.
Steven found himself admiring the system. Like many good ideas, it had simplicity at its core and, as a bonus, the money saved through streamlining the process was ploughed back into the budget. Unlike the situation in many health authorities, no drugs were off limits in the Newcastle area, even the most expensive anti-cancer ones. If the computer accepted the diagnosis and the doctor’s recommendation, and could find no better alternative, it would supply the drug. Everyone appeared to be thoroughly satisfied with the new scheme, and voices were raised in favour of its being extended across the nation. The only question lingering in Steven’s mind as he got up to make more coffee was why on earth that hadn’t happened.
As he read on, Steven could see that the fate of the Northern Health Scheme was inextricably linked to the fortunes of its designer, John Carlisle. At the height of its success, Carlisle was being mooted as a future Tory
