Ken McClure - Donor

‘I think I know him too,’ said Sandy, recognizing the name. ‘He helped me push-start the car one night when it played up. He’s some kind of government official, isn’t he?’

‘That’s right. Truth to tell, you have him to thank for Amanda’s referral to Medic Ecosse being successful. He had the final say over it and didn’t question it at all. Simply gave it his seal of approval. He seemed like a good bloke.’

‘I didn’t know that,’ exclaimed Sandy. ‘He never said. I owe him one.’

‘An unusual civil servant,’ said Turner. ‘Anyway, I’ll see if he can shed any light on Amanda’s marrow puncture.’

‘I’m obliged to you again,’ said Sandy.

Turner called Dunbar the following morning. They exchanged pleasantries, then Turner said, ‘I know this is not strictly up your street but I wonder if you can help me out with something?’

‘Not another free transplant, I hope,’ joked Dunbar.

‘Nothing like that,’ laughed Turner. ‘I do realize your resources are finite. I have a question I hoped you might be able to answer for me… discreetly.’

‘Try me.’

‘I’ve had Amanda Chapman’s father on the phone. He was a bit worried about why his daughter had to go through the unpleasantness of a marrow puncture when all her immunological data is already known. He didn’t want to make a fuss and appear ungrateful up there, so he asked me and, frankly, I couldn’t think of a reason either. I thought I’d try to find out quietly. That’s what made me think of you.’

‘I see,’ said Dunbar. ‘You don’t want to ruffle any professional feathers in this neck of the woods.’

‘Exactly. I thought you might conceivably have access to relevant files and might take a little look for me?’

Dunbar smiled to himself and said, ‘I can’t promise anything but I’ll see what I can do. If I come up with anything I’ll get back to you.’

Dunbar put down the phone and thought. He waited until Ingrid had left the room before requesting a current-costs listing for Amanda Chapman from the computer. It was hospital policy that reasons had to be given for all tests and procedures carried out, to avoid possible later accusations of performing unnecessary ones just to inflate the bill. Although Amanda’s parents were not paying, the computerized listing procedure was routine and would therefore apply in her case too. It would be too much trouble to change it all for an individual patient.

But the listing that came up on the screen made no mention of any marrow puncture having been carried out on Amanda Chapman. None at all. He checked the date on the file. It had last been updated that morning. Dialysis charges and standard daily fees were given, but there was nothing about any special tests or minor surgical procedures.

Dunbar sucked the end of his pen and considered. It could simply be that the staff had been tardy in keeping Amanda’s file up to date, knowing that in the end there would be no bill to settle, but that seemed unlikely in a hospital that ran like clockwork. The only alternative was that someone had taken a conscious decision not to enter the marrow puncture in the notes. Why? Because they didn’t want a record of it? Maybe that was being too melodramatic. A marrow puncture was not that uncommon a procedure. It was simply the fact that all her immunology stats were already known that made it seem questionable.

Some kind of mistake? Unnecessary duplication? Had one of the more junior staff, through ignorance of Amanda’s case, written her up for a procedure she didn’t need? It seemed plausible. Dunbar wondered how he could check. He supposed there must be a record of the test somewhere, even if it hadn’t been entered in the patient’s notes. He would call up the record of theatre usage for the past few days and find out where the marrow puncture had taken place and who had carried it out. He didn’t want to make a big thing out of it; he just wanted to know.

The computer obediently showed the schedules for each theatre in turn. There was no record of Amanda being treated in any of them. There was, of course, a theatre in the Obstetrics wing being used by the Omega patient. No information was available on its use, in keeping with the total confidentiality rule for these patients, but that didn’t seem a very likely choice… or did it? Dunbar suddenly remembered the little girl being taken into the lift leading to the Omega wing on the night he’d raided the Radiology Department. Now it made sense. The girl must have been Amanda Chapman.

Ingrid returned and said, ‘I’ve done the costings you asked for on transplant patients.’

‘Well done.’

‘I think you’re in for a bit of a shock,’ she said, putting the file in front of him.

Dunbar looked at the final figure and let out his breath in a low whistle. ‘That much!’ he exclaimed.

‘I’m afraid so,’ said Ingrid. ‘It’s an expensive business.’

Dunbar nodded and she smiled. ‘You’ll be regretting having agreed to the free NHS referral case,’ she joked.

‘Money isn’t everything,’ he replied.

‘I don’t think the Scottish Office would be too keen on hearing you say that,’ said Ingrid.

‘Perhaps not. But maybe a good part of the cost will be offset by the money coming in from the Omega patient?’

‘I’m sorry, I don’t think I understand.’

‘I just thought that Omega patient fees might subsidize the hospital’s generosity when it came to free transplant cases.’

‘Oh I see,’ said Ingrid.

‘Amanda Chapman isn’t the first transplant patient the hospital has taken on for nothing,’ said Dunbar. ‘I noticed there were two others in the past. They were on the list of free referrals you prepared for me. I just wondered if the cost of their operations had been offset against Omega patients too?’

‘I’m not sure.’ She sounded a little uncertain, but soon recovered and said, ‘I suppose you may be right.’

Dunbar was puzzled. There was so much money involved that he felt sure Ingrid ought to know how the free transplant referrals had been financed. In fact, he was surprised that more had not been made of the hospital’s generosity, in terms of publicity. After all, the news of Medic Ecosse using large fees to finance expensive charity cases would have reflected very well on the hospital and particularly, as most of the costs would have been borne by the transplant unit, on James Ross and his staff. It would, of course, be at odds with a unit callously conducting animal experiments on some of their patients…

Dunbar thought he could see a way of asking Ingrid about the tests on Amanda Chapman without arousing suspicion. He looked down her list of transplant costs, then said jokingly, ‘It looks like you folks are short-changing Amanda Chapman.’

‘What do you mean?’

‘According to her costing file, she hasn’t had any of these tests you put on the list for transplant admissions.’

Ingrid came over to stand behind him and look at the screen. Dunbar brought up Amanda’s file. ‘See?’

Her face relaxed into a smile and she said, ‘Oh, I know why not. Amanda didn’t have these tests because she came here from the Children’s Hospital. She had all her immunology stats done over there. She didn’t need them. She’s already on the register.’

‘Of course,’ said Dunbar. ‘I should have thought of that.’

But her words raised new questions. Just what the hell had Medic Ecosse been doing, giving Amanda-Chapman a marrow puncture at night in the Omega patient’s wing? If Ingrid Landes, a secretary, realized that Amanda didn’t need further immunology testing, then so without doubt did the nursing and medical staff. Come to think of it, how did Ingrid know about immunology testing? She worked for Giordano in administration; she wasn’t even a medical secretary. It made him curious. The next time she was out of the room he would pull her personnel file.