Death Before Time (23 page)
“So where do we go from here?” Marcus asked. “
Is
there anywhere we can go from here?”
“Let’s get something absolutely clear,” said Tom, looking round pugnaciously. “Philip Armitage and Helen St John were killing off their patients. Furthermore, I find it impossible to believe that Armitage killed either St John or himself.”
Jo stared at him,“…How can you possibly know that Armitage was involved?”
“Because he’s dead Jo. Do you really believe he and Helen were having an affair?”
“I … don’t know.” She raised the ghost of a smile. “It means she’d have had three on the go … which seems unlikely.“
“Then why did he kill her? If he
did
kill her … ”
“Well, he might have realised what Helen was doing, killed her for it in a fit of anger, and then himself out of remorse.”
“D’you really believe
that
?”
“Why not? It’s what the evidence says, isn’t it?”
“Helen couldn’t have killed those patients on her own Jo – “
“Why not?” she said again, “Substituting a Glandosalve dispenser isn’t that difficult.”
“Maybe not, but what about the trifling matters of acquiring the resistant bugs, making them virulent and then manufacturing the doctored dispensers. She’d have needed help and I think it has to be Armitage.”
“Why not Edwina, or Singh? We know she was still seeing Singh, so why not him?”
“Fascinating though this may be,” Marcus cut in, “What are we going to do about it? Bearing in mind that we’ve been ordered to stop?”
Tom turned to him. “D’you accept what the police said, Marcus? No euthanasia, just a love affair that went tragically wrong – do you believe that?”
“You know perfectly well I don’t. But what do you suggest we do about it?”
“Well, the first thing is to prove - to ourselves at least - that the euthanasia was real, and then find out who was in it with Helen.”
“How do we do that?”
“Is that a serious question?“
“Of course it is,” Marcus said impatiently.
“All right.” Tom gathered his thoughts, then: “You and I go back to London and research the past careers of Armitage, Singh, Helen and Edwina. You find out where they worked, I’ll go there and ask questions. OK?”
Marcus nodded and Tom continued, “Fraser, try and work out exactly how they did it, the capsule business. Doesn’t matter whether you work here or in Bristol. Jo – “
“Sorry Tom,” Marcus interrupted and turned to Fraser. “It really would help, Fraser. It’s the reason the police won’t take us seriously. If you can find it, they’ll have to listen. Go on, Tom … “
Tom nodded. “Jo, you carry on at the hospital. Find out what people are saying about Armitage and Helen, they’re bound to be talking about it. Look out for any more suspicious deaths, although I very much doubt there’ll be any, and keep an eye on Edwina and Singh.”
“Anything else?”
“No, I think that’s it.”
“I was being ironic … ”
“I know.”
“Look,” she said, “I’ve already aroused enough suspicion as it is - if I start asking questions now, it’ll only make it worse.”
“You won’t need to ask any questions, just listen. Anyway, you’re not going to be there much longer, so it doesn’t really matter what they think of you now, does it?”
“Oh, and Fraser,” said Marcus, “One other thing - try and remember everything Helen and Armitage said that might be important, will you?”
*
The first thing that struck Jo when she went back was the silence. Oh, there were noises of course, and the staff still went about their business, speaking to the patients and to each other – when necessary. It was the loudness of all those other noises that emphasised the silence of the people who worked there.
Sister Jackie had changed from a cheerful woman in her early forties to a careworn one in her late forties. She smoked more, usually in silence, and Jo knew better than to ask questions. Then she suddenly opened up of her own accord –
“I still can’t believe it, Jo – oh, I know it happened all right, but I can’t believe what the police are saying, that he was having an affair with Helen, that he killed her, for any reason … “
“But isn’t that what they say about all killers?” Jo asked temptingly, “The people who’ve known them, I mean?”
“You met him, Jo - do
you
believe it?”
“I didn’t know him as well as you, don’t forget.”
“But an affair with Helen? Killing her like that?”
“Well, it’s difficult to imagine, I must admit … “
Which seemed to be the opinion of everyone else there.
But within a day or two, they had other things to worry about. The hospital, which had been running at near full stretch for a month, suddenly couldn’t cope any more. Patients had to be turned away or referred to the main hospital and the staff became overworked, rather than just busy all the time, as they had been. They rushed around, impatient with the patients and each other, and the voice level rose again, although not its cheerfulness.
There was talk of bringing in agency staff and it occurred to Jo that quite apart from her work for Marcus, they really needed her there.
*
Fraser went home.
He was still slightly in shock, he supposed. He worked in a desultory way on the problem of the capsules, but without any result.
As Marcus had suggested, he also wrote down the things he could remember hearing Helen and Philip saying. This forced him to think about Helen, remember her ways, her mannerisms, the enigma of what she was. He felt an overwhelming sadness, and also guilt – had he somehow precipitated her death?
*
Marcus discovered that Philip and Edwina had worked together in Birmingham before they’d gone to Wansborough, while Helen was working in Reading. Tom went to both places, but learned nothing of interest about any of them, other than that they’d all left at about the same time, apparently head–hunted.
Singh had worked in St James’ for five years before moving to the new hospital. He’d been tainted by the stigma attached to the place, but other than that, there was nothing untoward in his past.
Before that, Philip and Helen (but not Edwina) had worked together in the Care of the Elderly department at St Margaret’s hospital in Southampton.
Tom went down there and asked questions. Again, they’d both resigned suddenly, and together – but this time, Tom’s antennae did pick up the miasma of something not quite right.
Most of the staff from the time had moved on. Tom tried pushing those who were left, but could feel them physically closing up. He traced two who’d moved, but with the same result.
In his experience, shellfish syndrome of this severity usually meant either hanky panky of the grossest nature, or something criminal.
He contacted his old police boss in London and asked if he knew of anyone he could speak to in Southampton. He was given the name of DCI Ron Shawhurst, recently retired. He phoned and arranged to see him.
Ron Shawhurst was a cheerful, open-faced man who lived with his wife in a neat bungalow in the village of Hythe, on Southampton Water. He asked Tom in, sat him down and made him coffee, but when Tom told him why he was there, his face clouded over.
“No offence,” he said, “But I’ll just check with Andy Fox if you don’t mind.”
He went out and shut the door. Tom didn’t mind at all; he’d been expecting something of the kind.
He was back in five minutes.
“Sorry about that,” he said, “But this one was a bit sensitive.” He sat down again and his eyes turned inwards. “And I’ve got personal reasons for remembering it … “
A young doctor had come to see him and told him she thought that patients in the Care of the Elderly department where she was an SHO were being deliberately killed.
“I was impressed by her,” Shawhurst said, “Both by her manner and what she had to say.”
And
maybe
by
even
more
than
that
, Tom thought, looking at him …
“She was very level headed, didn’t strike me at all the type who’d imagine something like this.”
“Did she say who she thought was doing it?”
“She did, and it clearly gave her no pleasure. It was Philip Armitage and Helen St John.”
“Did she say how they were doing it?”
“Overdoses of diamorphine ... ”
She’d admitted straight away that it was difficult to distinguish between a high dose to alleviate great pain, and a high dose to kill, but she’d become uneasy about the frequency with which Armitage was prescribing such doses.
“She told me quite frankly that she’d very much admired Armitage when she’d started, but had become convinced that he was, in fact, practising euthanasia.”
What kind of patients, Tom asked?
“Oh, all those who were gaga, but also anyone with any kind of terminal disease.”
They’d set up a team and investigated the whole department very thoroughly, but had not been able to come up with enough to satisfy the CPS.
“What did
you
think?” Tom asked.
“That they were as guilty as hell.”
“Why? Gut instinct? Not that I’ve anything against gut instinct,” he added hastily. “Truth be told, it’s half the reason I’m here.”
Shawhurst took a deep breath. “Yes, it was that,” he said. “And more than that.”
Tom waited.
“As I told you just now, the young doctor impressed me, and I simply wasn’t convinced by either Armitage or St John when I questioned them. But there was something else … during my investigations, I discovered that they both belonged to EXIT, the euthanasia group.“
“But EXIT’s a perfectly respectable organisation, isn’t it?“
Indeed it was, Shawhurst agreed, but when he’d questioned some of its members, he’d uncovered the existence of a shadowy offshoot of EXIT called RELEASE, which held views of a rather different nature.
“Which were?”
“In a nutshell, that people who are in any kind of vegetative condition, or who have terminal disease, should be
mercifully
released
, as they put it. Without option. Armitage and St John’s were both members.”
“But this wasn’t enough to convince the CPS?”
Shawhurst shook his head. “They said it was all too circumstantial.” After a moment, he continued slowly, “I told you I had reason to remember the case … “ He swallowed, “…I was officially bollocked for allowing myself to be unduly influenced by Emma, the young doctor, also for being overzealous, but she was sacked.”
“Sacked?”
“Yep. She had to emigrate to get another job. And we wonder why people are so reluctant to blow the whistle.” He sighed. “Armitage and St John were both asked to resign, but no stigma was attached to them. I was told very firmly to keep my mouth shut and it was all hushed up.” He nodded grimly. “Yeah, you could say I’ve got reason to remember that case.”
*
Marcus, meanwhile, was making a discovery of his own. He’d gone to see one of the department’s statisticians to check Fraser’s later figures from Glasgow and Bristol, the ones relating to pneumonia as a proportion of the causes of death. He’d realised they were crucial, because they showed that, once the rate had been corrected, Wansborough’s higher death was entirely due to pneumonia.
Mike Fisher, the statistician, soon confirmed this as well, although using data from a great many more hospitals.
Marcus had stood up to go when Mike stopped him. “How many beds did you say that Wansborough had?”
“Forty five – why?”
“D’you happen to know the size of population it serves?”
“Not offhand, no.”
They looked it up ...
Tom looked round at the others. “So can we agree now that Philip Armitage was involved in the euthanasia?”
Marcus and Fraser both nodded.
“Jo?”
“Oh, I suppose so … “
It was Friday and they were in Tom’s room at the hotel.
She went on: “You asked me to find out what people were saying at the hospital – well, all I’ve heard is complete disbelief that Philip Armitage could kill
anyone
. Especially stabbing Helen, I have to add - they just can’t believe it, or in any affair between them.”
“There’s a difference between giving an elderly person pneumonia and stabbing a young person to death,” said Marcus.
“They’re both murder, Marcus.”
“So they are, but from the murderer’s point of view, the former’s a lot easier.”
“Oh, all right,” she said. “I accept he was involved - what Tom’s found does seem to clinch it.”
“Then let’s move on to why they’re dead,” Tom said. “Are we agreed that the lovers’ tiff is out?”
“The more I think about it, the less I believe it,” said Fraser.
“Then why are the police so keen on it?” said Jo.
“Because they didn’t know them,” said Tom, “Because Singh and Edwina agree with it and because it’s the easiest solution for everyone.”
“But why are
they
so keen on it – Singh and Edwina, I mean? Especially Singh … ”
“Because it was less bad than the alternative”, he explained. “No one wanted to believe in the euthanasia.”
She nodded slowly, then: “Could he have realised – Armitage, I mean – that Helen was about to confess to Fraser? Is that why he killed her, to shut her up?”
“Why kill himself afterwards?”
“Remorse?”
“It just isn’t in his character, Jo. They were both members of EXIT and RELEASE, they were committed to the cause, idealists. If they’d been caught, they’d have used their trial as a platform for their beliefs, not tried to murder their way out of it.“
Fraser said, “I think that’s right - in their own twisted way they were both … well, honourable.”
Marcus nodded his agreement.
Jo said slowly, “But if Armitage didn’t do it, who did?”
“Whoever it was,” said Tom, “They didn’t do it for reasons of idealism. And I strongly suspect they employed a hit man, it’s got a professional look about it.”
“But
who
? Edwina, or Singh, to hide what was going on?”
Tom shook his head. “We’ve more or less ruled them both out of the euthanasia, so it wouldn’t be that.”
“What about Singh out of sexual jealousy?” suggested Fraser.
“He’d have been more likely to kill you,” Jo put in.
“I can just about see him killing Helen in a fit of passion,” said Tom, “But not Armitage as well.”
“Unless he was setting him up as fall guy … “
“That would be
very
quick thinking in a crime of passion.” He shook his head. “I don’t believe it.”
“Then who was it?”
“Who gains?” mused Tom, “Who would gain from people dying in a hospital?”
“Only an idealist, or a nutter,” said Fraser.
Jo said with an edge of desperation: “It’s got to be one of the people we’ve already thought of … ”
“Any ideas, Marcus?” Tom had turned to his boss with the polite smile of one who doesn’t think so for a moment.
“I may have, actually,” Marcus replied with the satisfied smile of one about to confound his underling. “For an area of its population, Wansborough should have a community hospital with at least 70 beds. As we know, it only has 45. Isn’t the question we should be asking ourselves:
How
have
they
managed
for
so
long
with
so
few
beds
?”
Tom and Fraser stared back at him.
Jo said, “Well, I can tell you how they’re managing now, and that’s bloody awfully …” She described the mess they were in. “It was busy enough when I first arrived, but it’s gone mad this last week.”
“It was getting worse before I left,” Fraser said. “And yet it was fine when I first got there … “
Tom, who’d recovered a little, said, “Well, it would be, wouldn’t it? They were still bumping the patients off.”
Jo, looking at him, said, “But that implies it was actually designed for killing people … “
“Who did design it?” Tom asked.
“Armitage,” said Fraser. “They brought him in especially.”
“They? Who?”
“The Trust.“
Marcus came in again: “That wasn’t all I found,” he said. “After that little nugget, I decided to do some more digging. It seems that the Trust wanted to build on the present spot, which was going spare on the Royal Infirmary site, but couldn’t because it wasn’t big enough for a 70 bed hospital. They were about to buy a plot adjacent to the RI, but then they couldn’t do that either, because of their mounting debts.“
Fraser got to his feet and started pacing around, “St James and the Euro … “
“Sounds like a parable,” said Marcus.
“You did tell me about that, didn’t you?” said Tom, “Remind me … “
So Fraser described again the saga of the St James’ scandal, the committee of four and the disasters of the Grade II listing of St James and the Euro conversion.
“So they were in the deepest of deep shit,” said Tom when he’d finished, “But then along comes that nice Dr Armitage and shows them how to build a smaller hospital on the existing site.” His brain moved up a notch “…The interesting question now is:
Was
it
deliberate
on
the
part
of
the
Trust
?
Did
it
happen
that
way
because
they
wanted
it
to
?”
Jo said, “You’re suggesting they deliberately employed Armitage knowing what he would do?”
“Can you think of a better idea?”
She turned to Fraser: “Remember those papers of his you gave me to mug up on before the interview? How do we know that the Trust didn’t see them as well and employed Armitage in all good faith because of his efficiency?”
“No,” said Fraser. He’d gone over to the window and now turned so that he was silhouetted against the light. “Do
you
remember when I was hauled off to that meeting with him – Armitage, I mean? You know, when Helen nearly caught you in my flat?”
She nodded.
“Well, he said something very strange to me when we walking back – I told you about this as well…” he said to Tom.
“Remind me.”
So Fraser related how Philip had warned him about the dangers of being corrupted and manipulated.
Tom leaned forward. “Can you remember his exact words, Fraser? It’s important …”
Fraser frowned. “It was something like:
All
doctors
are
corrupted
to
an
extent
by
economics
– “
“He definitely used the word
economics
?”
“Yes. Then he said:
The
thing
is
not
to
allow
yourself
to
be
corrupted
beyond
that
extent
,
to
be
on
your
guard
against
being
manipulated
–
by
government
,
or
anyone
…”
“Did you take that to mean he was being manipulated by someone?”
“You’re putting words in his mouth,” said Jo.
“It’s all right,” said Fraser. “I didn’t at the time, but I do now.”
“So who?” said Tom. “Who was doing the manipulating?”
Fraser thought about it. “Well, the only thing I can think of is the committee, the gang of four set up to deal with the St James’ scandal …”
“How did you find out about all that?” Jo demanded.
“Mostly from Helen, it was she who told me how they’d head-hunted Philip to redesign and run the new hospital.”
“Redesign?” said Tom, “She actually said that?”
He nodded.
“But is it enough to go on?” said Jo. “I’ve no trouble believing in a couple of nutters killing off patients, but
this
I find very, very hard to believe …”
“I have to say that I don’t,” said Marcus.
She turned to him. “But would it be worth it financially? How much did the euthanasia plot actually save?”
“I did work that out,” he said. “Costs in a community hospital are around £150 per patient per day. If we assume that Wansborough, by having 45 beds instead of 70 is saving 25 patients a day, that comes to a million and a half a year.”
Jo was visibly shaken by this, but ploughed on: “How much were they in debt?”
“The figure I heard was twenty million.”
“That’s what I heard,” said Fraser.
“But if they were in so much trouble,” she said, “They’d have needed an immediate saving, wouldn’t they? Not have to wait for year on year savings.”
“Yeah, I wondered about that,” said Tom, “But Marcus gave us the answer just now. I’ll have to work out the exact figures, but building a 45 bed hospital on a piece of land you’ve already got is a hell of a lot cheaper than building a 70 bed hospital on land you have to buy. Certainly milllions.”
There was a silence, then Jo said, “And you think that’s what this is all about, for the Trust to get themselves out of the shit?”
“Can you think of anything else that fits all the facts?”
“Not offhand, no,” she said in a small voice. “But it’s a hell of a leap, isn’t it?”
Fraser looked at Tom. “D’you think it’s all four of them, a conspiracy?”
“It’s possible, although I doubt it. In my experience, it’s unlikely to find four such criminally minded people thrust together by chance. I’d guess it was just one of them, manipulating the others.”
“It’s the way the upper echelons of administration work,” said Marcus. “There’s a problem, someone suggests a solution and everyone else agrees without looking too closely at the implications.” He shrugged. “If it works, don’t knock it.”
“And if it doesn’t?” said Fraser.
“Nothing to do with me, guv.”
Jo said to Marcus, “Is this what you’ve been thinking all along?”
He shook his head. “Not until last night, when I found out about the shortfall in beds.”
“But since then?”
“I suppose so.” He paused. “You see, I’ve been wondering for a while whether something like this was inevitable sooner or later.”
Silence, while they waited for him to go on.
“I was at a seminar a few months ago and we were presented with figures showing that the average person has more money spent on them medically in the last year of their life than in all the rest of it put together.” He looked round at them. “I’ve been wondering ever since how long it would be before someone came up with the bright idea of cutting that year out and saving some money.”
*
They had a sober lunch.
Afterwards, Fraser said to Tom, “If it
is
just one of them, couldn’t you find out which by questioning them? Find out whose idea it was to employ Armitage in the first place?”
Tom nodded. “Well, I’m going to try, but I don’t mind betting it’ll all be so tangled up by now that we won’t be able to pin it on just one of them.”
“Who d’you think it is?”
He shrugged. “You tell me, you’ve met them. What do you think are the respective strengths of their motives?”
“I suppose Fitzpatrick wants to keep his job, Matlock her political career … otherwise, no idea.”
“Well, it’s in the nature of Chief Executives to want to go on to better things and, as for Woodvine, I daresay he’s in line for some pretty bauble or other for his chairmanship of the Trust – his
successful
chairmanship, that is.”
Jo said, “I’m still finding it hard to believe that any of it’s a strong enough motive for this … ”
“Then you obviously haven’t met many ambitious politicians,” said Marcus dryly. “I sometimes think they’d do
anything
for another yard up the greasy pole.”
“Whichever, I don’t see how we’re going to prove it.”