Quite Ugly One Morning by Christopher Brookmyre Page B

For God’s sake, what kind of doctor had any knowledge of real decision-making?
    But now they would be forced to see, now they would be forced to sit up and take notice, because the Midlothian NHSTrust – ‘We’ve got a heart in the Heart’ © – was about to go into the black.
    When he had first arrived, the situation had seemed so horrifying and desperate that he thought for a moment he had been stitched up, and was almost about to ring the bank and find out whether his Party contribution cheque had bounced for some reason. To secure Trust status, as was very much the norm, the hospitals’ books had been cooked so complicatedly that Delia Smith would have been proud of the recipe. Debts and liabilities had been hidden, or their impact deferred, just waiting to loudly declare themselves throughout his first year in charge.
    However, a closer look at the figures revealed to him the massive potential for improvement, as well as for the private endeavours he had envisaged.
    The first important action was to declare the Trust’s true financial position, as it wasn’t as though Trust status would be withdrawn by the health ministry once the truth was known, and it meant that any savings he managed to make would be more visible.
    There had to be radical change. Right away he purchased a small fleet of company Mercedes, to attract the right calibre of management staff to undertake the stiff measures needed to turn the place around. There was the inevitable whining about why such perks weren’t required to attract the right calibre of doctors, but it was such a juvenile comparison. You had to think of the responsibility that would be in the hands of these people, for a start. If you wanted people who could handle that responsibility, you had to show them that they would be valued as much as if they worked in industry or in the City. And what the moaners didn’t appreciate was the commitment and loyalty that such perks engendered in staff, things impossible to put a price on.
    The Trust covered the massive, city-centre Royal Victoria Infirmary and a small geriatric hospital, the George Romanes. The administration department was based at the RVI, and was a run-down, shambling basement, totally unsuitable for its intended purpose.
    On a first tour of the sprawling, gothic monstrosity that was the RVI, Stephen Lime was most taken by the light and city-wide view afforded by the massive windows in the East wing, and within a month had moved the administrationdepartment there, closing two wards and moving the others to where admin had previously been. However, it couldn’t just be a matter of moving all that tawdry old Seventies office furniture up the stairs. Top-quality administrators had to feel they were working in a top-quality department. Massive refurbishment had to be undertaken immediately, and when it came to something as important to the hospital as that, no expense could be spared. New carpeting, proper wall-coverings, pot plants, a marble floor for the atrium lobby, new PCs, new desks, new chairs, new filing system, the works. Because when you really came right down to it, people’s lives were depending on the work done in there.
    Of course, savings desperately had to be made, and his successes in that field followed recovery from a major early setback. He had looked at the pay and conditions of all domestic and auxiliary staff, and the cumulative cost of their employment. Ideally, if he had a blank slate, he would have put their whole field out to tender, bringing in private firms who could do the job for half the current outlay, with some of the spend quietly trickling back to him from the chosen contractors as a mark of appreciation. However, the reality was that he was saddled with this unwanted, overpaid workforce. Then the idea hit him, so simple he really hadn’t been able to see it for looking at it. When the hospital became a Trust, these people’s employer effectively folded, which in other