The Third Way Holby City

We can't let him die in the back of this van.

There's been a complication with Michael Spence's patient.

The truth is my decision killed your father. Simple as that.

I told the truth.

-Was that part of the plan?

-We let a patient down.

You're a genius at making life difficult for yourself.

-Shut up.

-Honestly, it's what I love about...you.

They're prescribed to me as part of my medication.

They help with my anxiety.

You were happy to take my little pick-me-ups when they were on offer.

I wonder if you could get her two Camoxidan?

Failing that I'm sure aspirin would be just as effective.

-How many are you taking?

-One every now and then.

It's Luc Hemingway. Luc!

You're making a fool of yourself.

Because you're so God damn boring. Don't touch me!

Don't...Luc!

"I would like to make an announcement...

"To make an announcement... announcement.

"On behalf of myself and the Trust...Trust...me...

"Trust...Trust...Trust...me!"

Genius. Do you think he's seen it?

"Trust...Trust...Trust...moon.

-"Moon moon moon."

-I'd say so.

"I'd like to moon...moon...moon... moon moon moon."

-Do we know who uploaded this?

-Phil Dawson in paediatrics.

Tell him I congratulate him on his creativity.

Appendectomy list, please.

Thank you.

For its worth, I think that's the right attitude.

You know, I admire what you did.

Thank you.

Thank you for your feedback.

Does the man not wear shoes?

He's rattled.

Ah, has your firefighter arrived yet?

As ever, news travels fast. Perhaps you'd care to join us?

Why not? I am quite good at this sort of thing.

Well, when they arrive you can tell them we're on top of it,

thank them for their offer of help and take them out for lunch.

It's a tad more serious than that.

-I don't think it is.

-Right.

You've obviously not seen the Wyvern Post's website.

All those years I've paid National Insurance.

Now they say I have to pay for a scan

and have the op in Bolton.

I've got cancer, how am I supposed to get to Bolton?

-Well, it's pure fiction, isn't it?

-I've dug up his file.

-Oesophageal carcinoma.

-Hence the referral to Haysworth.

So, what do we do?

We don't rise to provocation.

KNOCKING

Come in.

Hello there. Sinead Bainbridge.

You must be Henrik Hanssen.

-Yes, indeed I am.

-Great to meet you at last.

They never stop banging on about you at the Department of Health.

-Sinead Bainbridge. I'm from Comms?

-Yes, we know why you're here.

Great. Well, then let's start with the number one issue.

Who brings us a cup of tea?

Morning.

Looking for these?

Good news, boys and girls.

Potentially exciting day ahead.

The transplant centre have a heart that is a match for one of our patients.

A young woman with myocarditis who is now in heart failure.

She's a recent referral, Aisha Bose, 22.

She's only been on the list seven days.

Wow. Lucky girl.

-Best part of our job being able to offer someone a second chance...

-PHONE BEEPS

..when all other avenues have been closed.

Right, she's on her way in now.

I'll need you both on board to do the usual tests

to check that she is still a suitable candidate.

Speed is of the essence.

Aah...

Luc...where are we?

-What?

-I said, where are we?

Oh, we're in the grounds of a stately home my friend owns,

he lets me park up whenever I fancy it.

Why are we here?

Well, you've developed an addiction to Camoxidan,

which you won't admit to. So we're going to stay here until you tell me

exactly how many you've been taking. I'll decide on an average amount,

and we'll gradually cut it down, sort this out.

Yeah, right.

Oh.

SHE COUGHS

'It's got to do with money, hasn't it?

'Always got to do with saving money,

'except when it's the case of lining their own pockets.'

It's not great. But it's not a disaster.

Well, what do you suggest we do?

-What would you like to do?

-Rebut it lie by lie.

He is most certainly not being forced to pay for a scan.

No, I don't think we should do that. It's an outsourced facility, right?

Yes. The NHS sub-contracts private companies,

but the patients themselves do not pay.

That is a fallacy cooked up by radicals to demonise...

Yes, I know how it works.

And if I had a pound for every time I had to explain it.

Mr Hanssen?

My view is that this is a politically-motivated

attempt to manipulate an old man. I think we should ignore it.

A few weeks ago I would've agreed with you.

But the horse has bolted on this one, I think.

Good TV. Bad PR. But good TV.

You kicked the monster.

Now you have to feed him.

Well, what would be the quickest way to shut it down?

Get him lynched by a bunch of angry Bolton folk.

Joke.

Remember to keep a sense of humour.

Could we not just keep it simple and give him the operation?

The trust aren't commissioned to do those procedures.

Could that be bypassable

if there was someone here who could perform it?

Not really, no. Though of course, Mr Hanssen could do it in his sleep.

But, he's not my patient and I know nothing about the case.

My mantra is always go for the simplest option.

Of course, I can't force you into anything.

Just here to advise.

Can I help you?

I'm here for the heart.

Aisha, I'm Dr Lo. I'll be working on your case

and this is Dr Valentine.

Nice...shoes.

Right, perhaps you should go get Professor Hope?

-He wanted to get things moving.

-Yeah.

Thanks.

This way.

Exciting day, right?

It's amazing how they've managed to find you a heart so quickly.

It usually takes about four months,

but sometimes it can be even longer.

This is us.

I hate hospitals.

I know it's hard not to be anxious

but Professor Hope is a fantastic surgeon.

He'll be examining you shortly, but in the meantime

-if you have any questions..?

-Got any plasters?

Er...I can find you some.

-Are your relatives on the way?

-It's just me.

Is there anyone we can call for you?

-I know it's all happened very quickly.

-No. It's fine.

Right...well...I need you to get changed into this gown,

and Professor Hope shouldn't be too long.

OK, thanks.

Mr Hope's in theatre. It's fine, there's just been a slight delay

with the donor heart. How is she?

Well, she's about to have major transplant surgery

but no-one's coming to see her and she doesn't even have any questions.

They are nice shoes, though.

Realistically, you would do just as good a job of it, if not better.

So if we're judging what's best for Mr Tilly...

Sorry, are you going to sack me for being the bearer of bad news?

Don't tell me, there's hilarious footage circulating of me

correcting Luke Skywalker on his parentage.

SHE LAUGHS

Not quite. Erm...there's a Mr Tilly here to see you.

And he's got a journalist with him.

Well, refer Mr Tilly back to his GP

and send the hack to the press office.

No, get bed two ready, please, Nurse Carter.

Mr Tilly, I'm Henrik Hanssen, director of surgery. Excuse me.

Now, what are your primary concerns, please?

I don't want to go to Bolton. I can't afford it.

I want the postcode lottery.

No, no I don't. I don't want the postcode lottery.

Not this willy-nilly willy-nillying all over the shop.

-I don't quite follow you, I'm afraid.

-He wants to be treated locally.

-Are you a relative?

-I'm here to advocate for him.

Advocate? Oh, well, before you start doing that

-would you excuse us while I do a quick physical?

-Shout if you need me, OK?

Will do. Got my beady eye on him.

Right, may I help you just hop on to the bed, please, Mr Tilly.

Thank you, Nurse Carter.

Well, it's important you have someone fighting your corner.

-Many people don't.

-Oh, he's been a life-saver.

Really? How did you meet?

Local elections last year. We knocked on doors together.

-Have you taken my phone?!

-Yeah.

-Have you lost your mind?

-I've taken your wallet as well.

-What?!

-I didn't know how else to keep you here.

-I thought you might react like this.

-You've kidnapped me!

-If you want to call it that.

-We're going to get in this van and you are going to take me home.

-No, no I'm not.

-Fine, I'll walk.

Walk where, Eddi? You have no idea where you are.

Take some deep breaths.

Calm down.

You really think you can get away with this, don't you?

We need to talk.

Talk?

Fine, OK. I'll talk to you.

Good.

I've got something I really want to say anyway.

I need you to listen to me really carefully.

Of course.

HE CRIES OUT IN PAIN

SHE STARTS THE ENGINE

Get out of the way!

Get out of the way, Luc!

Just give me the keys.

-Give me my stuff.

-Not going to happen.

Eddi!

So they're known activists, are they? That makes it easier.

I'm not sure failing to win a council seat makes them activists.

How many elderly patients are now terrified that we'll take their life savings?

There is a concerted effort going on to misrepresent any change.

Anyone trying to improve the system

is branded a profiteering capitalist pig! It makes me sick.

Sorry. It just makes my blood boil.

It's fine.

Doctors are supposed to be passionate, aren't they Mr Hanssen?

SHE LAUGHS

I'm sorry, no offence, but these local hacks are such numpties.

Tilly's got form. Drunk and disorderly.

Got in a fight with a...

With a woman at an armistice service. Nice.

That's not a suggestion that we sling mud, is it?

Yes. We put out an advert saying Tilly's a drunken wife-beater

who peed on the war-memorial. How could that possibly fail?

No. We simply state what we believe, that he's vulnerable

and being manipulated by the media, correct?

Now you're seeing how it's done. Not rocket science, is it?

Aisha, I really need you to get changed into this gown.

OK.

Oh! I'm sorry!

It's OK, I'll clear it up.

-Aisha! Are you OK?

-Yeah. How'd you find me?

I checked your phone app. I thought you were in an accident.

-Why didn't you call me?

-Just a quick blood test...all done now.

-Let's go.

-But this is a cardio ward.

What's wrong? What's wrong? Talk to me. Aisha! Aisha!

Help! Somebody please!

Eddi! Eddi!

Just give me the keys.

Don't make me come and get them, Eddi.

Go ahead.

You wouldn't.

You have.

You're using Mr Tilly.

Trashing my motives won't work. I'll just come after you.

Right, would you excuse use, please?

May I have a word with you about this over here.

That is not why I'm telling you. I'm merely trying to explain

-why Mr Tilly should be sent.

-So I can regurgitate your arguments?

No, so you can understand my arguments.

-No, it won't work.

-Why, because you've already made your mind up?

It is simply centralisation. Rather than a lot of district hospitals

offering the same treatment to a minimum standard,

larger hub centres offer focus, specialisation and excellence.

The clinicians there become the best in their field, and here at Holby...

How does he get to Bolton? Mr Tilly?

Well, there's reimbursement for transport.

Yeah, when you take your receipts to the office in Bolton.

-He could take...

-A pay day loan on his pension?

No, as I say, there's reimbursement

but also there's a limited number of patient transport cars.

-Limited being the word.

-Perhaps a friend might offer him a lift.

Someone with a car who takes a day off work?

There are also community groups which...

-Have had their funding cut.

-If you would stop interrupting me...

-Hey, I'm just giving you the bigger picture.

-Granted, the system is not without its flaws.

But there is a very limited amount of money

and it keeps getting spent on other little things, like police and education.

-You're shifting the cost to him?

-I don't accept that.

Why? Cos you've already made up your mind?

Good.

What happened?

You had a seizure triggered by an electrolyte imbalance.

Does that rule out the transplant?

No. Fortunately we can easily restore the balance

with an intravenous electrolyte replacement.

Your blood results show you're free from infection,

so all we need to do is repeat a few of the tests

from your initial assessment just to confirm that nothing has changed,

and then it's all systems go. Good.

Right, she'll need an ECG.

Er...keep an eye on the central pressures and cardiac output.

I'll see you later.

Oh!

Sorry...

Don't worry. Nil by mouth.

Where's Toby?

Erm...he's in the relative's room.

I can talk to him, explain what's happening.

No. Don't tell him anything.

You weren't expecting that, were you?

You're so predictable, Luc.

I mean, even to the small little things,

like where you keep your keys.

You've really got to change that up, you know.

But I guess that would be very, very hard for you because you're just so anal.

-Ow!

-SHE LAUGHS

Sorry, sorry. No, no please carry on.

This is just too good.

Whatever it takes to put a smile on your face.

Anything's better than that permanent scowl

you've been wearing the past few weeks.

Oh, I'm hurt. I am hurt by that.

SHE BECOMES BREATHLESS

Eddi?

I'm not usually in a suit.

But it's my graduation.

Aisha was supposed to come with me. Never turned up.

It's not glandular fever, is it?

I can't tell you anything, I'm afraid.

Why not? Why doesn't she want me to know?

I really can't say.

Is Toby still here?

As far as I know.

You must think I'm mad.

-He's very worried about you.

-That's just it. I don't want him to be.

I want everything to stay normal for once.

What are you doing with your degree?

I'm applying for aid work. It's voluntary to start with.

You know, to build contacts and big-up my CV.

Aisha's supposed to come with me. I thought it would be an adventure.

I wouldn't make any assumptions.

-That's hard when no one's telling me what's going on!

-I understand.

If it was you...you're telling me you'd just go,

"OK, yeah that's fine. Whatever."

I was diagnosed with leukaemia when I was 13.

In remission now.

But it's the chemo that damaged my heart.

-I see.

-As soon as people found out that I had cancer...

they gave me that look, you know?

They didn't see Aisha anymore. Just some sick girl with no hair.

I never want to see that look again.

What you looking at? Have you never seen a hungover person before?

A hangover? Is that what you call this?

Oh, give it a rest, Luc...

You've been unravelling at work, stealing prescription drugs.

Nearly killing patients by giving them the wrong meds.

Getting so drunk in front of your colleagues

that you look completely unhinged. What do you call that?

Just letting your hair down?

Are you seriously telling me you don't have a problem?

Right, prove it.

What?!

Stay here, let it play out.

If it's just a hangover you'll be fine, won't you? Prove it.

I don't have anything to prove to you...you of all people.

Stay away from me, Luc.

I'll try and hunt that down for you. All right, thanks.

He's demanding to see her. What do you want me to do?

-Chain him to a radiator?

-She made it perfectly clear.

This is crazy. He's going out of his mind.

He thinks she's got glandular fever, for heaven's sake.

Yeah, well, how she deals with it is her business.

She needs his support. Her parents are in India.

-She's about to have major surgery.

-You have no idea what it's like for her.

But she's lying, Tara, to someone she's supposed to care about.

-Yeah, well, people lie all the time.

-That makes it OK, does it?

You know nothing about her!

Sometimes there are good reasons for not telling the truth.

We don't all live in your perfect little world.

I can't see your most recent CT scan in here.

That's my point.

But you were referred last week

for another CT scan at the Bedminster Road clinic.

-I couldn't get an appointment.

-Did your GP not book it for you?

She did, but I had to rearrange it and you've got to use the internet for that.

-Can you not use the internet?

-Of course I can!

They just shut the library where I use the blinking internet.

-Could you ask your advocate?

-I shouldn't have to beg for favours.

I was paying taxes when the pair of you were disco dancing!

-You should be looking after me!

-Excuse me.

Well, someone's cutting their nose off to spite their face.

So you seem to be caving in rather spectacularly?

These indicate his case could do with review.

I'm going to treat him here.

I'm just forewarning you out of courtesy.

Owen's been outlining how his piece has been syndicated

and is now trending in the West Wyvern area.

You do a good line in pretending not to be worried.

-It's not going away.

-I wouldn't wish to undermine you

in a Wyvern-wide context, but I'm afraid your story is now out of date

and inaccurate. Mr Tilly will be taken to theatre here this afternoon.

Er...that's great news.

I'm pleased you're pleased.

Tanya, I've got Lucy tracing down some cyclizine for me

-for the dreaded Mrs Roberts, can you grab her from Keller?

-Yeah.

-Her notes, thank you.

-Just had a message from one of the big aid agencies.

They want to meet me.

Well, that's great. Why don't you grab a coffee

-and give them a call back.

-And what am I supposed to say?

That we jump out on the first plane out to Dhaka?

This is Aisha's future too... and where is she?

Tob...

-Look, just...

-You're a decent bloke...

-Wait!

-And you're only doing your job.

-Toby, please.

-But she's not thinking straight.

-Stop!

Toby! Just stay out of it, man.

I'm sorry, I couldn't stop him.

This is insane! Just talk to me.

-Do you want me to get security?

-No. Tell him the truth.

But not here, please.

So I'm checking to see if the tumour's attached itself

to the diaphragm, if it has we go from there.

And we made an exception because...?

This option seemed more appropriate

So because he's poor, he can't access excellence?

That's completely unfair, isn't it? Devil's advocate, got to do it.

If I didn't think we could offer excellence, I wouldn't be operating.

Now he's losing blood, is the B/P dropping?

MACHINE BEEPS

-That's never a good sound.

-Packs, please. We have circulatory collapse.

The sound of that is a bleed which is within normal occurrence

in gastro-intestinal surgery. Will you ask Ms Naylor

to come and look this over for me, please?

More packs, please.

You get that it would be good if this went well, don't you?

I understand the subtleties of that, yes.

Aisha will be very weak after the operation,

but she could be discharged in as little as two weeks.

And if all's well, then

in six weeks she could be close to getting back to normal.

How normal?

Well, she'll have to take medication to prevent rejection.

And there will be frequent trips to the hospital.

But with some adjustments, and a lot of support

most people live very fulfilled and active lives.

Thanks.

I just wish she could've told me herself.

The Aisha you first met was a normal, healthy 22-year-old girl.

I think she's finding that very hard to let go of.

Suction again, please.

Is this the guy who was supposed to go to Bolton?

Yes, it is. Two 26 Robinson drains.

Overrated. You're from the department, aren't you?

Press. I don't have policy influence.

Well, take it from me. Those Bolton guys had it handed to them on a plate. Centre of excellence, my...

They need to get established.

I wouldn't send my mother there, and that's saying something.

MACHINE BEEPS

Good, thank you. Right, let's pack him and take a look in a couple of hours.

As I suspected, the tumour was attached to the diaphragm.

Did the CT not show it up?

The CT's not as current as it could be.

Excuse me, is there a setback with Mr Tilly?

Oh, no, not necessarily. We'll get new scans,

observe him for a couple of hours and then hopefully bring him back in to excise the tumour.

Sorry, I kind of need a yes or no.

The outcome is not clear cut.

That I understand. I just need to be kept in the loop.

Where are you heading...exactly?

Unless you've transported us to another planet this must lead somewhere.

Oh, yeah, it does lead somewhere.

In about five miles you're going to hit a road, quite a small road.

-Fine, I'll just keep walking then.

-You won't get very far, Eddi.

Your withdrawal's going to start kicking in,

-you must be feeling it already.

-Whatever.

Right, well, you go on, I'll head back to Holby

but I'll have to report you.

I don't think anyone will be surprised, in fact it'll explain a hell of a lot.

I'm sure they'll be supportive, give you a second chance.

But it'll be a very public humiliation.

Suspension, counselling, rehab.

Er...drugs tests every single week once you are back at work.

You up for that? Or you could, er...

You could give up nursing, I suppose.

-You'd really do that to me?

-In a heart-beat.

But listen, you say you're not addicted, so...

just stay here, prove that to me. That's all I ask.

Fine.

But when this is over...

don't ever speak to me again, OK?

How is he?

I don't give out patient prognoses without their consent.

-Look, I know you think I'm just...

-Using him?

No, it's quite normal for young men to befriend the elderly.

It's why we're such a strong and healthy society.

I just wanted to make a point. I'm not an idiot.

Then prove it. Engage with me in reasoned debate.

Right, consent forms for Aisha, and then we're all done.

Right, I'll do that now.

Bye.

Just the usual consent forms. If you could read and sign.

Where's Toby going?

It's his big day. His graduation.

-He can still make it if he hurries.

-It's a big day for you too.

I told him to go. He's worked so hard.

-There's nothing he can do here.

-But you'd still rather he stayed.

How was he? About everything...

Lovely. Said all the right things about supporting me,

it making no difference.

Almost believed him.

Competition forces people in my position to raise our game.

In the past, I was a god.

And if I deigned to get off the golf course to see you,

woe betide you should question my competence

or ask to see someone else. Now, if a patient doesn't like what we do,

they can go elsewhere and I am penalised.

Like all those people who switch energy supplier?

Forcing down prices, right?

It empowers people. If they choose not to wield that power, well...

Have you switched energy supplier?

I'm a bad example. I work long hours...

-So does everyone.

-The alternative is the status quo

under which I fix only five hernias because my hours are restricted

under the Working Time Directive.

And if you're not lucky enough to fall onto my list

then you can suffer until I'm ready. Would you prefer that?

Obviously not. I just don't buy that competition will empower anyone.

It didn't work on the railways.

That's not an equivalent example. Retail is a better analogy.

The effects of supermarkets forcing down prices and increasing...

Obesity, alcohol-related illness, heart disease, malnutrition.

OK, it's plausible if you're educated or have time on your hands.

But what about people who aren't in a position to make that decision?

The elderly, people with mental health issues, working families.

I admit there should be safeguards to protect the most vulnerable.

Doesn't being sick make anyone vulnerable?

That is precisely why the GP system

will hopefully lead to more continuity.

So you have no qualms about the changes?

I do, but broadly speaking, I think something should be done.

Did we set up an interview?

Just getting some background.

-PHONE RINGS

-Excuse me.

He was right. His piece has been taken up by the nationals.

I suggest you switch off your phone.

No, don't...don't touch me, Luc. OK?

I'm sorry.

For what I did, for... for leaving you.

OK? I'm...I'm sorry.

I...I...I could try to explain why. I think you probably...

I...I did push you away, Eddi.

You had this really annoying habit of getting under my skin.

You still do.

You really hurt me, Luc.

I know I did.

I know.

But...

I...I care about you and I'm trying to put things right.

It's too late.

I don't want you in my life any more, OK?

You think these pills are bad?

You are ten times more toxic.

SHE VOMITS

I'm not denying anything, I just will not comment on any of my patients.

And that is not obfuscation, quite the reverse.

So, if you would just let me...

Give it to me before you swear at him.

Hello, you're speaking to Sinead from the press office.

Is it true Mr Tilly's operation was brought forward to kill off the story?

I'm sorry, I can't comment on individual cases.

Thank you for calling.

Honestly, turn it off.

Or if you must, the line is, we needed further investigation so we brought him in.

Otherwise known as the truth?

I know. I'll get sacked from the coven.

I blagged a favour with radiology.

Thank you.

Are those Tilly's new CTs?

Bad news?

Tell me.

Now, I think you can remove that. Don't you?

You don't make it easy for me, do you?

I like to keep you on your toes.

If I do it I'll get due credit, right? Publicly?

Is it true? You put him through unnecessary surgery

without full access to his medical records?

Mr Hanssen, your meeting's about to start.

-Hi.

-Hi.

Are you OK? You look a bit...rough.

Thanks. I'm just tired.

I reckon you're still hungover. You know what you need?

Chips, a ton of salt...

And my secret weapon...a whopping pickled egg!

It's kill or cure.

Maybe later...

OK.

You know what's happening, don't you?

You know it's just going to get worse. The anxiety,

the panic attacks, the aches and pains,

your stomach's going to keep contracting,

pretty soon you'll probably become incontinent...

-Oh, shut up!

-And if you've been binging

it's going to get worse quicker.

Just take one, OK?

That's the way to deal with it, a supervised dose.

All you need to do is tell me exactly how many you've been taking.

Oh! You would like that, wouldn't you? Hmm?

Me breaking down...and you having to save me, right?

Well, I'm sorry to disappoint you, Luc...

but I...

but I don't need it.

Their line is we operated without reason

and without adequate information because a private sector partner

failed to deliver.

-Have you finished with this?

-Yes, thank you.

Him not attending the scan is hardly them failing to deliver.

That is a complete subversion of the truth.

So...we blame the patient for their own misfortune?

Didn't we discuss how that sort of line backfires?

How on-side is this Wyvern Post guy?

-What do you mean?

-Can he be bribed?

PHONE RINGS

Don't.

If I can swing him an interview with the minister,

do you reckon he can be persuaded we're the good guys?

I didn't realise that was up for debate.

OK, I hate to give you the reality check

but this is not good for you personally.

All of this stuff online is name-checking you.

-That doesn't concern me.

-It concerns us.

There is a lot of goodwill towards you in the department.

If you get flamed, it questions our confidence in you.

We need to dial this down.

SHE LAUGHS

Quelle surprise, Tilly's being trolled by angry Boltonians.

Do we really need a ministerial visit

to take the heat out of the situation?

It's risky. But you know what?

These guys aren't going to win this by pulling stunts.

I'm fed up with it.

MACHINE BEEPS

-Excuse me.

-What's happening?

OK, just bare with me.

Not to worry. He's just having a wee bleed, OK?

-Why hasn't he woken up?

-The anaesthetic needs to wear off.

-That's good. Just a bit of blood there.

-Where's the doctor?

He's on his way. Has he no family?

I don't know. Does this usually happen?

He's a very old fella who's just come through surgery.

I know it looks scary but we're on it, OK?

It's fine, just a bleed from the drain.

But blood's clotting normally and pulse is 85.

B/P 120 over 80. Urine output?

-Good.

-Oh, well done. He's stable. Keep him under observation, please.

Will do.

-What's really going on with him?

-There's nothing untoward going on with Mr Tilly's care.

But he's ten times worse than when he came in.

Now you can misrepresent this as much as you like but it will not wash.

Mr Tilly is ill. That is not a systemic failure on our part.

Of course it isn't, why would anyone take any responsibility?

Don't let them ambush you.

I will not let some campaigning journalist...

Can you just step back and let me deal with this?

You know, in some places PR is even regarded as a profession?

Yes, of course.

You're one of the true breed doctors, aren't you?

Problem is, not everyone in the world is as smart as you are.

Needs a dumbo like me to communicate with the people.

Yes, yes of course. And the minister will be most welcome.

I'll see if I can drag him in en route to Cardiff.

And we'll supply the sick people.

And who is Mary-Claire Carter? You need to sack her.

That's lovely, thank you very much. Oh, Dr Lo.

Just had the call from the transplant team.

Harvesting has begun, so the clock's ticking.

I'll er...I'll let you know the timeframe

for prepping Aisha for theatre.

In the meantime, it's going to be a very long day,

so I'm going to need something to build up my strength

for the fray. Any suggestions?

Oh...pasta? Complex carbohydrates are good for endurance.

Yes, good call. Canteen spag bol it is then.

Don't you forget to eat, Dr Lo. You're looking a little peaky.

-And I'd like those consent forms on my desk on my return.

-Sure.

Everything's going according to plan with the donor heart,

so I just need your consent form.

I'm not signing them.

It's a massive breach of patient confidentiality.

All I said is that he wasn't a scrounger!

You do know your contract forbids you from speaking in public?

He was being slagged off, I just thought that because I knew him

-I should tell the truth.

-Is it the truth that you hate your job?

-You posted that.

-What! I'm only joking.

Did you tell the journalist about the CT scans?

No! That wasn't me! Honest!

-Who was it then?

-If I knew I'd tell you, wouldn't I?

I don't hate my job...I don't!

If I did do you think I would even bother coming in here in the morning?

Please...I need this job.

Right, I think you've learnt your lesson. Go back to your work, please.

Too soft.

Mary-Claire is very popular.

Your call, but it's wimping out.

-I hate gossips!

-But as you say, we dial this down,

neutralise the local hack and we move on from this whole sorry mess.

Leave me alone, Luc.

I...I told you...

I...I don't need it.

Are you doing this to punish me?

I don't need you. I don't...

I don't need anyone. I don't want anyone...

Eddi, please, please don't do this. I know you hate me,

but it's just not worth it. If this is as serious as I think,

if you've been taking as many as I think you have,

then this could kill you.

-Would that really matter?

-Stop it.

It's not like anybody really cares.

I care.

Eddi, look at me...look at me.

Look at me.

I care.

OK?

Come on, give me your arm.

Come on.

Bribery. I wondered when that would come.

A flying visit from the minister.

I give you two questions or we drop the Wyvern Express

from our contacts list.

It's the Wyvern Post, and the editor doesn't respond to threats.

Really? It's the Sexton Media Group, isn't it?

-I do know the MD.

-Whatever.

Tilly's video is giving us an 80% increase in traffic.

You know why?

Angry northerners and people having a laugh.

No-one's taking this seriously.

Could I quote you on that?

I'm not going to just leave this.

Do you truly believe that there's been an organised conspiracy

to deny Mr Tilly proper care?

And that the nurses here are nothing more than ciphers in a system that puts profit before people?

It's not the low level staffers that are the problem.

-It's the policies.

-Then use this opportunity

to confront the policy makers.

Using reasoned argument.

I understand it must be hard to process.

You wake up one day, your phone rings,

and suddenly you're here about to have major surgery.

I was going to tell Toby in my own time. I had it all planned out.

-You were just trying to protect him.

-No. I was trying protect myself

from his reaction.

It's very common to feel scared or to have doubts,

but turning down this heart will have major implications for your future.

It's like a freight train hurtling towards me.

I just want it to stop.

Here are the details.

Launching Excellence as Standard. Does that actually mean anything?

How well is Mr Tilly?

He's doing good. He just needs to rest.

Probably just as well.

-No chance he'll cark it, is there?

-Erm...

Because it would be most unpolitic if we lost him.

-I hear someone is dropping by on their way back from Cardiff.

-Yes.

It's a show of solidarity really whilst we're under bombardment.

I'm sorry I've not been onside as much as I hoped.

You did rather evaporate once the calls came in.

I was asked to a board meeting.

Well, not a meeting exactly.

A couple of board members wanted a chat.

They've asked me to facilitate Mr Tilly's transfer to Bolton.

Well, that won't be necessary. Miss Naylor and I

will be performing a second procedure.

I think they're keen we don't treat him anymore.

Am I to be removed from my case?

Only to avoid any potential fallout should it not go well.

Mr Tilly is my patient. I want to see his care through.

What are you, a GP?

Joke.

Oh, come on. Remember what she said, we've got to keep our sense of perspective.

Everyone leaves, Luc. Everyone always leaves...

Sshh. Come on, it's OK.

No. It's really not OK.

I think...I think I had this coming, though.

What?

I left Liam.

When he needed me. I left him...

-It wasn't that simple.

-He never really went to school.

Cos she...she wasn't... she wasn't up.

She...she was either too drunk,

or she just wasn't there.

The first day I ever could I just ran away.

I left him.

And now everyone leaves me, don't they?

You left me, Max left me.

-I really thought Max cared about me.

-I won't leave you, Eddi.

Eddi. Never again.

Do you want me help you?

-Just one.

-Just one.

Just...just take the edge off a little bit.

Take the edge off? Is that all it is?

Oh, no, Luc, just please give them to me. It's just one, please...

You can one when you admit you have a problem...

Please give them to me, please give them to me! Luc!

Eddi.

EDDI CRIES

Dr Lo, I understand that Aisha told you earlier that she'd doubts

and has refused to sign the consent forms.

Why didn't you tell me immediately?

PHONE BEEPS

We have ten minutes and then the heart will have to be declined

and passed on to the secondary recipient.

Go and talk to her.

Aisha.

Hi. Look, I know you're scared

but turning down this operation will leave you with very few options.

I've been here before. Five years cancer treatment.

Yes, I know. And of course it'll be hard

-but we will support you through it.

-I'd be on steroids,

-have mood swings, get fat.

-That's not necessarily the case.

Then there'll be all the drugs I'd have to take for the rest of my life.

Endless hospital appointments.

I could go through all that and reject it anyway.

There's a 20 to 30% chance I'll be dead in five years.

Yes, and a 70 to 80% chance of survival.

I'm going to take the life I've got now and live it,

-so if you don't mind.

-Can't you see what you're being offered here?

-You can't turn it down!

-I can do what I like.

No, you can't. You've got to grab this opportunity with both hands.

-It might never come again.

-What the hell is it to you anyway?

This is my life, not yours!

-Can't you see how lucky you are?

-Lucky? That's a good one.

-Tara, stop.

-No, I don't care!

I've got to make her see how important this is!

This is not a game, Aisha! You have got to wake up before it's be too late!

-Dr Lo, that's enough now.

-Tara, come with me.

Trust me.

-Let go.

-I can't. I can't, Luc.

-Come on. What's the worst that can happen?

-I'm so scared.

Of course you are.

But it can't be any worse than this, can it?

It can't be any worse than this. That's it. That's it.

I've got you. I've got you, let go.

Do you want me to help you?

Yeah?

I need to hear you say it.

I need to hear you say it.

I need you to help me.

I need you to help me.

-I can't believe you just did that.

-I was just trying to help her.

It's called bullying, Tara!

-But she was making the wrong decision!

-It's her decision to make!

-Sorry.

-It's Aisha you should be apologising to.

I cannot understand why you get so involved in these cases.

Aisha has just formally declined the heart. I've just let them know.

So what happens now?

She'll have to come to terms with her decision.

-I've referred her for counselling.

-Well, she'll need it.

If you don't mind, Oliver, I'd like a word with Dr Lo.

Thank you.

Dr Lo, I have serious concerns about your suitability

to work on the highly specialised, highly pressured environment of Darwin.

As this isn't the first time you've behaved in a questionable manner

I have to discuss this matter with Mr Hanssen.

I just wanted to warn you.

Mr Hanssen!

I've been trying to phone you. Have you got a minute?

It's important.

Very well.

I have just had a rather unfortunate incident with Dr Lo.

She totally mishandled a transplant patient

by trying to influence her decision.

-I see.

-Recently her behaviour has been rather erratic.

One minute she's fine, she's focused,

and the next...

The next she's flying off the handle.

-But given the right support...

-Tara has had the same support as any other F1 on my team, if not more.

I'm afraid I think we have no other choice but to put a formal note

of our concerns on her record.

This is my fault.

Dr Lo tried to call me earlier.

I failed to return her call when she needed me.

Needed you. How?

This has to remain absolutely confidential.

There is something you should know.

A few months ago Dr Lo came to see me.

Dr Lo.

It's fine Professor Hope, I'm going.

Sit down. Please.

Mr Hanssen told me everything.

Tara, I am so sorry.

He had no right to do that.

Well, I'm glad he did, because now I understand

why you felt so passionately about Aisha's decision.

However, you are a doctor. There is a line

and you crossed it.

You should never, ever impose your own agenda on a patient.

I won't be able to overlook this again. Is that clear?

If you just come through here, Minister.

This is the patient I was telling you about. Owen Tilly.

Mr Tilly is local to Holby, lived here quite a number of years now.

Sadly he was diagnosed with cancer, specifically an oesophageal carcinoma...

Not getting in on the action? Worried you might look fat on TV?

Just why oh why in an age of glorious high definition colour

must all journalism be so black and white?

Oh, no, no. Wait a minute.

This isn't on at all. Excuse me.

I'm sorry, but Mr Tilly did not give permission to be filmed.

-Oh, he wants this.

-I refuse to let a vulnerable post-op patient

be exposed to this level of intrusion. Sorry.

He wants to fight for the NHS. See he actually cares about it.

-Oh, and I don't?

-Well, you're nodding through stuff you don't agree with, so.

No, no. That is simply not true!

Nothing I think is as bald as you say.

As a surgeon, of course I'm concerned that we may lose our ability

to follow a patient from admission to surgery to discharge.

Which could mean that the person best qualified to treat

that patient is not managing their care pathway.

Now that does worry me a lot and not just in terms of continuity.

-Do you understand?

-No. You want to blindly throw us all to the lions

-of market forces.

-No, that's not what I want at all.

Yet it's happening and you don't seem to care.

Of course I care!

I care that by introducing competition

into each and every stage of the process

we're potentially throwing costs and waiting times onto the patient.

I care that this could impact onto the wider community

in ways that cannot yet be measured.

And I care that I'm not yet certain that there are safeguards in place

which will protect those who are not strong enough

to fight for the best treatment!

Gentlemen, if you'd like to come though.

Minister, if you'd like to come through.

The Wyvern Post has a couple of questions,

then the minister will do your two-way. Thank you very much indeed.

Mr Hanssen if you'd like to come through too. Minister, thank you.

Maybe you should have a quick word with Aisha before you leave.

Yes, of course.

You can have confidence that this goes no further.

Thank you.

And if ever you feel, you know, you want someone to...

just come to me and we'll deal with it together.

It's completely out of order and you know it.

I will speak to your editor. If it weren't for the Minister being here

-you'd lose the questions.

-Tell her I say hi.

-Behave yourself.

-Minister, are you ready?

-Yes, of course.

-Thank you very much indeed.

Mr Maxwell, if you would like now here is your chance

for your two questions with the Minister.

As we agreed before we go to the official television interview.

Thank you very much, gentlemen.

Thank you. Actually my question is for Mr Hanssen.

-Guys, are you rolling?

-Er, no. I said no stunts.

-Owen, Owen.

-Mr Hanssen. Mr Hanssen,

you said you had qualms about the reforms.

I said that off the record, yes.

Would you like to share them?

No, I wouldn't. They are complex and cannot be reduced to sound bites.

But if you have concerns, you should address them

to the minister in question, shouldn't you?

Unless you've been asked not to.

Of course he hasn't.

Mr Hanssen is free to say what he wishes.

Mr Hanssen, do you disagree with the changes

the government are bringing in?

Well...

Yes or no?

Well...

Mr Hanssen?

Broadly speaking, on balance I would say...

..yes, in their current form, I disagree with them.

-Was it on camera?

-Oh, yeah.

And batting for the other side. I knew it.

-At least he's standing up for patients.

-He's standing up for the status quo,

and a demand-led system that will keep people like him

making all the decisions.

It's fundamentally about his own self interest!

Sounds good to me.

How did things pan out with Elliot?

I got a bit told off. But...still here...just.

Look...

I'm sorry if I was too hard on you earlier.

It's fine.

-How is she?

-Not good.

Go and make it right.

I'm sorry.

Want to borrow my shoes?

Looks like I'll be stuck here for a bit.

And your boyfriend seems to like them.

Thanks but I'd probably break my neck in them.

So, he is your boyfriend? Nice eyes.

Aisha, I let things get on top of me today.

I should never have put pressure on you like that.

I just couldn't do it. Coward through and through.

No, I don't think you are.

PHONE VIBRATES

Toby. Says he's thinking of me. Kiss, kiss.

But he's not here, is he? Just me and my crappy old heart.

That's probably how it's going to be from now.

If I was him I'd run a mile too.

Right, well.

We're going to have you out of here in no time.

I'm so sorry, Minister, that must have been very uncomfortable.

If I'd known, it wouldn't have happened. I do apologise.

That was a complete disaster.

Well, I hope I made my points with a degree of fairness.

Are you completely nuts?!

On something as polarised as the NHS

you will only be seen as some senior quack

who stole the limelight for a moment.

-I suppose so.

-You might've told me you had some concerns.

Well, sometimes these things take a while to crystallise, don't they?

I stuck my neck out for you. For what?

You want to appear on TV? Apply to Mastermind.

Well played. I'm sure our paths will meet again.

I hope so.

You can take another two in four hours.

Obviously it takes longer to come off them

than the time you were on them, but it's OK. You'll do it.

We'll do it.

Yeah.

'Mr Hanssen, you said you had qualms about the reforms.

'I said that off the record, yes.

'No I wouldn't. They're complex.

'They should not be reduced to sound bites.

'Mr Hanssen, do you disagree with the changes

'the government are bringing in?

'Yes, in their current form I disagree...'

I'm taking Mr Tilly in to finish his excision. Are you coming?

Didn't the board expressly forbid...?

They don't have that kind of power, this being a democracy

and not a police state.

OK, will it get me in trouble?

Not with me. Possibly with them.

I can find another cardiothoracic person.

-If they go in via the third intercostal...

-I understand.

For what it's worth, I agree with pretty much everything you said.

Would you stand up and say so in public?

Then it's worth nothing.

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