James Ross looked surprised. He shifted uneasily in his seat. ‘Are you suggesting my department doesn’t pull its weight?’ he asked. His surprise was obviously shared by many at the table.
‘Far from it,’ replied Bannon, ‘Your unit is clearly a success story. Unfortunately, at the moment, it’s the only one.’
‘So why pick on us?’
‘Frankly, and not to put too fine a point on it, it’s more of a medical success than it is a financial one. Your overheads seem uncommonly high.’
‘We have to do our best for our patients,’ said Ross, taken aback. ‘Transplant surgery is an extremely expensive business in terms of both equipment and staff but our results are second to none.’
‘And this is reflected in the fees charged by the hospital,’ countered Bannon. ‘No one is disputing your expertise, Doctor. The excellence of your department is why you’ve been so successful in attracting custom. As I understand it, the survival rate shown by your patients is extremely good.’
‘Quite outstanding,’ interjected Giordano.
‘So what is it you want from me?’ asked Ross. ‘I can hardly cut staff.’
‘It’s not a case of cutting staff, Doctor. The money is coming in to your unit but investors don’t seem to be seeing the returns they should from it. We have pinpointed the problem as being your very high research-budget costs.’
Ross seemed to search for words before replying calmly, ‘My contract states that research funds at an agreed proportion of income will be made available to me. That’s why I agreed to come here in the first place.’
‘We understand that,’ said Bannon. ‘But if more public money is to be found to support the continuation of Medic Ecosse, this arrangement simply cannot continue.’
‘But my research programme is absolutely vital to me if we are to go on increasing our knowledge and improving patient care,’ Ross appealed.
‘I understand how you feel, Doctor, and it does you credit but this is not a research institute, it’s a commercial enterprise. It’s a private hospital and it’s a business. It treats sick people. It treats them and then charges them accordingly. It’s that simple. The universities and research councils provide funding for research. Medic International and its co-investor, Her Majesty’s Government, do not.’
‘But my contract-’
‘I think if you re-examine the exact wording of your contract, Doctor, you’ll see it states that the percentage of funding you refer to is only valid if other departments in the hospital are doing equally well.’
‘I don’t think I understand,’ said Ross, leaning forward slightly in apprehension. He looked to Giordano and Kinscherf for support.
‘Your agreement for research funding is that fifty per cent of net profits from your unit be returned to you to carry out your research programme,’ continued Bannon.
‘Exactly,’ said Ross.
‘But,’ said Bannon, holding up his index finger, ‘only if the receipts from the transplant unit amount to no more than twenty per cent of the total income of the hospital. As it is, income from your unit currently amounts to sixty per cent of profits.’
Ross slumped back in his seat and looked towards Giordano. Giordano was whispering to the Medic Ecosse accountant by his side but his expression told everyone the question. The nod he got in reply told everyone the answer.
‘But any adjustment in line with these figures would effectively bring my research to a halt,’ said Ross, obviously upset.
‘I’m sorry, Doctor,’ said Bannon. ‘But I repeat, this is a hospital not a university.’
‘In that case, gentlemen, I may have to consider my position very seriously,’ said Ross, gathering his papers together.
There was general discomfort at the way Ross was being singled out by Bannon. Everyone bar him seemed to realize that Ross was the hospital’s main asset. Without Ross and the transplant unit the hospital would be doomed to closure anyway, but the government side seemed determined to take a hard line.
Dunbar, as an outside observer, could only assume that the Scottish Office, riled by rumours of Medic International trying to put something over on them, had decided to take a tremendous gamble. He suspected that the ultimatum was really a bluff and they would back down if it looked as if Ross was going to resign. As Ross was head of the unit he was interested in, he was keen to see how things were going to turn out.
Bannon watched Ross prepare to leave the table before saying, ‘Doctor, I sincerely hope that you’ll find it possible to continue performing the marvellous feats of surgery you’ve been doing over the past few years.’
Ross acknowledged the words with the merest hint of a smile. He had obviously been totally unprepared for what had happened. He cleared his throat and asked, ‘Is there any room for compromise in the figures?’
‘I’m afraid not,’ replied Bannon.
Ross swallowed, then rose from the table, ‘If you’ll excuse me, gentlemen,’ he said. ‘There are things I have to do.’
Bannon said, ‘Believe me, Doctor, if there was some way we could continue funding you we would. I know how strongly you feel about your research and it does you credit. I urge you not to make any rash decisions. Things might be very different should this hospital start to give returns worthy of its potential.’
The Labour councillor, sitting opposite Dunbar, leaned across and whispered to him, ‘Bloody hypocrite. They don’t give a damn about research. Profit’s the only thing that lot understand.’
Dunbar smiled at the man’s volte-face in now defending Medic Ecosse, but he took his point. Ross did seem to be getting a raw deal. He could feel the tension round the table. People knew how high the stakes had gone. It was like watching a high-roller at the roulette wheel.
‘Would there be any other conditions?’ asked Giordano as Ross left the room. He said it tongue-in-cheek, clearly expecting a negative reply.
Bannon took the question at face value. ‘Yes,’ he replied. There would. We’d like to do something about the public perception of the hospital. There will be deep resentment at further public funding of a private institution, whatever the circumstances. If we were to reach agreement and the public were to inject yet more cash into a facility that for the most part they have no access to — even if it is just for long-term business reasons — I think Medic Ecosse might have to make some kind of popular altruistic gesture in return.’
‘Some kind of public relations exercise you mean?’ asked Giordano.
‘If you like. I thought perhaps you might consider offering free treatment to a reasonable number of Scots NHS patients who would benefit from your highly specialized equipment and professional expertise.’
Giordano had recovered his cool. He smiled and said, ‘Minister, I think that’s a splendid idea. We’ve taken a few patients in the past when approached, but I think I can safely say we would have no objection to taking a few more. It’s always good publicity for us.’
‘Good. I think our friend here should be pleased with that too,’ said Bannon, looking towards the Labour councillor.
The man shrugged and said, ‘If I had my way we’d be taking over the whole damn shebang and using it for the good of all the people.’
‘And running it on hot air, no doubt,’ said Bannon.
‘Anything else?’ asked Giordano.
‘One last thing,’ said Bannon. The room fell silent again. ‘We would like to have one of our people on-site, as it were. A sort of overseer of things in general.’
‘Another public relations exercise?’ asked Giordano quietly.
‘You could say that,’ agreed Bannon. ‘Our man would be here to monitor the prudent application of taxpayers’ money.’
‘An accountant?’
‘More than that. We would like him to have access to all aspects of the hospital’s administration, including files and records.’
‘Are you suggesting this man should have some kind of executive authority?’ asked Giordano.
‘No executive authority,’ said Bannon. ‘Just cooperation from you and the staff.’