Cat had made a risotto and gooseberry fool. There had been a bottle of New Zealand Sauvignon and then Kieron had left them together while he went into the den to watch a crucial football match. He and Luke had got on well in the end, though Cat had noticed with an amusement she kept to herself that Kieron had begun the evening by being his most formal self and had eyed Luke’s suit and richly coloured Missoni tie with some suspicion. But once he had satisfied himself that Luke had no interest in his wife whatsoever except in the way of good longstanding friends, nor she him, they had discovered plenty of things in common, not including football, and Cat had sat back and listened to them.
But Luke had come to talk business to her. She had invited him home because she wanted him to meet Kieron outside the less relaxed atmosphere of the hotel or a restaurant. And home was the best place to talk about work and the future. She made coffee and Luke opened his iPad on which were a draft website, brochure, financial forecasts and legal disclaimers and conditions. He handed it to Cat and then leaned over, picked up Wookie from his seat on the end of the sofa, and put him on his lap.
‘Careful – he bit Kieron the other day.’
‘This isn’t a vicious dog, this is a little pussy cat.’
‘And you’re a stranger to him. Kieron’s one of the family.’
But she saw that Wookie had settled down, curled into a ball and gone back to sleep. Luke was stroking him.
‘We provide high-quality, personal general practice delivered to your home in a caring, professional and discreet manner.
We choose to care for significantly fewer patients than traditional general practitioners, enabling us to spend that extra time understanding you and your medical needs. As a practice member, you will have unlimited access to the advice, support and reassurance of your own private doctors 24 hours a day, every day of the year.
We provide all that you would expect from your GP, delivered in a convenient and timely way. Whatever your health needs may be, we’re here to help.
We’re a completely independent service covering Lafferton and its surrounding areas. We’ve restored the traditional ‘doctor’s house call’ to the forefront of personal family medicine, rekindling that often lost relationship between doctor and patient. You and your family will always be cared for promptly and professionally by experienced local doctors whom you know and trust.
Our practice has been developed to focus completely on the health and well-being of our members. Enjoy a completely new approach and discover how medicine can be delivered in a caring, convenient and responsive way.’
Cat looked up.
‘How much do people pay?’
‘I want to keep this as reasonable as possible … we’ll save a lot by not having a bricks-and-mortar practice. We employ someone to do the office work, but there won’t be an office … we travel everywhere, see everyone in their own home. No surgery overheads.’
‘How much?’
‘Individual membership around £100 a month, couples £150, family £175 no matter how many so long as they are related and live in the same house.’
‘Do they remain registered with an NHS GP?’
‘We would recommend it, because of emergency hospital admissions and so on. Once you’ve left the system it’s not always easy to get back in.’
‘How big an area would we be covering?’
‘Depends. There would be three of us initially and we’d divide it quite simply according to where we start from. You’d consult by Skype, email and phone as well – not everything needs a visit but we’d go if the patient preferred it – a lot of older people probably would.’
‘And those with new babies.’
‘And some would want to see a female doctor. We’d try to oblige but it won’t always be possible.’
‘Emergencies?’
‘If we’re called at 2 a.m. because someone on the other side of the area has chest pains or fallen downstairs, obviously they should call an ambulance and we’d tell them that. No private A&E, as you know.’
‘What about palliative care?’
‘To be discussed. That’s where your input will be crucial.’
‘Luke … I haven’t said I’ll do it.’
‘Yet.’
‘I’ve thought about it and talked to Kieron – not that he’s remotely clued up about anything to do with medicine, other than being a hypochondriac. But it would impact on our time together.’
‘My guess is that you’d have more of that.’
‘Possibly. But I’m only a part-time GP at the moment so I’m here evenings, weekends – that would change.’
‘It won’t be going back to the old days of being on call, Cat – we didn’t do email and phone consultations, and if patients demanded a home visit at 2 a.m. for a hangnail, we were legally obliged to go.’
‘My patients weren’t often so unreasonable. But there are other things …’
She set down the iPad and was quiet for a while. Luke continued to stroke Wookie, who was snoring softly.
She knew that the idea was a good one and knew that it would be perfect for her. She had always liked home visits. They gave her time to get a full picture of the patient, to listen to them, to assess things more calmly. She would like being free of a packed surgery with ten minutes per appointment and panic if one person had to take twenty. She was happy driving, she agreed that many consultations could safely be made over the phone, on Skype or by email when there was also the backup of a visit if it then seemed necessary. Having fewer patients on the list meant giving them more time and attention, and she would be free of the admin that was the bane of every GP’s life.
‘But …’ Luke said.
‘Chris would have divorced me for even thinking about it. He would say it was totally unfair and unjust that people who could pay would get access to better medicine, that money shouldn’t talk …’
Luke went on stroking Wookie. He said nothing. He simply waited.
Cat had not cried for her first husband, father of their three children, for a long time but now it was impossible to stop the tears. She had a vivid picture of him, curled up on their bed, her arms round him, dying of an inoperable brain tumour, too young, with too much still to give and enjoy, too much love and life.
Luke put his hand over hers. ‘Don’t worry. There’s no hurry, you need to think it through. And I understand – I knew him too, remember. Chris was a fine doctor and he had principles he never wavered from … The thing is, Cat – this isn’t a question of things for the rich that the poor can’t get. A friend of mine runs a private practice like this – they were the first. And yes, they have some well-heeled patients, but they also have people who use some of their pension money, or their savings, because they want consistent reliable care. General practice is in crisis for all sorts of reasons, we know that, and especially as people get older they want peace of mind about their health. More ordinary people can afford this than you might think. £1,200 a year … think of that in terms of a holiday. I’m not doing this to get rich – I’ll be happy if I can eventually earn what I’ve earned in the NHS. I guess you would be too.’
Cat blew her nose and got up to make more coffee. At the sink, she splashed cold water onto her face. She would go on thinking Luke’s plan through. There were the details, the small print. There was Kieron’s input. All of that.
But she knew. She already knew what her answer would be.
When she returned to the sofa, the old cat Mephisto had come in and was pressed against Luke, purring, and Wookie was still firmly settled on his lap. Kieron put in a brief appearance to get a beer at half-time and ask if anyone else wanted one. And as he did so, Cat had a strange and quite unexpected sense of finally letting Chris go, and, with him, so much that she had been clinging to for so long – and that it was with his blessing.