In Place of Fear: A gripping 2023 medical murder mystery crime thriller set in Edinburgh

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The novel is set in 1940s Edinburgh the day before Britain's new National Health Ser It is not generally appreciated that after only one full year’s experience of the Service I was able to put in an estimate which was firm and accurate. This was remarkable. It meant that in so short a space of time we were able to predict the pattern of behaviour of all the many millions of people who would be using the Service in a particular year. Whatever abuses there were, they were not on the increase. From that point on, any increased expenditure on the Service would come from its planned expansion and not from unpredictable use and abuse. We now knew the extent to which the people would use the existing facilities and what it would cost us. The ground was now firm under our feet. Such abuses as there were could be dealt with by progressive administrative pressure.

When I was engaged in formulating the main principles of the British Health Service, I had to give careful study to various proposals for financing it, and as this aspect of the scheme is a matter of anxious discussion in many other parts of the world, it may be useful if I set down the main considerations that guided my choice. In the first place, what was to be its financial relationship with national insurance; should the health service be on an insurance basis? I decided against this. It had always seemed to me that a personal contributory basis was peculiarly inappropriate to a national health service. There is, for example, the question of the qualifying period. That is to say, so many contributions for this benefit, and so many more for additional benefits, until enough contributions are eventually paid to qualify the contributor for the full range of benefits. In the case of health treatment this would give rise to endless anomalies, quite apart from the administrative jungle which would be created. This is already the case in countries where people insure privately for operations as distinct from hospital or vice versa. A solution might be found if the reorganization of local government is sufficiently fundamental to allow the administration of the hospitals to be entrusted to the revised units of local government. But no local finances should be levied, for this would once more give rise to frontier problems; and the essential unity of the Service would be destroyed. Most of us might experience feeling uneasy when looking down from a high bridge, for example, but someone with acrophobia might feel so uneasy that they can’t even go onto the bridge in the first place. Anxiety can last for a short time and then pass when whatever was causing you worry is over, but it can also last much longer and disrupt your life. Ongoing anxiety can affect your ability to eat, sleep, or concentrate. It can prevent you from enjoying life, travelling, or even leaving the house to go to work or school.

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For anyone who enjoys historical fiction or mysteries, Catriona McPherson's In Place of Fear is a delight of a read. (The introduction below is a bit lengthier than I sometimes provide, so I want explain that it focuses on the context of the novel. It doesn't contain spoilers. It doesn't sketch out the full plot of the novel.)

The whole agitation has a nasty taste. Instead of rejoicing at the opportunity to practice a civilized principle, Conservatives have tried to exploit the most disreputable emotions in this among many other attempts to discredit socialized medicine. No one knows the exact causes of acrophobia. Most people think that it stems from the natural concern all humans have about falling from height and being injured.The author describes his own experience of induction in to Parliament and how after he had composed a thoughtful and pointed maiden speech, and expecting a lively debate to ensue, he was merely rebuffed by an opponent who exclaimed how he was looking forward to many lively debates in the future based on the strength of that maiden speech. We are perhaps fortunate in the UK that we now have Parliament TV and so the art of debate can be followed from the comfort of our own homes. Doubtless other defects can be found and further improvements made. What emerges, however, in the final count, is the massive contribution the British Health Service makes to the equipment of a civilized society. It has now become a part of the texture of our national life. No political party would survive that tried to destroy it. The field in which the claims of individual commercialism come into most immediate conflict with reputable notions of social values is that of health. That is true both for curative and preventive medicine. The preventive health services of modern society fight the battle over a wider front and therefore less dramatically than is the case with personal medicine. Complex phobias, on the other hand, typically begin later and can continue for many years. Social phobias tend to start during puberty and agoraphobia (the fear of going out) usually begins in early adulthood. The National Health Service and the Welfare State have come to be used as interchangeable terms, and in the mouths of some people as terms of reproach. Why this is so it is not difficult to understand, if you view everything from the angle of a strictly individualistic competitive society. A free health service is pure Socialism and as such it is opposed to the hedonism of capitalist society. To call it something for nothing is absurd because everything has to be paid for in some way or another.

The defects in the Health Service that have been brought to light by practical experience lie in quite other directions. Although it is essential to retain parliamentary accountability for the Service, the appointment of members of the various administrative bodies should not involve the Minister of Health. No danger of nepotism arises, as no salaries are attached to the appointments, but election is a better principle than selection. No Minister can feel satisfied that he is making the right selection over so wide a field. The difficulty of applying the principle of election, rather than selection, arises from the fact that no electoral constituency corresponds with the functional requirements of the Service. This is particularly so in the case of hospital organization. Hospitals are grouped in such a way that most, if not all, the different medical specialties are to be found within a given area. A free Health Service is a triumphant example of the superiority of collective action and public initiative applied to a segment of society where commercial principles are seen at their worst. ‘The old system pays me better, so don’t interfere.’ Who would dare to put it so crudely? But it is as well to keep in mind that a public undertaking of this magnitude is big business. It touches trade and industry at a hundred sensitive points. A striking illustration of this was provided by our efforts to take proper care of the deaf. It had always seemed to me that this affliction had received too little attention. Deafness is a grievous handicap, worse some say even than blindness, though here we must speak with diffidence, because no one who has not suffered both can really judge. But this at least is agreed: deafness causes much personal suffering and industrial loss. The mechanical aids to deafness were often deficient, and always too expensive for all but a tiny section of those in need.

What makes you anxious?

In place of fear` would seem to be an allusion to the idea that the national health service takes away the anxiety which might exist in a society where access to healthcare depends on one`s ability to pay for it and as Aneurin Bevan was instrumental in the inception of the National Health Service in the UK, I was expecting to find more about this in the book. The title of the book may also be a suggestion that Socialism offers peace of mind in contrast to the more prevalent capitalist leanings of Western democracies. Much of the book is concerned with the authors views on areas such as unemployment and industrial production and because it was written in 1952, much of it will now be out of date. But some of it is still pertinent today such as the question of the ongoing tensions in global politics and the arms race.