Analyze the in Office Ancillary Services Exception to the Stark Act as Research Paper

Analyze the in Office Ancillary Services Exception to the Stark Act as it relates to block leases - Research Paper Example he medical practitioner is financially associated with the care services; and d) the medical practitioner implements referrals to a care provider for purposes of furnishing the DHS. Physicians and health practices depend on the in-office ancillary services and related medical practice exceptions to the Stark law to permit DHS referrals within the parameters of the practice. Of these, Washlick (2008) noted that the in-office ancillary services exception is most commonly applied because it enables physicians providing various services to: a) make referrals for select DHS within the confines of medical practice; b) inform those DHS to provide the necessary patient care; c) apply Medicare and Medicaid cover to defray the costs resulting from the services; and d) retain and channel the revenues collected from rendering the services within the practice for settling practice expenditure and physician remuneration. These exclusions are therefore of great value to the rendering of patient services and other internal activities. As Micklos and Sevell (2004) noted, the in-office ancillary services exception (IOASE) is arguably the most significant allowance given under the outlaw of self-referrals of select health services by medical practitioners. In the recent past, however, renewed attempts to revisit referral rules have threatened the effectiveness of physician practice. For instance, the federal budget for the 2014-2015 financial year contains a number of measures which are intended to enhance a greater level of proper remuneration for the proper rendering of health care under the Medicare platform. The budget is responsive to various recommendations by the Government Accountability Office (GAO) and MedPac that self-referral of simpler services culminates in a higher volume of care when they are integrated with payments for the service fees (Clark, Johnstone, Lynch, & Cardenas, 2004). The Budget seeks to limit the IOASE by permitting only practitioners who meet given

Pharmacists Role in Complementary Alternative Medicines

Pharmacists Role in Complementary Alternative Medicines Pharmacists Role in Complementary Alternative Medicines The first section of this paper will provide background information on the use of complementary and alternative medicines (CAMs) and their associated risks and benefits. Additionally, information on the pharmacists’ role in CAMs and services in their pharmacies will be discussed. Next, the theory that potential ethical conflicts arise for pharmacists between keeping the health and wellbeing of clients and the community as their primary concern versus the prospect of turning a profit will be considered. Before concluding, other important ethical issues including duty of care, and liability will be discussed. Background The term CAM refers to any healing practise that doesn’t fall under the heading of conventional medicine. It encompasses not just pharmaceutical preparations, but diet, and traditional forms of health care including acupuncture, Chinese medicine, homeopathy, etc.1 In the past, people who sold CAMs were sometimes referred to as quacks, or someone who promotes unsupported methods that lack scientifically credible rational.2 CAMs were regarded as old wives tails, and their claims dismissed by the medical community.3   More recently CAMs have become a prominent feature in today’s health care regimens. In 2000 according to the Therapeutic Goods Administration (TGA) 52 percent of Australians were using at least one non-prescribed complementary medicine.4 The Therapeutic Goods Act of 1989 effectively legitimised CAMs by allowing them to be entered into the Australian Register of Therapeutic Goods (ARTG) as a listed medicine. They have to meet a lesser set of standards than conventional medicines, which is one of the major concerns of allopathic practioners.5 With the passing of this act, pharmacies could legitimately sell two types of products; medicines for which there is scientific evidence   (prescription and over the counter products) and unproven medications (some CAMs) that may lack efficacy.   There are many risks associated with using CAMS including direct risks, substitutions made, nonprofessional advice received, and unreliable diagnostic tests.6 In some cases, CAMs have caused serious harm. The adverse effects range from infection due to dirty acupuncture needles, altering the effectiveness of other pharmacologically proven agents, to death from chiropractic manipulation. Substitutions pose a great risk for serious conditions. Replacing conventional treatments with CAMs can lead to many adverse effects. For example, treating melanoma with a herbal ointment rather than surgery, radiotherapy, or chemotherapy can have disastrous consequences. Some patients, especially those with life threatening illnesses, will try anything to improve their symptoms. Some CAM practitioners take advantage of this and recommend treatments that are very costly and at the expense of other proven treatments. Unproven tests include, but aren’t limited to, reflexology and electro-dermal t esting.6 The danger in this type of testing is the high likelihood of misdiagnosis.   Despite the large body of evidence in the scientific community of the poor efficacy of CAMs, there is some evidence for their use as seen in cranberry for urinary tract infections St. John’s Wart for depression and a variety of others.7 In 1993 Australians spent an estimated 1 billion dollars on CAMs and by 2000 that number had risen to 2.3 billion.8   Shockingly, only 57 percent of Australians reported or discussed the use of these products to their doctors.9 The potential dangers outlined above and these statistics show the need for a pharmacists intervention. Pharmacist’s Role Pharmacists are a vital part of the allopathic health care team, often being the first port of call for patients requesting CAMs.10   The community pharmacy is an ideal environment to deliver quality, cost effective, and professional services to the general public. Patient’s safety and access to this high quality care is of paramount importance.11 Pharmacists counsel life style choices, recommend an appropriate non-prescription medication, or refer patient’s to a physician to improve outcomes.12      When responding to enquiries about CAMs pharmacists need to consider a variety of issues. The customers’ cultural and social beliefs and desire to take control of their own treatment should be viewed non-judgementally. Pharmacists need to stay up to date, and be aware of evidence to support the use of different products. Information about CAMs should be provided on an evidence-based level so the most accurate information is delivered to the patient. Pharmacist s also need to be aware of potential interactions with conventional products, and report adverse drug reactions to both the Adverse Drug Reaction’s Committee and the product’s sponsor.7 Furthermore, pharmacists must remind patients that CAMs are medications and should be openly discussed so potential interactions and side effects can be identified. Ethics and profit In a 2005 study of 484 community pharmacists in New South Wales 77% of respondents personally used CAMs and said that they offered CAM products for sale in their pharmacies. A majority of the pharmacists believed CAMs enhanced customers’ image of the pharmacy and 87% reported they increased customer numbers and annual sales.13 From these results it is evident that a potential conflict between promoting and selling CAMs and ethics could arise. Pharmacists are intrinsically placed in an ethical dilemma daily. They have dual roles as health care providers and businesspeople. As health care professionals they are expected to provide a high level of unbiased health care, while their business side is expected to sell products and generate a profit. Professional and business roles are generally believed to be in conflict with each other and roles are traditionally viewed as being exclusive. According to Chappell et al community pharmacists are one of the few occupations where professional and business values co-exist.   They found no correlation between the value placed on business and the level of care or â€Å"professionalism† displayed by the pharmacists. This suggests pharmacists are able to act dually as a salesperson but still deliver professional information.14 The degree of professionalism has been called into question by Kennedy et al. They demonstrated that in some cases pharmacists, especially proprietors, sometimes recommend more expensive products when a cheaper generic version is available, but the overall outcome was satisfactory. All pharmacists recommended an appropriate treatment for the condition but the product selected differed among owners and employee pharmacists. Although the patient received a high level of care, the fact that he or she had a cheaper option calls the level of professionalism into question.  Ã‚  Ã‚   Further evidence for professionalism is seen in a study by Perepelkin et al. where they found pharmacists, regardless of their ownership structure, are professionally oriented in their practise. The difference in services provided was only seen in terms of professional autonomy, decision-making and amount of control. There was no difference in the amount of profit-driven goals between the groups.16 Similarly, in a recent study, Kronus found that pharmacists, regardless of their role orientations (business versus professional), were similarly motivated by service and income values. She suggested that the theoretical model suggesting that business is based on extrinsic values and professionalism is based on altruistic values should be revised when talking about pharmacy. She found altruism (professionalism) was the dominant factor in the field of pharmacy. Since most pharmacists are salaried employees there is little pressure to increase profit by pushing CAMs with no supporting evidence. It would be very easy to jump to the conclusion that the need to make a profit would in some way have a negative effect on pharmacy owners or employed pharmacists (reward systems) to act as independent ethical health care providers when CAMs are viewed as huge profit generators.17 Wingfield et al suggest that ‘ethics is so integrated and intrinsic to daily practise that there is no need to single ethical issues for special attention,’ as demonstrated by a lack of a journal dedicated to pharmacy ethics (there are ethical journals for medicine and nursing). Rather the ethical behaviour of the pharmacist is displayed in all aspects of daily practise culling the drive for profits.18 In Australia the behaviour of pharmacists is guided by the Pharmaceutical Society of Australia’s Code of Professional Conduct (PSACPC).7 Pharmacists sell CAMs in pharmacies that does give credibility to CAMs and to some extent promote their usage.   Also, pharmacists are in a unique position to influence the sale of certain products. For example, CAMs are used by 60 to 80% of oncology patients. According to the British Columbia Cancer Society the psychosocial needs of patients including ‘increased anxiety, need for information, maintenance of a sense of hope, a sense of control, negative experience with conventional medicine, and perceived holistic nature of complementary medicine,’ is the reason for the high percent of people using the medicine and not the availability of the product in pharmacies.19 Pharmacists don’t need to promote these products as psychosocial needs are very powerful and patients are clamouring for these medications in increasing numbers. Although the pharmacy is a business, business objectives wouldn’t necessarily suffer, as knowledgeable and honest patient counselli ng plays an important role in customer satisfaction and thus profitability. An unsatisfied customer would certainly seek another pharmacy.20 These satisfied customers will keep coming back to the pharmacy not just for CAMs but for prescription and personal products as well. This is a win-win situation for both the customer and the pharmacist who now has the opportunity to play an active role in the health of the patient as well as make a decent living. It is the pharmacist who provides the factual advice for patients who seek out these products. Through professionalism this temptation to take advantage of this behaviour is easily removed. Pharmacists develop close relationships with their customers by taking time to talk about medications. Professional orientation happens because patient counselling of all medications including CAMs is at the cornerstone of ethical pharmacy practice and high quality care. As previously stated, the pharmacist’s role in counselling in the use o f CAMs is the most effective in ensuring the health and safety of patients.   When counselling patients, pharmacists follow the PSACPC. By following the PSACPC pharmacists remain in the scope of their practice, are covered for malpractice liability for negligent care and for informed consent issues, and foremost, ensure the health and well-being of clients and the Australian community. Under the 9 key principles of PSACPC, counselling advice for CAM usage is about adhering to the principles of evidence based medicine and critically examining and honestly informing patients of unproven medications and therapies. Pharmacists must also respect the beliefs and judgements of patients and other health professionals while regarding the patient’s autonomy to make decisions regarding their own treatment but at the same time offering guidance and advice based on evidence-based information.21  Ã‚   Thus, when a pharmacist gives advice on the use of Cams based on PSACPC guidelines after considering clinical and patient factors there may be commercial benefits but they do not necessarily compromise the quality of the recommendations. In pharmacy, ethics and profit can and do exist without conflict in the sale of all products.   Duty of care regarding informed consent As outlined above a majority number of Australians are using and want to use CAMs. It is therefore the duty of pharmacists to discuss these treatments with their patients.22 A study in the US found almost three-quarters of the pharmacists surveyed worked in stores where herbal medicines were sold.23 Almost half of the pharmacists agreed with the statement, ‘herbal medicines are not accepted by the majority of my colleagues’ and only a quarter agreed with the statement ‘herbs are efficacious’.24 25 It can be seen that most pharmacists don’t believe in the products so recommending them is difficult. But, they have an ethical obligation to adhere to the PSACPC and respect the autonomy and dignity of the patient to make informed decisions.21 Once the pharmacist has disclosed and openly discussed the different treatment options his or her ethical obligation has been fulfilled. In the United States this is taken one step further.   It is a legal obligatio n for practioners to disclose information for CAMs if they are generally accepted within the medical community. Failure to do so can result in legal action.26 Liability in referring to CAMs Liability issues are new territory for pharmacists recommending CAMs to patients. Homeopathy, for example, is completely contradictory to the principles of modern pharmacology. The incompatibility of homeopathic paradigms with all of basic science must be taken into consideration.22   Keeping in line with the PSACPC, pharmacists cannot ethically recommend a product or service to which they know there is no evidence to support its use, and is not in the best interest in the health and well being of the patient or community. In Canada, The Pharmacy Code of Ethics requires pharmacists to never knowingly provide any products which are not good quality.27   In the United States medical practitioners can be held liable for referring patients to a CAM practitioner if they â€Å"should have known† the CAM practitioner might be â€Å"incompetent†. This shows that medical professionals are not just ethically but legally responsible for protecting patients from inferior medical treatments.28 CAM practitioners argue that their treatments are holistic and some of the therapeutic benefits are unmeasurable. Because western medicine supports evidence based on quantifiable outcomes the two doctrines of practise often clash. It is very difficult to compare the s piritual healing power of CAMs to the physical healing of western medicine.28 As long as the CAM treatment is not interfering with a patient’s level of care, there is no reason to discredit a potential treatment that may make a patient ‘feel’ better. An honest answer to the efficacy of a specific CAM and reporting that some people say it makes them feel better is the best course of action.     Further compounding the issue is the training level of the CAM providers. Most are not ‘health care professionals’ and have inadequate understating of biology, pharmacology, patho-physiology, and other sciences that govern western medicine. Since pharmacists cannot ethically refer a patient for a treatment that they believe may affect their health or wellbeing the ethical dilemma of whether to recommend this option is exacerbated. Although, a recent Canadian study reported only 2% of pharmacists felt they had adequate information about complementary and alternative health care, they are still better suited than CAMs to provide information on the prodcuts.10 A pharmacists guidance is based on principles 1 and 8 of the (PSACPC), advising patient of the scientific evidence available while still respecting their autonomy.28 Where CAM providers have no such code of ethics. Conclusion This paper examined the background issues associated with complementary and alternative medicines (CAMs) and the associated risks and benefits that go along with them. Additionally, the pharmacists’ role in providing CAMs was discussed. The many ethical issues, including profit, although seemingly complex can and should be negotiated using the PSACPC guidelines. The introduction and sale of CAMs have not changed the pharmacist’s code of ethics where the patient’s well-being and health remains the focus. As CAMs are becoming more popular and accepted by the public, pharmacists need to have a high level of understanding of the many issues associated with them. The ethical issues pharmacists face daily are apparently being handled appropriately according the literature cited, and based on the public’s perception of pharmacists being one of the most trusted health professionals.

Legal Prostitution :: essays research papers

Prostitution has long been considered as illegal. But is it necessary to do so? It is said that prostitution causes inconvenience and troubles to general public. However, the act that considers prostitution as illegal causes inconvenience and troubles to prostitutes either. Does general public has the right to live without prostitution nearby, which will prevent prostitutes from making money with their 'resources', or do prostitutes have the right to make money with their 'resources', which will prevent general public from living in 'an more enjoyable' environment? This is obviously a conflict of interest. The right should be granted to the side with more social benefits. For example, if legal prostitution brings the social, says, $100 and at the same time causes $50 harms to general public, the right should be granted to prostitutes. One may argue that it is very difficult to determine which side brings larger social benefits. But under some situations, we can easily determine it. If prostitutions are located in some low-population-density areas, the harms or inconvenience caused by prostitutions will be smaller. But some may argue that although the inconvenience is smaller, people still suffer. If satisfactory compensations for people who suffer are availble, people are willing to suffer. The right to prostitute, or the right to stop prostitution should be granted to general public (or people who are affected by prostitutions) or prostitutes by the time the compensation system operates. However, it is very difficult to delimitate such right. What should be considered as prostitutions? If a female who provides a male with sex service for returns is said to be a prostitute, then is a wife who provide sex service for her husband for his love said to be a prostitute? Is having sex before marriage called as a prostutition? We can see that it is very 'costly' to delimitate such right.

Comparison of two Egyptian Sculpture Relief Depicting

Comparison of two Egyptian Sculpture Relief Depicting a Man Inspecting His Stables; Ships Unloading Merchandise and Relief Block, Plucking and Roasting Fowl, Herds Crossing Water By shackles Comparison of two Egyptian Sculpture Relief Depicting a Man Inspecting His Stables; Ships Unloading Merchandise and Relief Block, Plucking and Roasting Fowl, Herds Crossing Water In Egyptian art, the greatest achievements are tomb relief, huge number of tomb relief shows the people who were rich enough at that period want to bring their rich and glory even after they dead.The Early royal relief are somewhat too idealism on the figures, heir figures on the tomb relief are usually rough on the surface. However, the technique of making tomb relief developed extremely quickly starting from the 3rd Dynasty; the techniques were already extremely advanced, and styles are increasing a lot. Using the finely detailed decoration in the tomb relief are the tradition way. This kind of technique that shows the figures standing out slightly above the Egyptian period continued through the 6th-Dynasty and into the Middle Kingdom, especially using for royal monuments. Visual-arts-cork. Com) There are many characteristics that diddle kingdom and new kingdom have are clearly crucial and a little different from each other, including the details of the techniques, color and style. The Tomb Relief from late dynasty 18 and Relief from a tomb at E-Light are the two tomb relief which have some commons and differences; both of them are tomb relief and both of them are about the farming figure, there are some figures about people working in different sections and also a lot of animals on that too. The Egyptian art's function was twofold.Firstly, the function shows the god's glory and making the passage after-life more comfortable. Then, the function Europeanizes the information and the value of the Egyptian art. The life in Egypt was generally stable such as the cultural and life; even the arts, inclu ding their architecture and sculptures, also painting, metalwork, goldsmith and ceramics. (visual-arts-cork. Com) Most of the art works in Egypt have the characteristic which is ‘highly conservative adherence to traditional rules' (Neil Collins, visual-arts-cork. Mom), it had a good affection on focus on the order rather than creativity and artistic expression. (visual-arts-cork. Com) During The Middle Kingdom, with its capital at Thebes (2000-1786 B. C. ), was a brand new age of experiment and invention which grew out of the turbulence of the First Intermediate Period (2134-c. 2000 B. C. ). (encyclopedia. Com) Most of the forms of the Old Kingdom were retained; However, the traditional unity style was changed. The development of formalism was mixed with a meticulous delicacy of craftsmanship. Precancerous. Com) There were more from the artists' inside thought, most of them were successful in tomb relief or sculpture, like the rock-cut tombs at Ban Has are outstanding for free dom of draftsmanship, and the sensitive portraits of Stories Ill ND Amendment Ill were all extremely famous and successful in doing the Egyptian arts. (Precancerous. Com) Also, their figures are more idealism on the torso but realism on their head and face, the animals were set as a line organized. (encyclopedia. Mom) The Relief from a tomb at EL-Light is from the middle kingdom, it has found reused as a door sill that in a door of a later house by the modern cemetery near the pyramid, possibly from the tomb of Ankhs. Inside the picture, ancient Egyptian outdoor life is preserved clearly. Two men sit in a tent and preparing for a meal that the tomb when will later enjoy. The man on the right plucks the feathers of a large goose, and the other one on the left roasts a duck on a spit over a low fire that he brings to glow with a fan. The other birds, a bag, and two rolled-up sheets of cloth were hanged up from a line above.Then, on the bottom of the picture, a number of cattle have Ju st emerged from swampy water, and some water spilled because the herd is on its way to higher ground. (Wall texts from Mutest) From this tomb relief, the function is a traditional Egyptian tomb relief that is showing the daily life even including the errors' lives. It reflects the life at that period, even a tiny thing like preparing for a meal. Zoom in to the lines and the expression of the three- dimensional from, the technique the sculptor used is fine and smooth. These two men' figures are not naturalism; the pose and the arrangement of the figure are neat and orderly.Especially those animals, the cattle are all the same. Additionally, one symbolist thing is the pose that the man holding the ducks neck. This tomb relief is realism on the face and idealism in the torso, also extremely well done in some specific details. The New Kingdom's art (1570-1342 B. C. ) can be seen as the final development of the traditional classic Egyptian style of the Middle Kingdom, there is a combinat ion of the drive inspiration of the Middle Kingdom and the monumental forms of the Old Kingdom. This period's painting are famous because boldness of controlled vitality and boldness.Their sculpture usually emphasis on bulk, solidity and impersonality. In some single scenes, or the works on the wall from ceiling to the floor, each figure had its place properly and was not allow to overflow its space. Then en of the most table achievements of Egyptian craft men was the technique when they put human figure in a space, it seems to be cramped or overcrowded, but the they still take control of the whole picture's balance. (visual-arts-cork. Com) Then, The Tomb Relief from late dynasty 18 is a perfect example of this period.The pictures of this relief use the cattle that being force-fed while the tomb owner followed by several retainers on the right of the picture. In the bottom of the picture, ships unload their produce that is first heaped on shore then carried away by porters. This rel ief block almost certainly came from a tomb at Memphis. With an infusion odd liberating energy and ideas from Marin, private relief work flourished in Memphis in the post-Marin period and at that period, the wealthy people more like to let the figure on the tomb relief more naturalism. Wall texts from Mutest) This way that shows the life of workers is a terrific way which be used to show the multiple stages in a developing sequence of actions, rather than the frames of a strip cartoon because it is clearer. During the Old Kingdom, the agricultural is one of the most popular themes for most of the tomb relief. (visual-arts-cork. Mom) Also, the wall paintings during that period which shows plunging, sowing harvesting and threshing the grain are all symbolist faithfully represented.It shows the herdsmen working in the pastures taking care of the cattle so prized by the ancient Egyptians even other views depict the trapping of the waterfowl especially in the Nile marshes and fishing in the river itself. (visual-arts-cork. Com) Because of these views from daily life let the sculptors were able to use their initiative and let themselves feel free and explore a little of theirs imagination and retreat. When they show the dead man and his family, it had to be more presented in regular poses as a description: larger than life, strictly proportioned, and always calm and somewhat aloof, (visual-arts-cork. Mom) However, The rural workers on the estate could be shown at their daily lives in a relaxed way, something with lives or energetic can be usually captured, and that always have an outstanding characterized which can symbolize the ancient Egyptians. (visual-arts-cork. Com) While the offering-bearers, symbolizing the funerary gifts from the estates to their rod, are depicted moving towards him in formal and stately procession, the peasants at work in the fields seem both sturdy and vigorous. (visual-arts-cork. Mom) Look inside the tomb relief techniques, it clearly sho ws the details and the meaning of the whole story, every people have their own characteristic and different poses. Further, the tomb relief from here is becoming more three-dimensional. Even when we see these two tomb relief and find out they look remarkably similar from each other, they are all about the daily life in Egyptian, they all shows the real unusual smoothly techniques that people in that period have the highly developed skill of making the tomb relief. Using tomb relief is the good way to reflect their owner's life and the dynasty they were in.The relief from a tomb at EL-Light shows the owner's power and their wealthy life; the second Tomb Relief is a little different from the first one, it show about the owner wants to be more kind, they were not like to show their glory anymore; they more want to have a kind of feeling of realism, but the way they show is mostly idealism from the torso and the heads. The most preference is the level of the three-dimensional of the tom b relief, the middle kingdom seems there is a start of doing this, then it is getting more three- dimensional until the New kingdom.

Part Five Chapter III

III To Gavin's disappointment, it seemed that he would have to attend Howard Mollison's birthday party after all. If Mary, a client of the firm and the widow of his best friend, had asked him to stay for dinner, he would have considered himself more than justified in skipping it †¦ but Mary had not asked him to stay. She had family visiting, and she had been oddly flustered when he had turned up. She doesn't want them to know, he thought, taking comfort in her self-consciousness as she ushered him towards the door. He drove back to the Smithy, replaying his conversation with Kay in his mind. I thought he was your best friend. He's only been dead a few weeks! Yeah, and I was looking after her for Barry, he retorted in his head, which is what he'd have wanted. Neither of us expected this to happen. Barry's dead. It can't hurt him now. Alone in the Smithy he looked out a clean suit for the party, because the invitation said ‘formal', and tried to imagine gossipy little Pagford relishing the story of Gavin and Mary. So what? he thought, staggered by his own bravery. Is she supposed to be alone for ever? It happens. I was looking after her. And in spite of his reluctance to attend a party that was sure to be dull and exhausting, he was buoyed inside by a little bubble of excitement and happiness. Up in Hilltop House, Andrew Price was styling his hair with his mother's blow-drier. He had never looked forward to a disco or a party as much as he had longed for tonight. He, Gaia and Sukhvinder were being paid by Howard to serve food and drinks at the party. Howard had hired him a uniform for the occasion: a white shirt, black trousers and a bow tie. He would be working alongside Gaia, not as potboy but as a waiter. But there was more to his anticipation than this. Gaia had split up with the legendary Marco de Luca. He had found her crying about it in the back yard of the Copper Kettle that afternoon, when he had gone outside for a smoke. ‘His loss,' Andrew had said, trying to keep the delight out of his voice. And she had sniffed and said, ‘Cheers, Andy.' ‘You little poofter,' said Simon, when Andrew finally turned off the drier. He had been waiting to say it for several minutes, standing on the dark landing, staring through the gap in the door, which was ajar, watching Andrew preen himself in the mirror. Andrew jumped, then laughed. His good humour discomposed Simon. ‘Look at you,' he jeered, as Andrew passed him on the landing in his shirt and bow tie. ‘With your dicky-bow. You look a twat.' And you're unemployed, and I did it to you, dickhead. Andrew's feelings about what he had done to his father changed almost hourly. Sometimes the guilt would bear down on him, tainting everything, but then it would melt away, leaving him glorying in his secret triumph. Tonight, the thought of it gave extra heat to the excitement burning beneath Andrew's thin white shirt, an additional tingle to the goose-flesh caused by the rush of evening air as he sped, on Simon's racing bike, down the hill into town. He was excited, full of hope. Gaia was available and vulnerable. Her father lived in Reading. Shirley Mollison was standing in a party dress outside the church hall when he cycled up, tying giant gold helium balloons in the shapes of fives and sixes to the railings. ‘Hello, Andrew,' she trilled. ‘Bike away from the entrance, please.' He wheeled it along to the corner, passing a brand-new, racing green BMW convertible parked feet away. He walked around the car on his way inside, taking in the luxurious inner fittings. ‘And here's Andy!' Andrew saw at once that his boss's good humour and excitement were equal to his own. Howard was striding down the hall, wearing an immense velvet dinner jacket; he resembled a conjuror. There were only five or six other people dotted around: the party would not start for twenty minutes. Blue, white and gold balloons had been fastened up everywhere. There was a massive trestle table largely covered in plates draped with tea-towels, and at the top of the hall a middle-aged DJ setting up his equipment. ‘Go help Maureen, Andy, will you?' She was laying out glasses at one end of the long table, caught gaudily in a stream of light from an overhead lamp. ‘Don't you look handsome!' she croaked as he approached. She was wearing a scant, stretchy shiny dress that revealed every contour of the bony body to which unexpected little rolls and pads of flesh still clung, exposed by the unforgiving fabric. From somewhere out of sight came a small ‘hi'; Gaia was crouching over a box of plates on the floor. ‘Glasses out of boxes, please, Andy,' said Maureen, ‘and set them up here, where we're having the bar.' He did as he was told. As he unpacked the box, a woman he had never seen before approached, carrying several bottles of champagne. ‘These should go in the fridge, if there is one.' She had Howard's straight nose, Howard's big blue eyes and Howard's curly fair hair, but whereas his features were womanish, softened by fat, his daughter – she had to be his daughter – was unpretty yet striking, with low brows, big eyes and a cleft chin. She was wearing trousers and an open-necked silk shirt. After dumping the bottles onto the table she turned away. Her demeanour, and something about the quality of her clothing, made Andrew sure that she was the owner of the BMW outside. ‘That's Patricia,' whispered Gaia in his ear, and his skin tingled again as though she carried an electric charge. ‘Howard's daughter.' ‘Yeah, I thought so,' he said, but he was much more interested to see that Gaia was unscrewing the cap of a bottle of vodka and pouring out a measure. As he watched, she drank it straight off with a little shudder. She had barely replaced the top when Maureen reappeared beside them with an ice bucket. ‘Bloody old slapper,' said Gaia, as Maureen walked away, and Andrew smelt the spirits on her breath. ‘Look at the state of her.' He laughed, turned and stopped abruptly, because Shirley was right beside them, smiling her pussycat smile. ‘Has Miss Jawanda not arrived yet?' she asked. ‘She's on her way, she just texted me,' said Gaia. But Shirley did not really care where Sukhvinder was. She had overheard Andrew and Gaia's little exchange about Maureen, and it had completely restored the good mood that had been dented by Maureen's evident delight in her own toilette. It was difficult to satisfactorily puncture self-esteem so obtuse, so deluded, but as Shirley walked away from the teenagers towards the DJ, she planned what she would say to Howard the next time she saw him alone. I'm afraid the young ones were, well, laughing at Maureen †¦ it's such a pity she wore that dress †¦ I hate seeing her make a fool of herself. There was plenty to be pleased about, Shirley reminded herself, for she needed a little bolstering tonight. She and Howard and Miles were all going to be on the council together; it would be marvellous, simply marvellous. She checked that the DJ knew that Howard's favourite song was ‘The Green, Green Grass of Home', Tom Jones' version, and looked around for more little jobs to do: but instead her gaze fell upon the reason that her happiness, tonight, had not quite that perfect quality she had anticipated. Patricia was standing alone, staring up at the Pagford coat of arms on the wall, and making no effort to talk to anybody. Shirley wished that Patricia would wear a skirt sometimes; but at least she had arrived alone. Shirley had been afraid that the BMW might contain another person, and that absence was something gained. You weren't supposed to dislike your own child; you were supposed to like them no matter what, even if they were not what you wanted, even if they turned out to be the kind of person that you would have crossed the street to avoid had you not been related. Howard took a large view of the whole matter; he even joked about it, in a mild way, beyond Patricia's hearing. Shirley could not rise to those heights of detachment. She felt compelled to join Patricia, in the vague, unconscious hope that she might dilute the strangeness she was afraid everyone else would smell by her own exemplary dress and behaviour. ‘Do you want a drink, darling?' ‘Not yet,' said Patricia, still staring up at the Pagford arms. ‘I had a heavy night last night. Probably still over the limit. We were out drinking with Melly's office pals.' Shirley smiled vaguely up at the crest above them. ‘Melly's fine, thanks for asking,' said Patricia. ‘Oh, good,' said Shirley. ‘I liked the invitation,' said Patricia. ‘Pat and guest.' ‘I'm sorry, darling, but that's just what you put, you know, when people aren't married – ‘ ‘Ah, that's what it says in Debrett's, does it? Well, Melly didn't want to come if she wasn't even named on the invitation, so we had a massive row, and here I am, alone. Result, eh?' Patricia stalked away towards the drinks, leaving Shirley a little shaken behind her. Patricia's rages had been frightening even as a child. ‘You're late, Miss Jawanda,' she called, recovering her composure as a flustered Sukhvinder came hurrying towards her. In Shirley's opinion, the girl was demonstrating a kind of insolence turning up at all, after what her mother had said to Howard, here, in this very hall. She watched her hurry to join Andrew and Gaia, and thought that she would tell Howard that they ought to let Sukhvinder go. She was tardy, and there was probably a hygiene issue with the eczema she was hiding under the long-sleeved black T-shirt; Shirley made a mental note to check whether it was contagious, on her favourite medical website. Guests began to arrive promptly at eight o'clock. Howard told Gaia to come and stand beside him and collect coats, because he wanted everyone to see him ordering her around by name, in that little black dress and frilly apron. But there were soon too many coats for her to carry alone, so he summoned Andrew to help. ‘Nick a bottle,' Gaia ordered Andrew, as they hung coats three and four deep in the tiny cloakroom, ‘and hide it in the kitchen. We can take it in turns to go and have some.' ‘OK,' said Andrew, elated. ‘Gavin!' cried Howard, as his son's partner came through the door alone at half-past eight. ‘Kay not with you, Gavin?' asked Shirley swiftly (Maureen was changing into sparkly stilettos behind the trestle table, so there was very little time to steal a march on her). ‘No, she couldn't make it, unfortunately,' said Gavin; then, to his horror, he came face to face with Gaia, who was waiting to take his coat. ‘Mum could have made it,' said Gaia, in a clear, carrying voice, as she glared at him. ‘But Gavin's dumped her, haven't you, Gav?' Howard clapped Gavin on the shoulder, pretending he had not heard, and boomed, ‘Great to see you, go get yourself a drink.' Shirley's expression remained impassive, but the thrill of the moment did not subside quickly, and she was a little dazed and dreamy, greeting the next few guests. When Maureen tottered over in her awful dress to join the greeting party, Shirley took immense pleasure in telling her quietly: ‘We've had a very awkward little scene. Very awkward. Gavin and Gaia's mother †¦ oh, dear †¦ if we'd known †¦' ‘What? What's happened?' But Shirley shook her head, savouring the exquisite pleasure of Maureen's frustrated curiosity, and opened her arms wide as Miles, Samantha and Lexie entered the hall. ‘Here he is! Parish Councillor Miles Mollison!' Samantha watched Shirley hugging Miles as though from a great distance. She had moved so abruptly from happiness and anticipation to shock and disappointment that her thoughts had become white noise, against which she had to fight to take in the exterior world. (Miles had said: ‘That's great! You can come to Dad's party, you were only just saying – ‘ ‘Yes,' she had replied, ‘I know. It is great, isn't it?' But when he had seen her dressed in the jeans and band T-shirt she had been visualizing herself in for over a week, he had been perplexed. ‘It's formal.' ‘Miles, it's the church hall in Pagford.' ‘I know, but the invitation – ‘ ‘I'm wearing this.') ‘Hello, Sammy,' said Howard. ‘Look at you. You needn't have dressed up.' But his embrace was as lascivious as ever, and he patted her tightly jeaned backside. Samantha gave Shirley a cold tight smile and walked past her towards the drinks. A nasty voice inside her head was asking: but what did you think was going to happen at the concert, anyway? What was the point? What were you after? Nothing. A bit of fun. The dream of strong young arms and laughter, which was to have had some kind of catharsis tonight; her own thin waist encircled again, and the sharp taste of the new, the unexplored; her fantasy had lost wings, it was plummeting back to earth †¦ I only wanted to look. ‘Looking good, Sammy.' ‘Cheers, Pat.' She had not met her sister-in-law for over a year. I like you more than anyone else in this family, Pat. Miles had caught up with her; he kissed his sister. ‘How are you? How's Mel? Isn't she here?' ‘No, she didn't want to come,' said Patricia. She was drinking champagne, but from her expression, it might have been vinegar. ‘The invitation said Pat and guest are invited †¦ huge bloody row. One up to Mum.' ‘Oh, Pat, come on,' said Miles, smiling. ‘Oh, Pat, fucking come on what, Miles?' A furious delight took hold of Samantha: a pretext to attack. ‘That's a bloody rude way to invite your sister's partner and you know it, Miles. Your mother could do with some lessons in manners, if you ask me.' He was fatter, surely, than he had been a year ago. She could see his neck bulging over the collar of his shirt. His breath went sour quickly. He had a little trick of bouncing on his toes that he had caught from his father. She experienced a surge of physical disgust and walked away to the end of the trestle table, where Andrew and Sukhvinder were busy filling and handing out glasses. ‘Have you got any gin?' Samantha asked. ‘Give me a big one.' She barely recognized Andrew. He poured her a measure, trying not to look at her breasts, boundlessly exposed in the T-shirt, but it was like trying not to squint in direct sunlight. ‘Do you know them?' Samantha asked, after downing half a glass of gin and tonic. A blush had risen before Andrew could marshal his thoughts. To his horror, she gave a reckless cackle, and said, ‘The band. I'm talking about the band.' ‘Yeah, I – yeah, I've heard of them. I don't †¦ not my kind of thing.' ‘Is that right?' she said, throwing back the rest of her drink. ‘I'll have another one of those, please.' She realized who he was: the mousy boy from the delicatessen. His uniform made him look older. Maybe a couple of weeks of lugging pallets up and down the cellar steps had built some muscle. ‘Oh, look,' said Samantha, spotting a figure heading away from her into the growing crowd, ‘there's Gavin. The second most boring man in Pagford. After my husband, obviously.' She strode off, pleased with herself, holding her new drink; the gin had hit her where she most needed it, anaesthetizing and stimulating at the same time, and as she walked she thought: he liked my tits; let's see what he thinks of my arse. Gavin saw Samantha coming and tried to deflect her by joining somebody else's conversation, anybody's; the nearest person was Howard and he insinuated himself hastily into the group around his host. ‘I took a risk,' Howard was saying to three other men; he was waving a cigar, and a little ash had dribbled down the front of his velvet jacket. ‘I took a risk and I put in the graft. Simple as that. No magic formula. Nobody handed me – oh, here's Sammy. Who are those young men, Samantha?' While four elderly men stared at the pop group stretched across her breasts, Samantha turned to Gavin. ‘Hi,' she said, leaning in and forcing him to kiss her. ‘Kay not here?' ‘No,' said Gavin shortly. ‘Talking about business, Sammy,' said Howard happily, and Samantha thought of her shop, failed and finished. ‘I was a self-starter,' he informed the group, reprising what was clearly an established theme. ‘That's all there is to it. That's all you need. I was a self-starter.' Massive and globular, he was like a miniature velvety sun, radiating satisfaction and contentment. His tones were already rounded and mellowed by the brandy in his hand. ‘I was ready to take a risk – could've lost everything.' ‘Well, your mum could have lost everything,' Samantha corrected him. ‘Didn't Hilda mortgage her house to put up half the deposit on the shop?' She saw the tiny flicker in Howard's eyes, but his smile remained constant. ‘All credit to my mother, then,' he said, ‘for working and scrimping and saving, and giving her son a start. I multiply what I was given, and I give back to the family – pay for your girls to go to St Anne's – what goes round, comes round, eh, Sammy?' She expected this from Shirley, but not from Howard. Both of them drained their glasses, and Samantha watched Gavin drift away without trying to stop him. Gavin was wondering whether it would be possible to slip out unnoticed. He was nervous, and the noise was making it worse. A horrible idea had taken possession of him since meeting Gaia at the door. What if Kay had told her daughter everything? What if the girl knew that he was in love with Mary Fairbrother, and told other people? It was the sort of thing that a vengeful sixteen-year-old might do. The very last thing he wanted was for Pagford to know that he was in love with Mary before he had a chance to tell her himself. He had imagined doing it months and months hence, perhaps a year down the line †¦ letting the first anniversary of Barry's death slip by †¦ and, in the mean time, nurturing the tiny shoots of trust and reliance that were already there, so that the reality of her feelings stole gradually upon her, as they had upon him †¦ ‘You haven't got a drink, Gav!' said Miles. ‘That situation must be remedied!' He led his partner firmly to the drinks table and poured him a beer, talking all the while, and, like Howard, giving off an almost visible glow of happiness and pride. ‘You heard I won the seat?' Gavin had not, but he did not feel equal to feigning surprise. ‘Yeah. Congratulations.' ‘How's Mary?' asked Miles expansively; he was a friend to the whole town tonight, because it had elected him. ‘She doing OK?' ‘Yeah, I think – ‘ ‘I heard she might be going to Liverpool. Might be for the best.' ‘What?' said Gavin sharply. ‘Maureen was saying this morning; apparently, Mary's sister's trying to persuade Mary to go home with the kids. She's still got a lot of family in Liver – ‘ ‘This is her home.' ‘I think it was Barry who liked Pagford. I'm not sure Mary will want to stay without him.' Gaia was watching Gavin through a chink in the kitchen door. She was clutching a paper cup containing several fingers of the vodka that Andrew had stolen for her. ‘He's such a bastard,' she said. ‘We'd still be in Hackney if he hadn't led Mum on. She's so bloody stupid. I could have told her he wasn't that interested. He never took her out. He couldn't wait to leave after they'd shagged.' Andrew, who was piling additional sandwiches on an almost empty platter behind her, could hardly believe that she was using words like shagged. The chimeric Gaia who filled his fantasies was a sexually inventive and adventurous virgin. He did not know what the real Gaia had done, or not done, with Marco de Luca. Her judgement on her mother made it sound as if she knew how men behaved after sex, if they were interested †¦ ‘Drink something,' she told Andrew as he approached the door with the platter, and she held up her own polystyrene cup to his lips, and he drank some of her vodka. Giggling a little, she backed away to let him out and called after him: ‘Make Sooks come in here and get some!' The hall was crowded and noisy. Andrew put the pile of fresh sandwiches on the table, but interest in the food seemed to have waned; Sukhvinder was struggling to keep up with demand at the drinks table, and many people had started pouring their own. ‘Gaia wants you in the kitchen,' Andrew told Sukhvinder, and he took over from her. There was no point acting like a bartender; instead, he filled as many glasses as he could find, and left them on the table for people to help themselves. ‘Hi, Peanut!' said Lexie Mollison. ‘Can I have some champagne?' They had been at St Thomas's together, but he had not seen her for a long time. Her accent had changed since she had been at St Anne's. He hated being called Peanut. ‘It's there in front of you,' he said, pointing. ‘Lexie, you're not drinking,' snapped Samantha, appearing out of the crowd. ‘Absolutely not.' ‘Grandad said – ‘ ‘I don't care.' ‘Everyone else – ‘ ‘I said no!' Lexie stomped away. Andrew, glad to see her go, smiled at Samantha, and was surprised when she beamed at him. ‘Do you talk back to your parents?' ‘Yeah,' he said, and she laughed. Her breasts really were enormous. ‘Ladies and gentlemen!' boomed a voice through the microphone, and everyone stopped talking to listen to Howard. ‘Wanted to say a few words †¦ most of you probably know by now that my son Miles has just been elected to the Parish Council!' There was a smattering of applause and Miles raised his drink high above his head to acknowledge it. Andrew was startled to hear Samantha say quite clearly under her breath, ‘Hoo-fucking-ray.' Nobody was coming for drinks now. Andrew slipped back into the kitchen. Gaia and Sukhvinder were alone in there, drinking and laughing, and when they saw Andrew they both shouted, ‘Andy!' He laughed too. ‘Are you both pissed?' ‘Yes,' said Gaia, and ‘no,' said Sukhvinder. ‘She is, though.' ‘I don't care,' said Gaia. ‘Mollison can sack me if he wants. No point saving up for a ticket to Hackney any more.' ‘He won't sack you,' said Andrew, helping himself to some of the vodka. ‘You're his favourite.' ‘Yeah,' said Gaia. ‘Creepy old bastard.' And the three of them laughed again. Through the glass doors, amplified by the microphone, came Maureen's croaky voice. ‘Come on, then, Howard! Come on – a duet for your birthday! Go on – ladies and gentlemen – Howard's favourite song!' The teenagers gazed at each other in tantalized horror. Gaia tripped forward, giggling, and pushed the door open. The first few bars of ‘The Green, Green Grass of Home' blared out, and then, in Howard's bass and Maureen's gravelly alto: The old home town looks the same, As I step down from the train †¦ Gavin was the only one who heard the giggles and snorts, but when he turned around all he saw were the double doors to the kitchen, swinging a little on their hinges. Miles had left to chat with Aubrey and Julia Fawley, who had arrived late, wreathed in polite smiles. Gavin was in the grip of a familiar mixture of dread and anxiety. His brief sunlit haze of freedom and happiness had been overcast by the twin threats of Gaia blabbing what he had said to her mother, and of Mary leaving Pagford for ever. What was he going to do? Down the lane I walk, with my sweet Mary, Hair of gold and lips like cherries †¦ ‘Kay not here?' Samantha had arrived, leaning against the table beside him, smirking. ‘You already asked me that,' said Gavin. ‘No.' ‘Everything OK with you two?' ‘Is that really any of your business?' It slipped out of him before he could stop it; he was sick of her constant probing and jeering. For once, it was just the two of them; Miles was still busy with the Fawleys. She over-acted being taken aback. Her eyes were bloodshot and her speech was deliberate; for the first time, Gavin felt more dislike than intimidation. ‘I'm sorry. I was only – ‘ ‘Asking. Yeah,' he said, as Howard and Maureen swayed, arm in arm. ‘I'd like to see you settled down. You and Kay seemed good together.' ‘Yeah, well, I like my freedom,' said Gavin. ‘I don't know many happily married couples.' Samantha had drunk too much to feel the full force of the dig, but she had the impression that one had been made. ‘Marriages are always a mystery to outsiders,' she said carefully. ‘Nobody can ever really know except the two people involved. So you shouldn't judge, Gavin.' ‘Thanks for the insight,' he said, and irritated past endurance he set down his empty beer can and headed towards the cloakroom. Samantha watched him leave, sure that she had had the best of the encounter, and turned her attention to her mother-in-law, whom she could see through a gap in the crowd, watching Howard and Maureen sing. Samantha relished Shirley's anger, which was expressed in the tightest, coldest smile she had worn all evening. Howard and Maureen had performed together many a time over the years; Howard loved to sing, and Maureen had once performed backing vocals for a local skiffle band. When the song finished, Shirley clapped her hands together once; she might have been summoning a flunkey, and Samantha laughed out loud and moved along to the bar end of the table, which she was disappointed to find unmanned by the boy in the bow tie. Andrew, Gaia and Sukhvinder were still convulsed in the kitchen. They laughed because of Howard and Maureen's duet, and because they had finished two-thirds of the vodka, but mostly they laughed because they laughed, feeding off each other until they could barely stand. The little window over the sink, propped ajar so that the kitchen did not become too steamy, rattled and clattered, and Fats' head appeared through it. ‘Evening,' he said. Evidently he had climbed onto something outside, because, with a noise of scraping and a heavy object falling over, more and more of him emerged through the window until he landed heavily on the draining board, knocking several glasses to the ground, where they shattered. Sukhvinder walked straight out of the kitchen. Andrew knew immediately that he did not want Fats there. Only Gaia seemed unperturbed. Still giggling, she said, ‘There's a door, you know.' ‘No shit?' said Fats. ‘Where's the drink?' ‘This is ours,' said Gaia, cradling the vodka in her arms. ‘Andy nicked it. You'll have to get your own.' ‘Not a problem,' said Fats coolly, and he walked through the doors into the hall. ‘Need the loo †¦' mumbled Gaia, and she stowed the vodka bottle back under the sink, and left the kitchen too. Andrew followed. Sukhvinder had returned to the bar area, Gaia was disappearing into the bathroom, and Fats was leaning against the trestle table with a beer in one hand and a sandwich in the other. ‘Didn't think you'd want to come to this,' said Andrew. ‘I was invited, mate,' said Fats. ‘It was on the invitation. Whole Wall family.' ‘Does Cubby know you're here?' ‘Dunno,' said Fats. ‘He's in hiding. Didn't get ol' Barry's seat after all. The whole social fabric'll collapse now Cubby's not holding it together. Fucking hell, that's horrible,' he added, spitting out a mouthful of sandwich. ‘Wanna fag?' The hall was so noisy, and the guests so raucously drunk, that nobody seemed to care where Andrew went any more. When they got outside, they found Patricia Mollison, alone beside her sports car, looking up at the clear starry sky, smoking. ‘You can have one of these,' she said, offering her packet, ‘if you want.' After she had lit their cigarettes, she stood at her ease with one hand balled deep in her pocket. There was something about her that Andrew found intimidating; he could not even bring himself to glance at Fats, to gauge his reaction. ‘I'm Pat,' she told them, after a little while. ‘Howard and Shirley's daughter.' ‘Hi,' said Andrew. †M Andrew.' ‘Stuart,' said Fats. She did not seem to need to prolong conversation. Andrew felt it as a kind of compliment and tried to emulate her indifference. The silence was broken by footsteps and the sound of muffled girls' voices. Gaia was dragging Sukhvinder outside by the hand. She was laughing, and Andrew could tell that the full effect of the vodka was still intensifying inside her. ‘You,' said Gaia, to Fats, ‘are really horrible to Sukhvinder.' ‘Stop it,' said Sukhvinder, tugging against Gaia's hand. ‘I'm serious – let me – ‘ ‘He is!' said Gaia breathlessly. ‘You are! Do you put stuff on her Facebook?' ‘Stop it!' shouted Sukhvinder. She wrenched herself free and plunged back inside the party. ‘You are horrible to her,' said Gaia, grabbing onto the railings for support. ‘Calling her a lesbian and stuff †¦' ‘Nothing wrong with being a lesbian,' said Patricia, her eyes narrowed through the smoke she was inhaling. ‘But then, I would say that.' Andrew saw Fats look at Pat sideways. ‘I never said there was anything wrong with it. It's only jokes,' he said. Gaia slid down the rails to sit on the chilly pavement, her head in her arms. ‘You all right?' Andrew asked. If Fats had not been there, he would have sat down too. ‘Pissed,' she muttered. ‘Might do better to stick your fingers down your throat,' suggested Patricia, looking down at her dispassionately. ‘Nice car,' Fats said, eyeing the BMW. ‘Yeah,' said Patricia. ‘New. I make double what my brother makes,' she said, ‘but Miles is the Christ Child. Miles the Messiah †¦ Parish Councillor Mollison the Second †¦ of Pagford. Do you like Pagford?' she asked Fats, while Andrew watched Gaia breathing deeply, her head between her knees. ‘No,' said Fats. ‘It's a shithole.' ‘Yeah, well †¦ I couldn't wait to leave, personally. Did you know Barry Fairbrother?' ‘A bit,' said Fats. Something in his voice made Andrew worried. ‘He was my reading mentor at St Thomas's,' said Patricia, with her eyes still on the end of the street. ‘Lovely bloke. I would have come back for the funeral, but Melly and I were in Zermatt. What's all this stuff my mother's been gloating about †¦ this Barry's Ghost stuff?' ‘Someone putting stuff on the Parish Council website,' said Andrew hastily, afraid of what Fats might say, if he let him. ‘Rumours and stuff.' ‘Yeah, my mother would love that,' said Patricia. ‘Wonder what the Ghost'll say next?' Fats asked, with a sidelong glance at Andrew. ‘Probably stop now the election's over,' muttered Andrew. ‘Oh, I dunno,' said Fats. ‘If there's stuff old Barry's Ghost is still pissed off about †¦' He knew that he was making Andrew anxious and he was glad of it. Andrew was spending all his time at his poxy job these days, and he would soon be moving. Fats did not owe Andrew anything. True authenticity could not exist alongside guilt and obligation. ‘You all right down there?' Patricia asked Gaia, who nodded, with her face still hidden. ‘What was it, the drink or the duet that made you feel sick?' Andrew laughed a little bit, out of politeness and because he wanted to keep the subject away from the Ghost of Barry Fairbrother. ‘Turned my stomach too,' said Patricia. ‘Old Maureen and my father singing along together. Arm in arm.' Patricia took a final fierce drag on her cigarette and threw the end down, grinding it beneath her heel. ‘I walked in on her blowing him when I was twelve,' she said. ‘And he gave me a fiver not to tell my mother.' Andrew and Fats stood transfixed, scared even to look at each other. Patricia wiped her face on the back of her hand: she was crying. ‘Shouldn't have bloody come,' she said. ‘Knew I shouldn't.' She got into the BMW, and the two boys watched, stunned, as she turned on the engine, reversed out of her parking space and drove away into the night. ‘Fuck me,' said Fats. ‘I think I might be sick,' whispered Gaia. ‘Mr Mollison wants you back inside – for the drinks.' Her message delivered, Sukhvinder darted away again. ‘I can't,' whispered Gaia. Andrew left her there. The din in the hall hit him as he opened the inner doors. The disco was in full swing. He had to move aside to allow Aubrey and Julia Fawley room to leave. Both, with their backs to the party, looked grimly pleased to be going. Samantha Mollison was not dancing, but was leaning up against the trestle table where, so recently, there had been rows and rows of drinks. While Sukhvinder rushed around collecting glasses, Andrew unpacked the last box of clean ones, set them out and filled them. ‘Your bow tie's crooked,' Samantha told him, and she leaned across the table and straightened it for him. Embarrassed, he ducked into the kitchen as soon as she let go. Between each load of glasses he put in the dishwasher, Andrew took another swig of the vodka he had stolen. He wanted to be drunk like Gaia; he wanted to return to that moment when they had been laughing uncontrollably together, before Fats had appeared. After ten minutes, he checked the drinks table again; Samantha was still propped up against it, glassy-eyed, and there were plenty of fresh-poured drinks left for her to enjoy. Howard was bobbing in the middle of the dance floor, sweat pouring down his face, roaring with laughter at something Maureen had said to him. Andrew wound his way through the crowd and back outside. He could not see where she was at first: then he spotted them. Gaia and Fats were locked together ten yards away from the door, leaning up against the railings, bodies pressed tight against each other, tongues working in each other's mouths. ‘Look, I'm sorry, but I can't do it all,' said Sukhvinder desperately from behind him. Then she spotted Fats and Gaia and let out something between a yelp and a sob. Andrew walked back into the hall with her, completely numb. In the kitchen, he poured the remainder of the vodka into a glass and downed it in one. Mechanically he filled the sink and set to washing out the glasses that could not fit in the dishwasher. The alcohol was not like dope. It made him feel empty, but also keen to hit someone: Fats, for instance. After a while, he realized that the plastic clock on the kitchen wall had leapt from midnight to one and that people were leaving. He was supposed to find coats. He tried for a while, but then lurched off to the kitchen again, leaving Sukhvinder in charge. Samantha was leaning up against the fridge, on her own, with a glass in her hand. Andrew's vision was strangely jerky, like a series of stills. Gaia had not come back. She was doubtless long gone with Fats. Samantha was talking to him. She was drunk too. He was not embarrassed by her any more. He suspected that he might be sick quite soon. ‘ †¦ hate bloody Pagford †¦' said Samantha, and, ‘but you're young enough to get out.' ‘Yeah,' he said, unable to feel his lips. ‘An' I will. ‘Nigh will.' She pushed his hair off his forehead and called him sweet. The image of Gaia with her tongue in Fats' mouth threatened to obliterate everything. He could smell Samantha's perfume, coming in waves from her hot skin. ‘That band's shit,' he said, pointing at her chest, but he did not think she heard him. Her mouth was chapped and warm, and her breasts were huge, pressed against his chest; her back was as broad as his – ‘What the fuck?' Andrew was slumped against the draining board and Samantha was being dragged out of the kitchen by a big man with short greying hair. Andrew had a dim idea that something bad had happened, but the strange flickering quality of reality was becoming more and more pronounced, until the only thing to do was to stagger across the room to the bin and throw up again and again and again †¦ ‘Sorry, you can't come in!' he heard Sukhvinder tell someone. ‘Stuff piled up against the door!' He tied the bin bag tightly on his own vomit. Sukhvinder helped him clear the kitchen. He needed to throw up twice more, but both times managed to get to the bathroom. It was nearly two o'clock by the time Howard, sweaty but smiling, thanked them and said goodnight. ‘Very good work,' he said. ‘See you tomorrow, then. Very good †¦ where's Miss Bawden, by the way?' Andrew left Sukhvinder to come up with a lie. Out in the street, he unchained Simon's bicycle and wheeled it away into the darkness. The long cold walk back to Hilltop House cleared his head, but assuaged neither his bitterness nor his misery. Had he ever told Fats that he fancied Gaia? Maybe not, but Fats knew. He knew that Fats knew †¦ were they, perhaps, shagging right now? I'm moving, anyway, Andrew thought, bent over and shivering as he pushed the bicycle up the hill. So fuck them †¦ Then he thought: I'd better be moving †¦ Had he just snogged Lexie Mollison's mother? Had her husband walked in on them? Had that really happened? He was scared of Miles, but he also wanted to tell Fats about it, to see his face †¦ When he let himself into the house, exhausted, Simon's voice came out of the darkness from the kitchen. ‘Have you put my bike in the garage?' He was sitting at the kitchen table, eating a bowl of cereal. It was nearly half-past two in the morning. ‘Couldn't sleep,' said Simon. For once, he was not angry. Ruth was not there, so he did not have to prove himself bigger or smarter than his sons. He seemed weary and small. ‘Think we're gonna have to move to Reading, Pizza Face,' said Simon. It was almost a term of endearment. Shivering slightly, feeling old and shell-shocked, and immensely guilty, Andrew wanted to give his father something to make up for what he had done. It was time to redress balances and claim Simon as an ally. They were a family. They had to move together. Perhaps it could be better, somewhere else. ‘I've got something for you,' he said. ‘Come through here. Found out how to do it at school †¦' And he led the way to the computer.