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In a Place of Fear by Catriona McPherson.

‘Helen leaned close enough to fog the mirror with her breath and whispered, ‘You, my girl, are a qualified medical almoner and at eight o’clock tomorrow morning you will be on the front line of the National Health Service of Scotland.’ Her eyes looked huge and scared. ‘So take a shake to yourself!”

In Edinburgh, 1948. Helen Crowther leaves her crowded tenement for her own office in a doctor’s surgery. She is aware of other people’s opinions and disapproval- ‘Upstart, ungrateful, out of your depth’ – but she’s determined to take part in this incredible new service that will help so many people. She’s not even settled in when she blunders into a murder. Even though Edinburgh is the most respectable of cities, no one wants to stand up for justice, but Helen is determined to find the killer. She’s taken into a world she didn’t know existed, it’s darker than her own as hard as her own can be. Disapproval is now the least of her worries. Helen, known as Nelly, takes on a newly created position within the NHS, as a Medical Welfare Almoner. This was a position based within the free hospitals that is the forerunner to a hospital social worker. The very first almoner in the U.K. was Mary Stewart, appointed at the Royal Free Hospital of central London in 1895. The Royal Free was a charitable hospital and gave free medical treatment to those patients considered morally deserving, but unable to afford medical care. An Almoner would means test patient to ensure that only those deemed “appropriate” received free medical treatment. However, Stewart slowly reshaped her role of and fashioned the position into a medical social worker, referring patients to other means of medical and charitable assistance, visiting patients’ homes, and training almoners for positions at other voluntary hospitals.

Nelly is there in the role’s infancy and while she’s still finding her bearings in her new job she begins to notices that all is not as it should be. Nelly isn’t the type of person to brush things under the carpet, so she starts to investigate. There is so much more there than she expects, especially when a body is found in the garden of the house she’s been living in as part of her employment. Even then her curiosity about cause of death and any motive pushes her to carry on investigating, even if it puts her in danger. I felt like I really understood Nelly. I loved her no-nonsense attitude and her dogged refusal to let things go. She wants to make a difference to the patients she sees at the hospital and it was fascinating to be taken back to the birth of the NHS and see how it was implemented. New patients had no idea what help they were entitled to and no-one, even those working in it, fully knew how it worked. I thought that the title was a clever nod to Aneurin Bevan’s own book of the same name.

The mystery was clever and well paced, it kept me reading and surprised me at times, but it wasn’t my favourite part of the novel. I’m used to Edinburgh based stories taking me to the university and male dominated academia, which also suggests people of a certain class. The author focuses on the blue collar, working people of the city. We see a generation and class still struggling in the aftermath of war. This is the beginning of universal health care; health for everyone, not just those who can afford it. The writer gripped me from page one by bringing to life the sights, sounds, and smells of this point and place in time. As someone who has needed the NHS more than most, I found it so interesting to see how it began from a character working on the frontline and making tough decisions.

Meet The Author

Catriona McPherson was born in the village of Queensferry in south-east Scotland and left Edinburgh University with a PhD in Linguistics. Her historical fiction has been short-listed for the CWA Ellis Peters award and long-listed for Theakston’s Crime Novel of the Year, as well as winning two Agathas, two Macavitys, and four Leftys in the USA. Catriona lives most of the year in northern California, spends summers in Scotland, and writes full time in both.


Hello, I am Hayley and I run Lotus Writing Therapy and The Lotus Readers blog. I am a counsellor, workshop facilitator and avid reader.

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