I left the junior doctors and returned to my office, where my secretary Gail had now been joined by Julia the bed manager, one of our senior nurses, who is responsible for the thankless task of trying to find beds for our patients. There are never enough beds, and she spends her working day on the telephone, frantically trying to cajole other bed managers elsewhere to swap one patient for another or to take patients back from the neurosurgical wards so that we can admit a new one.