A murderer is using his computer expertise to blackmail hospital doctors, and threatens that a patient will die every twenty-four hours unless his demands are met. Commander Blake has her own personal problems - she is being stalked by the sister of a victim of James Lampton and is stabbed in the arm, and her sister is still fighting her battle against cancer.

The police are still no closer to the blackmailer and Vera and Eileen Judd, the sisters of one of his victims, are chasing compensation for medical negligence. Brenda Thornton has managed to escape from the secure psychiatric unit and leaves a disturbing message on Commander Blake's answerphone. Commander Blake finds her sister snorting cocaine and takes it off her, hiding it in her desk at work. Brenda tries to attack Blake but Sarah gets in the way and it ends with Brenda getting burned by acid. The police discover the the wife and child of Alistair Morrison died in the same hospital as the brother of Vera and Eileen Judd. The sisters deny any knowledge of the Morrison or the blackmail but the police follow them and find that they are working with Morrison. During a police chase Eileen falls to her death.

The perfectly-preserved body of a two-year-old girl is found in a sealed oil drum in the basement of the derelict Elliston psychiatric hospital. Commander Blake assumes the role of senior investigating officer from DI Doug James, creating early conflict within the team as they set about investigating former patients and staff. As the team closes in on two particular suspects, there is a clash with the drugs squad, who are running a parallel investigation into one of them.

The murder of Mrs Thornton makes Eric the prime suspect for both deaths, but conflicts with a parallel investigation into the landscape gardening business where Eric works threaten to undermine both cases.