Theatre preview: Fringe shows to explore the NHS at 70
As Clement Attlee’s health minister, Aneurin Bevan understood the difference his brand new National Health Service had made to the lives of working people. Hence the title of his collection of essays, In Place Of Fear, published in 1952. “No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means,” he wrote.
“We need to be mindful of what fear is,” says comedian and theatremaker Mark Thomas today. “Fear of illness, of being in pain, of feeling you can’t afford to go, of feeling your life is being taken out of your control… You conquer fear with care.”
In this 70th anniversary year, Thomas is one of several Fringe artists putting the NHS under the spotlight – or in some cases, imagining it wasn’t there at all: After The Cuts by Gary McNair is set in a post-NHS world where a couple are forced to perform a DIY operation, and In Addition by Orange Skies is set in a future where minor medical problems quickly turn major.
Others, including Thomas in Check Up: Our NHS At 70, have gone into surgeries and hospitals to see the NHS at work for themselves. The frontline experience of doctors and nurses informs the Grassmarket Project’s Where It Hurts, which is performed by the people who know the NHS best, as well as New Perspectives’ A Fortunate Man, an update of John Berger’s 50-year-old study of a rural GP.
“The more shows there are and the more discussion there is, the better,” says Thomas, whose mother, grandmother and aunt were nurses and who did a month-long residency in a west London hospital in the name or research.
His sentiment is echoed by Jeremy Weller of Edinburgh’s Grassmarket Project. “It’s brilliant for the public to get an overview of the human side of it,” says the director, who is putting nurses, psychiatrists and counsellors on stage. “The NHS doesn’t actually exist: it’s just people helping people who are hurt.”
The NHS is, of course, a political hot potato. It’s the organisation that makes people more proud to be British than the monarchy or the army. Yet it’s the subject of intense debate about funding, creeping privatisation, outsourcing, understaffing, waiting times, social care provision and the capacity to treat an aging population. All of the theatremakers are alive to these issues at the same time as being awestruck by the commitment of the staff.
“For an organisation that is founded on science, it is held together with faith,” says Thomas. “The people who work in it really do hold it together.”
“All I met in the NHS,” says Weller, “was idealism, profound engagement in the human condition, wonderful caring, and love for human beings they didn’t know. The NHS belongs to all of us and when everything else fails – love, family, society – the NHS is there. It’s almost the thing we dream of: unconditional love.”
Writer and director Michael Pinchbeck had much the same reaction when researching A Fortunate Man. “The overriding sense we got is that doctors love what they do,” he says. The play draws on the book of the same name by writer John Berger and photographer Jean Mohr about John Sassall, a GP doing his rounds in the Forest of Dean in the 1960s. Presented in lecture format, A Fortunate Man also includes interviews with modern-day doctors.
“The things doctors today love most about it are the people and the place,” says Pinchbeck. “That’s exactly the same as the doctor in the 1960s. We’re also drawing parallels between the pressures doctors face today and the pressures Sassall faced.”
In this, he’s not alone. All three of the productions drawing on first-hand research sing the praises of NHS staff without glossing over the strains on the system. “You have to be critical and say we want better,” says Thomas, who interviewed everyone from Peter Bennie, chair of the BMA’s Scottish Council, to Lord Darzi, the surgeon and Labour politician. “This whole love fest for the NHS, which is great, is also a hindrance.”
Straddling the decades has given Pinchbeck a sense of what we’ve lost. “We’ve moved from meeting patients to meeting targets,” he says. “In 1967, doctors could make house calls and weren’t under pressure to see someone in ten minutes, which is what happens now. When we’ve gone into doctors’ surgeries today we’ve found out that doctors don’t take lunch breaks, they take their work home with them and they’re constantly doing admin. What this doctor had in the 1960s was more time.”
Even though Weller is keen for his performers to speak for themselves, he believes the problems of the health service are too apparent to miss: “The biggest thing the NHS faces – and the most political thing – is their being asked to deal with the massive inequality in society. That’s not what it was created for. Think about what lands at the door of the NHS: domestic violence, child abuse, childhood trauma, alcoholism, addiction, obesity, depression, isolation… everything.”
Thomas agrees: “The NHS exists as a landlocked entity and it is surrounded by austerity, poverty and social care – and that’s what walks in the door.”
Noting the differences between England and Scotland, where he remarks on provision at “pretty near the 1948 model”, he sees a system creaking under the strain. “We’re on the cusp of the NHS losing the nuts and bolts that hold it together,” he says. “You talk to everyone and they say, ‘This year has been harder.’”
If Thomas has a call to action, it is to change attitudes to the elderly. When the NHS reaches its centenary, he will be 85 and he’s hoping it will be in a fit state to care for him. That can only happen if we see our aging population as a shared problem. “We need to see older people not as ‘them’, not as ‘bed blockers’, not as ‘the others’, but as our future selves,” he says. “We need to emotionally and intellectually invest in how we care for people – because that’s us.”
Check Up: Our NHS At 70, Traverse, Saturday until 26 August; After the Cuts, Summerhall, Wednesday until 26 August; In Addition, Underbelly Cowgate, Thursday until 26 August; Where It Hurts, Summerhall, Wednesday until 26 August; A Fortunate Man, Summerhall, Wednesday until 26 August