Finally, a TV show about the damage caused by austerity


During the COVID-19 pandemic, the British public has seen the Tory-led National Health Service (NHS) pushed to breaking point.

The BBC’s adaptation of the 2017 memoir of former NHS doctor Adam Kay, This is going to hurt, comes at precisely the right time, as the nation now grapples with the wasting of the healthcare system that was once considered the best in Britain. The tragicomedy garners praise for its many outstanding qualities, including a stellar performance from Ben Whishaw and writing that will leave you in the dots (pardon the pun). It’s also refreshingly honest about the pitfalls of an austerity-starved NHS.

The series’ protagonist, Adam, is a brilliant underpaid and overworked doctor. He’s also rude and short-tempered in a charming and distinctly British way. Break the fourth wall Flea bag the fashion, Adam’s offhand asides and the gaze towards the audience – handled with remarkable fluidity by Whishaw – reinforce the theatricality of the show by transporting the viewer into the world of hellishly ill-organized maternity wards. (Warning: spoilers ahead.)

In one episode, Adam is on the verge of bankruptcy. In lack of money, he takes a shift in a private maternity ward. With its gargantuan chandelier and marble pillars, the private hospital seems to make work easier. But as we have just seen, the facility suffers from insufficient resources, and so a mother who gives birth in crisis is rushed to the accident and emergency services (A&E) at Adam’s NHS hospital. Although the NHS service is delighted with the success of the rescue of mother and baby, Adam laments that the staff do not receive the cash for their work, which will of course still go to the private hospital.

Another episode details a press visit by a politician to the neighborhood, like those Boris Johnson has made regularly during the pandemic. The hospital realizes it’s not quite suitable for public exposure, with an alarm that hasn’t worked for four years and shoddy, overcrowded rooms. To improve the appearance, short-notice renovations are taking place around the service. With wires hanging from the ceiling and drill dust covering every surface, Adam’s senior consultant Lockhart (played by Alex Jennings, who brings his impeccable acting from The crown to this role as well), remarks: “Jesus Christ, it’s like downtown Basra here.”

‘They must be thinking the whole NHS smells like fresh paint,’ one of the nurses bites about the facelift inspired by the politician’s visit. “Still, new computer.”

“I wouldn’t get too attached, my love. Once the right honorable bastard does his little rounds, everything will go faster than you can say ‘A&E closing’,” replies Nurse Tracey, played by Michele Austin.

The real Adam Kay left the NHS after being ‘disbarred’ (his revocation of his medical license) following a faulty C-section which resulted in the baby’s death. In the show, Adam delivers the baby and he survives. He avoids having his license revoked by explaining how he worked understaffed night shifts, how he was the only doctor available to come in that night despite it being supposed to be his night off, and as a result how desperately tired he was.

This story resonates with the experiences of a young NHS doctor I spoke to. George Huntington said Jacobin that while on call, he covers ten medical departments, tending to emergencies or admitting patients to the hospital from A&E. “Today is supposed to be a day off,” he said. “My consultant called to ask me why I’m not here and who he can contact who is in the department.”

Huntington said “even before the pandemic, it was obvious that things had gotten very tense.” For example, in 2018 the NHS recorded its worst A&E waiting hours. While he doesn’t think things will “fall apart overnight,” he thinks patient outcomes could get worse and “there could be more malpractice lawsuits; nurses and doctors are being written off, creating a spiral of people leaving the workforce. He adds: “I think the situation is likely to get worse before it gets better.

Unlike most hospital-based television series, everyone in This is going to hurt looks like a normal person instead of a dummy-surgeon (I’m looking at you, Grey’s Anatomy). The series also doesn’t shy away from reality in other aspects, from medical crises to social crises. There are typical social issues, like when Adam struggles to come out as gay to his co-workers, while co-worker Shruti struggles to choose between doing the right job for her and pleasing her South Asian immigrant parents. But there’s also a hilarious scene depicting a workshop on politically correct language, like replacing “patient” with “customer” and “disabled” with “disabled different.” Tracey, a black nurse with a disabled child, asks how beneficial changes like this really are when workers don’t have “a working printer on our ward.” We’ve had a ceiling leak for over four years, and that’s what they’re spending their money on? »

Shruti Acharya is the series’ most tragic and disturbing character. The subject of Adam’s repeated bullying, Shruti’s stamina as a doctor is tested several times throughout the show. Lively teasing from Adam and other senior doctors quickly wears down the young doctor-in-training.

The show breaks our hearts before its climax with the devastating suicide of Shruti. The storyline therefore focuses on the “last taboo” of the NHS – the disproportionately high suicide rate of NHS doctors. According to a 2018 Office for National Statistics report, a healthcare professional commits suicide every three and a half days in the UK. The pandemic has only worsened the mental health of NHS workers, with a record number of staff quitting – 27,000 over three months, leaving around 6 million patients on a waiting list.

“Many of the nurses I have worked with at ITU [intensive therapy unit] through the first and second wave are leaving intensive care. . . or breastfeed altogether. Even though I hate it, I don’t really blame them,” Huntington tells me. Almost half of intensive care staff surveyed by Kings College London during the first wave of the pandemic suffered from PTSD, severe anxiety, depression or alcohol dependence, and one in eight workers suffered from claimed to have had suicidal thoughts or had thoughts. to hurt themselves.

Low wages don’t help matters. In 2021, a 3% pay rise was given to NHS staff, but not young doctors, despite the fact that take-home pay for young doctors has fallen by 23% since 2009. Additionally, according to the British Medical Association (BMA), “a three percent salary increase. . . does nothing to address years of wage erosion. Junior doctors Sarah Hallett and Mike Kemp said in a BMA press release:

With days spent on Covid wards with no end in sight, redeployed to unfamiliar wards, wearing ill-fitting or non-existent PPE that left us fearful for our own safety and that of our patients, being excluded from further rewards is an insult extraordinary.

Afshan Sharif worked in the NHS for two years as a mental health nurse and worked in intensive care as a healthcare support worker. “The biggest problem is the lack of staff,” she said. Jacobin, “There’s too much work, which adds to stress and people taking time off because they don’t feel physically and mentally well. But we don’t have the budget, so . . . “She passed away.

Sharif was hired at the height of the pandemic to work in COVID wards, and although it was “emotionally exhausting”, she explains that her team was “so amazing it didn’t feel so bad at times”. Sharif, being a recent addition to the NHS, did not experience conditions before the pandemic, but she believes staff have become burnt out, and she has seen many people ‘leaving or going private because of it’.

Although Sharif herself has not experienced bullying similar to that of Shruti, she knows people who have experienced racism. “I think a lot of black healthcare workers are hurting the most. I saw it, and I try to talk when I can. It’s definitely a problem.

The question is exposed and questioned, with a good dose of dark humour, in This is going to hurt. In one episode, Tracey experiences racism from a patient who prefers not to have her tests handled by Tracey, a black nurse, or her baby by Shruti, a South Asian doctor. This type of treatment is not uncommon for the 22% of NHS staff who are black, Asian and “minority ethnic”.

Huntington says one of the main problems currently facing the NHS is that “there is no funding for more training places”, which he says will “lead to a worse staffing crisis in about five to ten years. If he could change one thing, it would be “more money in the right places”. Huntington adds:

The service must operate at a loss. Obviously the public needs to get their money’s worth, but you need to create redundancy so that we have surge capacity for the next pandemic or winter crisis. If money is the bottom line, then people’s health becomes secondary.

The truth is that public health is already taking a back seat to belt-tightening in the NHS. And while the truth can sometimes hurt, we must face it if we are to have any chance of healing a wounded national health care system.


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