Britannia Hospital was not a hit. Released in 1982, the film was a grand slab of British oddity from director Lindsay Anderson, arriving after the boarding school revolt of If … and business-land romp O Lucky Man. The lead was the great comic actor Leonard Rossiter, star of TV’s Rising Damp, cast as the administrator of a chaotic NHS hospital preparing for a visit from royalty.
It’s a movie that feels like a panic attack – the staff mutiny at creeping privatisation, strange experiments take place behind closed doors. Often it seems about to implode as you watch, leaving just a cloud of strange-smelling smoke – but then, it is supposed to be a portrait of collapse. As per the title, the idea was that the NHS was the soul of the nation. It was us, we were it, and we were both in trouble.
The distress flare went off in the faces of its makers. The response at the box office was such that a month after its release, it was quietly withdrawn by the distributors. Anderson never directed another British film. But the sense of the health service as national essence survived on screen. This Saturday, like most Saturdays, TV viewers can see the latest episode of Casualty, still stitching and defibrillating at 31 years old. On Tuesday, it will be the turn of spin-off Holby City.
For those unsated, every single weekday afternoon offers a new episode Doctors, its 3,363rd. The nagging feeling may be that long-running BBC1 medical shows are now far better resourced than the actual NHS. But British TV always had the hots for the health service, attracted by the endless potential for human drama in a world that was by design available to all, around the clock. Even on film, that rolling capsule of British life ended up in serial form, channelled into the starched white coats and stiffened innuendo of the Carry Ons – after the early innocence of Carry On Nurse in 1959 came Doctor (1967), Again Doctor (1969) and, finally, Matron (1972).
The old world cultural staples of naughty nurses and bedbaths remained in rude health even once Carry On ran its course. In 1981, a troubled year in which riots flared in London, Birmingham, Liverpool and Leeds, the film of the summer was the – glorious – An American Werewolf in London, with Jenny Agutter as a staff nurse who took her newly lycanthropic patient home to bed. On TV, meanwhile, the hospital ward as open-ended limbo inspired the popular sitcom Only When I Laugh. The set-up was simple – the misadventures of three male patients awaiting surgery at some abstract point in the future, one chippily working class, one timidly suburban, one louchely well-to-do in a silk dressing gown, with no actual illness specified so no-one could recover and no-one could die. They and the NHS would just be there forever, like Britain, a place of warm Lucozade and feeling peaky.
But then came Britannia Hospital, and Anderson’s vision of a sputtering bedlam machine being mined for profit, like a JG Ballard take on Carry On Doctor. For all the indifference of cinemagoers, the timing was interesting. Perhaps forever wouldn’t last after all.
In September 1982, just a couple of months after Britannia Hospital came and went, word reached the press of confidential cabinet memos. According to leaked documents, Margaret Thatcher was personally driving plans that involved making private healthcare compulsory and stripping the NHS to a rump service only for the elderly and “mentally handicapped.”
The furore had enough whiff of scandal for the prime minister to have to disown the idea, publicly announcing “the National Health Service is safe with us.” It was a pivotal moment – one where it became apparent the country’s leader wanted to shutter the NHS at the same time doing so openly became politically impossible.
Only When I Laugh suddenly looked passé. Its malingering heroes were finally discharged in the last episode at the end of that year. But the simmering new reality of British healthcare turned up elsewhere on TV. In 1985, writers Jeremy Brock and Paul Unwin pitched the BBC the idea for Casualty, a programme they meant as campaigning drama at a time of ceaseless cuts. Indeed, the first two series were notably blunt, with an overarching plot about the forced closure of the A&E night shift. None of this went unnoticed. Regular calls to the producers from Thatcher’s snarling lieutenant Norman Tebbit and health secretary Edwina Currie registered their displeasure at a time when the BBC often braved the ire of government.
Eventually, a truce was declared. By the end of the 80s, a change in the Casualty production team saw a softening of the storylines – but soon Thatcher was gone too. Almost 30 years later, the show goes on. It can, in truth, feel a little plaintive, still dutifully healing the sick of Holby even as its real-world inspiration faces an existential crisis.
On the other hand, the mere idea of a beloved BBC series about the NHS may well vex the present government twice over. Anyway, Britannia Hospital was not quite the last word British film had on the subject. Danny Boyle had already conjured a politically ominous image in his zombie horror 28 Days Later – Cillian Murphy waking to a deserted London hospital – when he became artistic director of the 2012 Olympic opening ceremony. The result was, by common agreement, a triumph, among the most acclaimed moments the mass jive of 600 health service staff prefacing a vast illumination of the letters NHS, a loving celebration of what the Olympic programme called “the institution that most unites our nation.”
It was reported that for reasons unknown, the then culture secretary had pressured Boyle to cut the sequence. Three weeks after the Olympics, the same minister, Jeremy Hunt, took the post he has filled ever since, secretary of state for health.
Laura Mayne picks five optimistic postwar films about the newly established health service
A severely put-upon National Health Service is threatening to buckle under the combined weight of hundreds of thousands of patients who require immediate treatment. Waiting lists are increasing. Severe staff shortages combined with rapidly rising costs adds to an increasing sense of trepidation among government officials. This is the NHS, not in 2017, but shortly after its establishment in July 1948, when its future was far from secure. To understand why these early problems were taken very much in stride, we really need to understand the optimism and postwar spirit of collective action under which the NHS was founded, a spirit perhaps best exemplified in the British films of the period. From public information films to documentaries to slapstick comedies, they offer up a variety of fascinating perspectives on the newly established service.
Your Very Good Health (Joy Batchelor, John Halas, 1948)
This Technicolor short was one of several government propaganda films to feature Joy Batchelor’s “Charley”, a cartoon character created to inform the public about the Labour government’s new welfare reforms. In Your Very Good Health, a happy Charley cycles around his neighbourhood while the film’s narrator tries to convince him of the benefits of the new health service by portending a number of scenarios in which Charley and his wife might become ill. Visually resembling Disney animations, it was a colourful beacon in a sea of stuffy public information films starring be-suited men reading excerpts from government leaflets.
Life in Her Hands (Philip Leacock, 1951)
Produced by the Crown Film Unit as part of a national recruitment campaign, which aimed to address nursing shortages, melodrama Life in Her Hands is a fiction film with an interesting pedigree. It was scripted by Monica Dickens, great-granddaughter of Charles, and stars Kathleen Byron (best known for her role as the madwoman in the 1947 Powell and Pressburger film Black Narcissus) as Nurse Peters, a grieving widow who finds solace by dedicating her life to others.
This melodrama was specifically designed to appeal to women in a way that feels rather heavy-handed today. The film blends the personal and impersonal, balancing the emotional journey of Nurse Peters (demonstrated by means of soft lighting and a surfeit of extreme close-ups of her reactions) with the stark, well-run efficiency of the hospital environment. Life in Her Hands is ostensibly an NHS ad, but it doesn’t shy away from showing the gruelling nature of the job, the strict hospital hierarchy and the fact that nursing is a calling that requires far more from its employees than just a basic level of competence. There are moments of real poignancy within the film’s plot, which begins with a death and ends with a birth, and Peters’ convincing line: “isn’t it dramatic ... to be in at the start of someone’s life, to have made them live.”
On Call to a Nation (Richard Cawston, 1958)
Today, doctors lead the fight to save the NHS from privatisation, so it’s a little strange to think that when the service was first established the doctors were among its harshest critics, fearing its creation would destroy their profession. Divisions among the medical establishment were the subject of the 1958 BBC television documentary On Call to a Nation, which features real doctors reflecting on the achievements of the NHS after its first 10 years. Some are firm believers in the efficacy of the new system, while others question whether it was even a sound idea in the first place. The programme caused a stir in the correspondence pages of the November 1958 edition of the British Medical Journal, where one doctor worried that presenting consultants as fallible human beings would lead to a loss of public confidence in the medical profession.
Life in Emergency Ward 10 (Robert Day, 1958)/Emergency – Ward 10 (ATV, 1957-1967)
Emergency – Ward 10 (1957-1967) was Britain’s first long-running medical soap opera and the blueprint for all subsequent medical dramas produced in the UK. The ITV series began as a six-part schedule filler but proved so popular that it became a full series and even spawned a feature film. The programme courted controversy in 1964 with a storyline involving an interracial relationship between a doctor and a surgeon. The overwhelming popularity of Emergency – Ward 10 indicated that there was a real public appetite for medical drama, and by the late 1950s British film producers in particular were finally cottoning on to one undeniable fact: the NHS was pure box office gold.
Carry On Nurse (Gerald Thomas, 1959)
In 1951, Pat Jackson’s medical drama White Corridors reached number eight at the UK box office, while in 1954 Doctor in the House broke box office records to become one of the Rank Organisation’s most successful films of all time. But the real outstanding success of the 1950s has to be Carry On Nurse, the second instalment in the Carry On … film series. Nurse topped the box office charts in 1959 on both sides of the Atlantic and proved that there was a lot of comedy mileage in the hospital farce. Carry On … producer Peter Rogers, a man who was never afraid to flog a dying horse, would revisit the hospital scenario again and again over the 20-year life of the series. After the success of Carry On Nurse he realised one important thing: that the founding principle of the NHS also happens to lend itself to great comedy.
