Thursday, 14 February 2013

A Matter of Trust

In the mid-90s, having found myself on a hiatus from surgeries where huge chunks of my bowel got hacked out, and having survived giving birth to a very small boy, I was writing quite a lot for radio. A producer asked if I had any series ideas, and I came up with Trust; a satire on the NHS.  Remember satire? It has a long history, and was still alive and well during the Tories’ last, endless reign, and then it seemed to disappear. It’s not gone exactly, I think it just hides, masquerading occasionally as drama, when we’d expect it to be comedy.  Certainly, we have to look a lot harder to find it. The dictionary describes satire as ‘the use of wit, especially irony, sarcasm and ridicule, to attack the vices and follies of humankind’. I think we’d all agree that’s a good thing.

Anyway, I digress – whatever satire is or isn’t, and whether it is or isn’t represented adequately on television or radio today, is not my point.  My point is the story of Trust.  The simple premise of Trust was that a corrupt hospital manager was brought in to do a kind of top-down reorganisation of the hospital he was charged with running.  Sound familiar? Maybe so, but bear in mind the first series went to air in 1995. This nonsense of which I wrote was made up. Silly. Satire, with the emphasis on the ridiculous.

An aside, at this point. I, like many other leftie types, have often acknowledged that Labour was to blame for the first wave of the ludicrous amount of managers, without any medical knowledge or expertise, brought in from the business and industry worlds to take charge of the NHS and its treasures.  However, looking back at Trust - which I wrote, but clearly don’t remember all that well - I have to accept that that’s wrong. I’m wrong. All of us who admit to Labour’s part in starting the regime that is now becoming the end of the NHS, are not quite right.  I was and remain no Blair fan, and he did definitely make things worse on that score, but clearly – and apologies for sounding like Cameron in reverse - the Tories started it. I may have had my own vision of where it was going, but I certainly didn’t make up NHS trusts and hospital managers. I extrapolated from what was there. And it was put there by the Tories.

It wasn’t the greatest writing in the world, I don’t imagine. It was quite knockabout with scenes of total lunacy at times.  The basic premise was that the hospital manager – played by a brilliant actor, whom I won’t name, because I never do in this blog, but it’s easy enough for you to find out – met up every week with the managers of other hospitals to bid for surgeries; the hospital offering the cheapest deal got the operation and the aftercare that went with it, and made their profits from that.  Our evil manager took to undercutting the other hospitals on surgeries for patients who might not make it through their particular procedures, then didn’t do the surgeries and ‘let them’ die.  The relatives were told their loved one had died on the operating table, and our ‘hero’ made the hospital finances look good, whilst pocketing a nice chunk of change for himself.  He managed to blackmail enough of his staff for the scam to work, and from that seed grew a whole series with, as they say, hilarious and horrifying consequences. Hopefully.  Certainly, the reviews were good, including – and this may well have been the highlight of my career so far – one in the British Medical Journal,  which was quite long, complimentary in parts, and ended with the warning that such a hospital manager as the one I’d invented may well turn up at the reader’s place of work any moment. (You can read a bit of it here.)

Back then, some of the things that ended up in the series I thought were completely ridiculous. There were drug companies bribing staff to use only their products; we had wards running out of syringes and dressings and having to make deals with other wards to get the apparatus they needed.  When I was in hospital in 2010 I saw that actually happen.  Only it wasn’t syringes or dressings, it was giving sets, which are used to give patients fluids intravenously. There weren’t any on the ward and they had to swap something they did have with another ward to get them, so that patients waiting for iv fluids could get what they needed.  In Trust, we joked that the NHS would become all about money.

Happily, a second series was commissioned, and we had to come up with a new scam.  This time we went with organ harvesting.  Illegal organ harvesting, where patients were kept alive, when that wasn’t exactly their care plan, and their organs harvested without the relatives’ consent or knowledge, and before they knew their loved one was ‘dead’.  The organs were then sold on, and again, our hospital manager and his accomplices profited, despite the accomplices’ many attempts to bring the whole situation to a halt.  None of this sounds funny, I realise that. Back then though, it did seem crazy and impossible, and led to the requisite jokery its time slot demanded.

And then, halfway through the airing of series 2, Trust was pulled.  There was to be an election that year, you see, and the BBC couldn’t be seen to be transmitting anything that may influence the way that election would go.  Infuriating, obviously. Stupidly complimentary in a way; the merest suggestion that my writing could be that powerful.  That someone lying in a late night bath would hear my words coming from the mouths of wonderful actors and think, fuck me, I’ve voted Tory all my life but I’m not going to any more because of this comedy, satire thing I’ve just half listened to. That they would then wash their armpits with renewed vigour and a whole different take on life, thanks to our little late night show. Nonsense, of course.  But it happened.  Which was okay, we thought.  The producer and I, both of whom had grown to love our programme and all who worked on it, worried slightly that listeners would be doing other things over the summer when the series returned. Things like going on holiday, or spending balmy nights in their gardens listening to music, rather than words. We needn’t have worried, though, because Trust never did return.  I still have a letter somewhere from the then controller of Radio 4, telling me that now that Labour had got into power, the destruction of the NHS was no longer a concern.  Not a worry.  It would all be fine now, because Labour were in charge.  I did honestly sneer back then; I’d like to think it was because I didn’t believe it; because I knew Labour under Blair was nothing like the Labour of old, but it was a long time ago and I might just have been cross that I wasn’t going to get another series.

Fast forward 15 years and my son, 20 years old, is at the wrap party for an indie film he worked on. Coincidentally, and somewhat age highlightingly, the director’s mother and I had worked together in an advertising agency a hundred years ago, and our children – I’m not even going to think about how old this tale makes me feel -  were talking about said coincidence with a couple of the actors. One of the actors is dating the son of the brilliant actor who played my evil trust manager, and my son tells this actor of this similar coincidence. My son tells her his mother also worked with her boyfriend’s father. On a radio series about the NHS. She looks at him, and says, ‘It wasn’t Trust was it?’ My son confirms that it was, indeed, Trust, and she tells him that her boyfriend plays it to her often, citing it as his father’s finest work.  Which kind of brings the whole story into a nice circley thing, makes me feel very old indeed, and gives me the comfort of imagining that if I ever write something about kids in their 20s, I could probably get a couple of this country’s most promising young actors to be in it.

I don’t know if  Trust was that actor’s finest work; certainly I’ve seen him be extraordinary in many things, but I’m just happy that somebody who knows a lot about him would think that it might be.  I occasionally worry that it may end up being my finest work, but l should probably talk to a therapist about that.

I’d love to have another crack at a satire on the NHS. I’d love to revive Trust, if I’m honest, and find out what these characters would be getting up to now – older, wiser, and way more experienced at the evil they can do.  Now with added legislation to help them, and influential people happy to turn a blind eye in return for a favour or two.  I’m not sure I could come up with anything more outrageous, more horrific, less compassionate, than what is actually happening, though.  I’m quite sure I never would have dreamed that responsibility for universal health care would no longer be a government duty.

I’m not sure if we can save our NHS. I am pretty sure it will never be the glorious thing it was when our generation was growing up, and I seriously doubt our children will get healthcare free at the point of use for the rest of their lives. I fear for people who, like me, have chronic illness and use the NHS and its services on a daily basis.  For the terminally sick, the disabled, and the old.  And never would I have imagined that such an important institution would slip through our fingers so quietly, so unnoticed, so unreported as it is. (See a an excellent overview of what is happening here, by committed campaigner, Marcus Chown)

We have to keep fighting, protesting, signing petitions, writing to MPs, screaming at Cabinet Ministers, doing whatever the hell we can to halt the demise of our NHS.  I hope we can. I hope we will. I know it’ll take a lot more than a bit of satirical radio.


  1. Lovely writing: clear, astute, relevant, funny, committed. Good to see something of 'our' struggle as disabled writers/filmmakers to go mainstream. if you ever want to develop a script let me know. best wishes, Ron Moule at

  2. I figure if Dallas can be resurrected, there's no reason Trust can't find an audience today. We take a perverse pleasure from entertainment that shows us just how despicable our socio-political and economic puppet masters really are.

    As for your NHS, it's been a source of alarm for me to monitor from afar and I don't believe it's a coincidence that the greatest attacks to it have occurred concurrent with the efforts here in America to move closer to what you've enjoyed on your side of the pond for decades.

    Here's a free story pitch for you should you resurrect Trust: Your former hospital manager is re-engaged to run a hospital by a politician in bed with American conservatives who want to hold up the flawed, failing NHS as a cautionary tale to dishearten all of us here who have envied it so long. It probably isn't far from the truth.

  3. Well-written and well said, as ever, Wendy. I dread to think, if we don't carry on campaigning, what the NHS will have become by the time my children grow old, or perish the thought, sick or disabled.