“I’m not going in there. It’s full of sick people; I’ll catch something,” says an injured boxer admitted to hospital at the start of Carry On Nurse (1959). It’s a gag that takes on an ominous topicality at a time when hospitals are perceived as such perilous places that even sick people have been trying to avoid them, and where inadequately protected hospital staff are as much at risk from the Covid-19 pandemic as their patients.
It’s not supposed to be like this, according to decades of films and TV soaps in which doctors and nurses are more at risk of broken hearts than broken healthcare systems, and even these can be fixed. George C Scott as Dr Bock in The Hospital (1971) is impotent, alcoholic, suicidal and given to portentous monologues: “We have established the most enormous medical entity ever conceived, and people are sicker than ever. We cure nothing! We heal nothing!” Luckily, a one-night stand with a patient’s daughter (Diana Rigg) leaves Bock’s morale, libido and idealism instantly restored.
There are few institutions as dramatically versatile as the hospital, with its ensemble casts and many subplots. Hospital-set TV series are legion; the longest running American daytime soap is General Hospital (1963-present), and one of the most influential was ER (1994-2009), conceived by onetime medical student Michael Crichton to reproduce the chaotic pace of a real emergency room via a pell-mell of overlapping storylines, jerky camerawork and medics shouting “clear!” as they apply paddles to patients’ chests.
The hospital is mined for comedy in sitcoms (Scrubs, Green Wing) or films such as Young Doctors in Love (1982), which tried – and failed – to do for hospitals what Airplane! had done for passenger jets. In Doctor in the House (1954), Dirk Bogarde and Kenneth More play medical students who pursue women and play pranks; six sequels and a TV spin-off would continue in a similar vein. With its bedpans, sponge baths and visitors’ bodily fluids, hospitals are petri dishes for sexual and scatological humour. Even esteemed documentarian Frederick Wiseman, in his Emmy-winning Hospital (1970), is unable to resist an explosion of sustained hilarity when an ailing junkie responds to emetic treatment with Mr Creosote levels of vomiting amid the grim reality of an east Harlem hospital awash with child neglect and social deprivation.
Hospital settings are reworked as whodunits in TV’s House or Sidney Gilliat’s magnificent Green for Danger (1946), starring Alastair Sim as a cocky detective investigating a murder in a rural hospital during the second world war. It provides backdrop for historical drama (The Knick) or ghosts (Lars von Trier’s The Kingdom). The building itself, already steeped in sickness and death, is a virtual haunted house of labyrinthine corridors, basements and morgues, making it the perfect setting for horror movies or psychological thrillers (Visiting Hours, Halloween II, Desperate Measures et al) in which serial killers fell staff and patients like unstoppable viruses. Even Paddy Chayefsky’s Oscar-winning screenplay for the aforementioned The Hospital is structured around the serial murders of hospital staff.
Nefarious malpractice abounds in thrillers such as Coma (black-market organ trading), Extreme Measures (Gene Hackman’s neurosurgeon experimenting on the homeless) and Anatomy (a secret society of neo-Nazi vivisectionists). John Collee’s razor-sharp screenplay for Paper Mask (1990), while ill-served by drab directing, shines a critical light on hospital hierarchy – and the tendency to close ranks when something goes horribly wrong – through its story of a porter (Paul McGann) who steals the identity of a dead doctor and escapes exposure only thanks to the medical know-how of a sympathetic nurse (Amanda Donohoe).
Yes, the hospital is a microcosm of society. “Obviously I meant that to be the health of the nation as well,” Peter Nichols confirmed with regard to The National Health (1973), adapted by the playwright from his Old Vic hit. The film contrasts everyday life in a London hospital ward (a young Bob Hoskins plays one of the patients) with a hospital TV soap showing on the ward television – though the soap is filmed in such a ridiculously exaggerated way that one wonders if Nichols or his director, Jack Gold, had ever actually seen one. The workplace smoking and paedophiliac innuendo have dated; the overworked intern nodding off over her stethoscope (“I’ve been on duty for 19 hours”) has not.
But for definitive state-of-the-nation statements, look no further than Lindsay Anderson’s Britannia Hospital (1982), concluding part of his Mick Travis triptych after If… and O Lucky Man! Leonard Rossiter plays a harassed administrator preparing his hospital for a visit from the Queen Mother while kitchen staff work to rule, rioters storm the gates in protest at an African dictator being treated in the private wing, and Travis himself (Malcolm McDowell) investigates the mad doctor (Graham Crowden) conducting secret Frankenstein-type experiments with Grand Guignol results.
Anderson’s film opened in UK cinemas in the middle of the Falklands war, which had triggered a wave of jingoism that boosted support for a government struggling with recession, unemployment and civil unrest. It just wasn’t done to talk Britain down. “I could see that the image of the headless torso waving a union jack was not a good idea,” Anderson wrote of a prospective poster design.
With some notable exceptions (including David Robinson in the Times and Alexander Walker in the Evening Standard), the British press gave Britannia Hospital what Anderson described as “a frightful pasting”. The Daily Mail huffed: “Would any other country stand for a film that portrays us all as mad?” and even the Guardian, NME and Time Out, which one might have expected to be more receptive to Anderson’s social satire, frowned on his take-no-prisoners swipes, not just at privatisation and police brutality but leftwing mobs and unions, the latter led by an obstreperous official (played by the peerless Robin Askwith, alumnus not just of Confessions of a Window Cleaner but the lunatic low-budget carnage of Antony Balch’s Horror Hospital) only too willing to suck up to royalty at the hint of an OBE.
Britannia Hospital did for Anderson’s career what Peeping Tom had done for Michael Powell; it would be the last theatrical feature he would make in Britain. But the film pinpointed national deficiencies that would only become more pronounced in years to come, including stealth privatisation and the systematic undervaluing of key workers (Britannia Hospital’s shiny new Kipling Ward is unoccupied because there aren’t enough cleaners).
Meanwhile, one waits in vain for the British Film Industry to come up with anything half as sad or incisive as The Death of Mr Lazarescu (2005), Cristi Puiu’s social-realist tragicomedy of a terminally ill widower’s epic journey through the Romanian health service. It’s impossible to watch the old man’s condition deteriorating without reflecting on the way our own society sees its senior citizens as expendable; Puiu’s film may be set in Bucharest 15 years ago, but add face masks and it could be Britain now.
For social realism in British hospitals, we must look to TV. When Paul Unwin and Jeremy Brock first pitched Casualty to the BBC, their proposal read like a manifesto. “In 1948, a dream was born – a National Health Service. In 1985, the dream is in tatters.” Unwin told the Radio Times: “We were passionate, leftwing and both of us had recently been in hospital so we knew what stories there were to tell and how we wanted to tell them.” Needless to say, Margaret Thatcher’s government didn’t take kindly to plots highlighting NHS underfunding and poor hospital conditions, and after only a handful of episodes the BBC was persuaded to tone it down.
Nevertheless, Casualty continues to skirt controversy. Only last month, much to the outrage of regular viewers, an episode was yanked from the schedules with the announcement: “The episode we were due to watch tonight, filmed before the spread of Covid-19, was considered inappropriate to show at the moment.” All that was left was a recap containing a glimpse of hazmat suits. One might have thought that now was precisely the best time to show the episode; Casualty couldn’t do worse than the UK government in disseminating public health messages. To judge by the way Steven Soderbergh’s Contagion (2011) shot up the streaming charts earlier this year, a sizeable portion of the public learned more about pandemics from that film than from official sources. Indeed, if only the Sage committee had paid attention to Contagion when it first came out, they might have taken those early reports from Wuhan more seriously.