Do you have a recurring stress dream? Of the Americans who suffer from nightmares – America is, I suspect, the only country that would commission this polling – 39 per cent of them are afflicted by terrors about work. Being late, being unprepared, making a mistake: we all know these anxieties, not to mention the sense of relief when you wake up and discover you haven’t made the error, haven’t left a glaring typo in your reveiw. But what if something terrible did happen? This is the fear that Malpractice, the ITV drama about healthcare professionals under extreme pressure, plays upon as it returns for its second season.
Tom Hughes is Dr James Ford, a brooding psychiatrist with designer stubble, working on an overstretched unit. “You have no idea what this department is up against,” his boss, Kate (Zoe Telford), warns. But the fortunes of both Dr Ford and his beleaguered colleagues take a further dive over the course of a day. As the on-call registrar, Ford is sent to attend a postpartum consultation with a mother, Rosie (Hannah McClean), who is struggling. At the same time, he’s supposed to be attending a sectioning under the Mental Health Act. Tugged in two directions, he fails to offer either patient sufficient support, incurring disastrous consequences and the wrath of obstetrician Dr Sophia Hernandez (Selin Hizli). With one of his charges dead via an apparently needless set of circumstances, is Dr Ford to blame? Or was there a more complex chain of events that led to the tragedy?
The premise of Malpractice is simple. We watch disaster unfold with most – but not all – the cards on the table. We see the pressures being faced, and watch as human error slips into high-stakes work. We are encouraged to sympathise with both patients and doctors, and then watch as the investigatory process scratches away at the facade of propriety. This is not a medical whodunnit like House nor a hospital drama like Fox’s The Resident. Instead, the setting is relatively incidental to that most human of tendencies: the blame game. “Don’t you dare put the blame on me!” Sophia reacts when the finger takes its turn to land on her. “It’s on both of us,” Ford assures her. But soon they will be at loggerheads.
And in the current environment, where we are greeted every day by news headlines about systemic failings in the NHS, and where horrific acts of personal responsibility, like the murders by Lucy Letby, are married in unholy union with underfunded, overworked and profoundly broken fail-safes, it is refreshing to see a hospital drama spread the responsibility. Elements of melodrama naturally seep in (this is ITV after all), such as an illicit affair between a boss and employee, which precipitates an inexplicable suicide attempt. But the show’s creator, Grace Ofori-Attah, generally shows admirable restraint. The sequence of events that leads up to the scrutiny placed on doctors Ford and Hernandez feels plausible – all too rare a plaudit when it comes to medical drama.
It is also all too rare when it comes to British TV. ITV’s recent series Playing Nice, which was also scripted by Ofori-Attah, opened with a premise of genuine moral complexity – what if your children had been accidentally swapped at birth? How would you navigate that realisation as the parent of a toddler? – and then descended into psycho-farce that culminated with someone being pushed off a cliff. This twisted tendency towards excessive spectacle demonstrates a lack of belief in the ability of audiences to connect with a drama that is both tense and relatable. But Malpractice shows – like TV’s biggest hit of the year so far, Adolescence – that there is something gripping about watching a scenario right at the fringes of your personal fears. And being investigated for a mistake at work is a stress we can all appreciate, whether you’re a psychiatrist or a dog-walker or a bricklayer or a TV critic.
Malpractice might not sublimate the instinct towards sensation quite as effectively as Adolescence, but they are tonal siblings in how they present the spiral of a nightmarish situation. Because we all fear the label of “incompetence”, we can all inhabit the drama of Malpractice in first-person, like the world’s bleakest video game. It’s proof that in order to be gripping, you must first retain your grip on reality.
‘Malpractice’ season two is on ITV1 and ITVX
