Interview | Mark Thomas – Check Up: Our NHS at 70

By Maisie Marston

Mark Thomas’ is best known for the Channel 4 show ‘The Mark Thomas Product’; a satirical standup format which ran between 1996 and 2002. Thomas’ most recent projects have combined comedy, investigative journalism and the theatre to highlight issues like freedom of speech in Palestine. Now the activist has shifted his attention to the UK’s beloved NHS.

Check Up: Our NHS at 70 will be performed in Cardiff on Thursday 28th February at the Sherman Theatre. The show is based on a series of interviews with leading experts and residencies in NHS hospitals and surgeries. It paints a broad picture of what is going wrong; how we can fix it; and what this may mean for our futures.

The last show you toured was Showtime from the Frontline which was about Palestine. What made you turn your attention to the NHS?

Whenever you write as a performer you want to create new things and new ways of doing shows. You also want to write about different things. I wanted to write about the NHS because this is the institution that all of us will need most. It is the institution in the British state that all of us will visit and depend on at some point in our lives. It’s probably the most important institution we have and it’s under enormous pressure; I think you could describe it as an attack.

What do you mean by attack?

The NHS has been underfunded and undervalued, I think everyone will agree with that. The effects of constant outsourcing and re-tendering of contracts in England has been enormous. It’s not just an attack from people like Hunt and Hancock but also because of austerity. Every single person we spoke to said if you fix social care, you’d be able to free up the NHS.

There’s an example I like in the show where one of the doctors I meet talks about a patient she had with swollen legs. She says: “ah, that might be blood clot so you have to be careful, could be dangerous”. In the end she had to do some detective work and turns out, the patient was an intravenous drug user in the nineties who got clean in the noughties, got on a program, got rehoused, got a job and got into a relationship. Then in 2010 when the relationship broke-up he moved out, became homeless, ended up sofa surfing and started re-using. So now there are no programmes for him to get onto. This is literally the failure of social care in a man’s legs.

Do you think Brexit is only going to make this worse?

We’re 40,000 nurses short, go figure! How’s Brexit going to help if we’re demanding that: “they need to earn over £30,000 before they can apply to come in”. How’s that going to help with nursing? I think Brexit has created its own hostile microclimate that dissuades people. And once it comes in it’s going to be even harder to get staff.

Whilst you were doing your research, you were talking to NHS staff, were there any stand out experiences which have stayed with you since?

I mean that’s what the show is! There’s a whole load of things, we spent an evening in the major trauma unit which I wasn’t expecting. I thought I’d get a short tour but ended up staying the evening and it was full on. I was left hugely impressed by what people do, but I especially loved the dementia nurses because of their level of care they expend.

There’s a woman on one of the wards who has dementia who says: “oh, I can’t eat my dinner unless I have a glass of red’”. Now of course you can’t go around dishing out Beaujolais on a medical ward where people are on umpteen drugs. You can’t do that. So what the nurses did, out of their own money, they bought non-alcoholic red wine, and just didn’t tell her. They just went, “there you go love, there’s your glass of wine”. What I witnessed was lots and lots and lots of acts like that.

Did you notice that there was a difference in attitudes towards the NHS from the people you spoke to in the NHS and the policymakers and economists that you talked to?

Yeah there are different attitudes towards the NHS. I mean it’s interesting because there are four different NHS’s: England, Wales, Scotland and Northern Ireland. And the differences between them are important. Some are privatized, some charge for a prescription and some have hospital car parking charges. But, what’s interesting was that in Scotland the BMA, the guy there was just sort of like: “the NHS needs critical friends because there’s bits where we’re not doing well and we need to do well.” He said that we need to stop seeing the NHS as the most beloved, cherished service and start saying that, “it’s a thing where if you put an average amount of money in you’ll get an average amount of health outcomes out the end.”

Do you think this attitude is also reflected in the attitudes of the policymakers?

Interviewing policymakers, was really interesting. People like ex-health minister Frank Dobson apologised. He basically apologised and said his biggest regret was PFI. He’s very vocal on leading the charge against what’s happening now. I mean this makes you think, well, bit late mate but, better late than never I suppose. There were also others like Lord Darzi though who supported the changes.

What are you hoping people will take away from your show?

Apart from a copy of the play script and some merchandise! I think there’s enough in there to shock people. We start on the issue of health, of why the NHS was founded and also talking to the people like Professor Marmot who look at health inequalities and are very open about it. Michael Marmot’s academic research says that the main determinants of someone’s health lies largely outside the NHS. Bad housing creates bad health illiteracy. Bad diet, unemployment, homelessness, all of these things create health outcomes. The show starts with that point that if you are looking at health, we have to look at the enormous burden that needs to be shouldered outside the NHS as well as inside. It’s about social care as well. So what do I want? I want people to come away with a nice big fat picture of the NHS. I want them to be shocked by some of the stats and facts and moved by the stories.

Do you think that there is something that the everyday person, rather than the policymakers, can do to help secure a better future for the NHS?

I think the thing that you can do is to recognize that it is a political being. To paraphrase Jeremy Hardy, The NHS is ‘socialism at work’. You fund it with taxes, we all contribute what we can and take what we need. It’s a political concept from start to finish. It was socialists that brought it in: they introduced it, they created it, they fought for it. In my opinion, if you want to improve the NHS, then you should make sure that your pen doesn’t slip to the Tory box.

The other thing I’d add about the show is that the chief medical officer of England we interviewed has invited us to perform the show for the department of health. So that’s quite cool. It’s nice to be in the room with people who’ve got their hands on the levers.