This Is Going To Hurt Is A Brutal Look At The NHS (& It’s A Comedy)

We can all agree that being tired at work is never a good idea. Whether it's down to late-night drinking or getting up in the early hours with a newborn, working on little sleep rarely creates the desired outcome. For many that might mean typos in emails and files going unsent; in the NHS, working while tired can mean the difference between life and death. This sobering statement forms the basis of the BBC’s newest medical drama, This Is Going To Hurt, alongside wider conversations about the state of staffing, funding and quality of care in Britain’s NHS.

Based on the bestselling memoir by Adam Kay, the seven-part series explores the medical profession from a first-person perspective, pulling on Kay’s experience as a junior doctor in the early 2000s. The first episode begins with Adam (Ben Whishaw), the acting registrar in the obstetrics and gynaecology department of a London hospital, waking up inside his car. Exhausted and drowsy, he barely makes it to the hospital steps before he’s greeted by a woman in the throes of labour.

Checking under her hospital gown in the middle of the car park, Adam discovers that the baby has already started its journey Earth-side as a hand appears from between the patient's legs. In a race against time, he makes use of some slightly dodgy service lifts to get the patient safely to a ward and deliver the baby, all before a morning cup of coffee. Despite this somewhat stressful beginning, the book’s dark humour comes thick and fast, with a fourth-wall-breaking monologue introducing the name of the ward as "brats and twats". 

It’s this gallows humour that makes the series feel shiny and new, a world away from the hero complex-ridden medical shows of old. Adam’s comedic coping mechanism isn’t appreciated by everyone on the ward, however, not least hospital newbie Shruti (Ambika Mod). As the pair fly from patient to patient, it's clear that she’s struggling to cope on the job, with everyone too busy to teach her the real-world mechanics of delivering babies. Under Adam's supervision, she's finally given the chance to grab life by the forceps – which unfortunately results in a valuable lesson about tearing.

Shruti gets the chance to redeem herself when a woman heads to surgery in need of a Caesarean. But the exciting professional moment comes crashing to a halt when she is forced to deal with a racist patient. The expectant mother – who has been warned about her behaviour already after making comments to a midwife – leaves no doubt about her sentiments by demanding that Adam deliver the baby instead of Shruti. But with a curtain in between them, Shruti is encouraged to perform the C-section, putting her duty of care above all else to expertly deliver a baby.

While the show’s first episode focuses on many of the routine pressures facing NHS staff, the impossibility of a work-life balance for hospital workers is a steady theme throughout. We see Adam's personal life on the brink of disaster as his boyfriend and loved ones take a back seat to his 97-hour work week. This all comes to a head when he's finally able to escape the ward to attend his best friend's stag do. Exhausted after a double shift, he makes his way to the pub to wash away the day with a gin and tonic. Yet almost immediately on arrival he's called back to the hospital, where he’s greeted with skeleton staff and an emergency patient. 

This Is Going To Hurt has its funny moments but underneath the stained scrubs is a story about the horrifying, real-world implications of a slowly sinking NHS. Throughout the myriad high-stakes storylines, the pipeline for disaster is clear to see: underpaying staff leads to staff shortages, staff shortages lead to overworked staff, overworked staff leads to improper care and improper care leads to fatal consequences. Applying this formula to obstetrics and gynaecology proves how much the politics of the NHS is a feminist issue by pinpointing the disastrous emotional and physical effects that government failings can have on women.

On the surface, This Is Going To Hurt wins with its realistic bodily fluids and wholly believable performances. But its true triumph is the unflinching portrayal of a system in crisis. Beyond the graphic surgeries and births, what actually makes This Is Going To Hurt hard to watch is the knowledge that these circumstances are a daily truth for those on the front line. Set in 2006, the series shows the state of the NHS even before years of increased budget cuts, a financial crash and a global pandemic. It begs the question: how close is the system to breaking point? Whatever the answer, we owe the NHS more than a rainbow or a clap. We owe it everything.