Annie McCartney Tackles Compensation Culture in Radio 4 Play

The author and playwright turns her sights on the NHS in Afternoon Drama slot

Who/what/where/why/when is Annie McCartney?

I am primarily a playwright and author, though I still think of myself as an actor. Most of my work has been in radio drama, but I have also I have written three books: Desire Lines (which won World Book Day for Northern Ireland 2003) Your Cheatin’ Heart, and Two Doors Down.

I have also written some short stories for both Radio 4 and RTE, who provided me with my first computer when I won the PJ O’Connor Award in 1994. I am currently working on a new book, which is proving a lot harder than I would like since it is very different from the others.

Your new radio play, The Biggest Issues, is the Afternoon Drama on BBC Radio 4 at 2.15pm on Tuesday, April 24. What is the play about?

It's a tale about a hard-working cardiologist who makes a perfectly good call about a patient not being fit for a 'stents' operation because she is dying and obviously wouldn't survive. The family of the woman have other ideas and go to a local radio station and start a campaign against the doctor. It deals specifically with the high expectations people now have regarding cures, the government rundown of the NHS, and the compensation culture that is now so prevalent everywhere. 

Who stars as who?

I was very lucky with the cast. It features Maureen Beattie as the cardiologist, Conleth Hill as her husband, Ian McElhinney as the hospital CEO and Eleanor Methven as the talk-show host.

What made you write the play? Personal experience, or simple curiosity?

Both. There is so much chat about the NHS in the news these days, and we are really developing a compensation culture here. It is discouraging. The NHS, and by implication hospital doctors, have not been receiving very good press recently.

I know a lot of doctors, both friends and family, and I can see many of them are overworked and under-appreciated. Their hours are long – in many cases as much as 12 hours per day – and all the mythical salaries they are paid don’t exist (at least outside the private sector). Most of the doctors that I know well work purely for the NHS.

What are your thoughts on the Tory government's proposed changes to the NHS: good, bad or indifferent?

As a result of the latest health bill I fear our health service will be in the same state as American medicine within ten years. That is put simply. No money, no treatment. We will be moving by default on to private health insurance, and those with money will get the best treatment.

I think the Tories are destroying the NHS with these 'reforms', which a vast number of doctors are opposed to. What is happening is privatization by stealth. Currently, increasing amounts of NHS work is being done by private health care companies, and there are several US companies lining up to ‘help’ GPs run the service. Then, of course, it will be all about profit and the shareholders, not about patient care.

Can the NHS stand up to our increased demands for instant results, or is change inevitable?

Because of ‘Dr Google’ many people think they know so much more about their ailments and have unrealistic expectations and demands. While this may not necessarily be a bad thing, the costs of investigations and drugs are rapidly rising, and people expect tests for everything. The NHS can’t afford this without some changes and controls.

There is little doubt that restructuring is needed to cope with a steadily increasing number of people living longer (ironically, due to better health care). Therefore I think a certain amount of change is definitely needed, but it was slowly happening anyway.

A trimming down of bureaucracy and allowing doctors to have more say is essential, and there is – to use the cliché – a need for more ‘joined up thinking’. But to suddenly impose a whole new plan at this point in the changes is lunacy. To use another cliché, I think they are ‘using a sledgehammer to crack a nut’.

A large proportion of GPs don’t want the responsibility of managing their particular region of the Health Service, and feel they are trained to care for patients, not to decide how much certain operations should cost or where to source best value for them. I can see problems ahead.

What is your view on talk radio shows? Are they really necessary?

Absolutely. I believe they are a vital part of our democracy. We couldn’t do without them. I worked for five years on live radio in the USA. I could see then that the ‘phone-in’ has become a reliable way for people to air their opinions. But I have noticed that increasingly it’s more about the opinionated presenter than the issue, and there is so much disinformation and endless hours of rubbish talked that I sometimes turn the radio off and take refuge in my own music, or listen to Radio 3.

Have you ever felt the need to phone in during a debate?

Yes of course, all the time, but on the few occasions I did try I didn’t get through. Afterwards I was glad because I probably would have talked absolute rubbish in the heat of the moment and regretted it.

The Biggest Issues seems like something of a departure for you... Can we expect touches of your customary humour in the drama, or is this a straight up 'issues' piece?

The Biggest Issues is serious, though my last play was a comedy about a woman who had a relationship with a fridge. When James Nesbitt accepted the part of the fridge he did ask me who was doing the costumes! I do prefer to write comedy and my series Two Doors Down was 'comedy drama', but about half of my plays have been serious, or dealt with serious issues.

Who would you most like to listen to the play, and what would you like them to take away from it?

I’ll be happy if anyone listens to it. The Afternoon Drama is a good slot since it’s on just after The Archers, and also people doing the school run can catch it. And of course iPlayer is great. But I suppose I would like people who have listened to it to think about some of the media/tabloid 'causes' and consider whether some group or person is being excessively victimised.

Also, focusing on doctors, people expect a lot of responsibility and care on the part of doctors and this role/relationship will be damaged if they are constantly being attacked. There is a risk that the profession will cease to attract promising young people, with inevitable unwanted consequences. I would hate this to happen.

What's next on the agenda?

My fourth book, Memory and Desire, and maybe a stage play. I have always wanted to write a stage play. I haven’t quite worked up the confidence for that yet – at least people can turn off the radio or choose not to finish a book. I do have an idea I am playing around with. I sort of alternate between that and the book... Then I sometimes end up playing Solitaire and deciding to give up writing.

The Biggest Issues airs on BBC Radio 4 at 2.15pm on Tuesday, April 24