Malpractice, ITV1, Series 2 review - fear and loathing in the psychiatric unit

Following on from the first series of Malpractice in 2023, this second season again probes into issues of medical malfeasance and institutional corruption, in an environment where patient care frequently comes second to internal politics and self-preservation. The protagonist first time around was Niamh Algar’s Dr Lucinda Edwards, but this time it’s Tom Hughes as Dr James Ford, who works as a psychiatric registrar at the fictional Queen Mother’s University Hospital.

Writer Grace Ofori-Attah had personal experience as an NHS psychiatrist, which has undoubtedly helped to lend the show a sense of frequently uncomfortable plausibility. The real-world NHS seems to be in a permanent state of crisis involving funding, staffing and horrific waiting lists, and that perception is accurately mirrored here.

The opening emergency which sets up the series is a case in point. Dr Ford is feeling the pressure as he’s called on to attend to two cases simultaneously. Consequently, his assessment of new mother Rosie Newman, who seems to be suffering some kind of mental disturbance, is somewhat cursory, as he merely asks her a preset checklist of questions. However, it satisfies him that at present she’s no danger to herself or anybody else, and he dashes off to attend to the other case, the sectioning of a psychotic patient, as ordered by his supervising consultant Dr Kate McAllister (Zoë Telford, pictured below).

But it all comes back to bite him when Mrs Newman suffers a disastrous deterioration, and Ford finds himself a horrified bystander as she throws herself off the hospital’s roof. Inevitably his all-too-brief assessment of her condition comes under scrutiny from the scary Medical Investigation Unit (MIU), and before he knows it he’s facing the threat of a Fitness to Practise assessment.

The MIU investigators Dr Norma Callahan (Helen Behan) and Dr George Adjei (Jordan Kouamé, both pictured below) are returning from the first series, and will presumably feature in any future ones, and their forensic adventures sometimes makes Malpractice look like Line of Duty with doctors. The MIU certainly seems to wield a remarkable range of powers, like trawling through phone records and having access to police traffic surveillance cameras.

However, their thoroughness will ultimately bear fruit, as a trail of incompetence and confusion is gradually unravelled during the course of their investigation. Dr Ford may not be blameless, but he can certainly claim mitigating circumstances, including punishing deadline pressures and the hospital’s skeletal staffing levels.

Particularly dispiriting is the willingness of his fellow-medics to throw him under a bus to protect their own positions, though he’s by no means the only victim of this. The hospital is portrayed as a Darwinist dog-eat-eat environment, where rule number one is to keep your own back covered at all costs. Hence, even Dr McAllister can’t be entirely trusted, while Dr Sophia Hernandez (Selin Hizli), who supervises the maternity ward, is similarly reluctant to own up to any failings on her own account.

But they say a fish rots from the head, and a trail of cynicism and turpitude leads steadily upwards towards the boss of the hospital’s trust, Dr Eric Sawers (Rick Warden). It seems there may be more to the threatened closure of the psychiatric unit than merely its dubious medical track record, while prioritising costs over patient safety has led to hideous suffering for numerous mothers in the maternity unit.

Gruesome as it is, this makes for addictive viewing. Maybe give it a miss if you’re due for a hospital visit, though.

• Malpractice continues on ITV1 at 9pm on May 5,6,11 and 12. All episodes available on ITVX

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