Gary took a job with NHS 111 during the COVID lockdowns. He’s still there five years later. Gary is a kind, straightforward, innocent sort of bloke. He believes his job is to help people.
First mistake.
‘Productivity is key!’
Sam Macgregor’s new play Hold the Line reveals the stark reality of life as a ‘health adviser’, ie someone paid to answer the phones in an NHS 111 call centre. This is not the caring, sharing NHS we like to think still exists; this is a business run on corporate principles. Targets, wait times, avoidance of blame; these are its key missions. A Big Brother-style voiceover constantly reminds Gary of the company’s needs.
‘It’s what’s best for the service.’
Like life, Hold the Line blurs the boundaries between comedy and tragedy. Performed by Macgregor and co-performer/producer Gabi Chanova, who each take several roles, it shows us the results of treating people as numbers and products. Gary’s phone rings constantly, he must process his target number of calls per hour, move people along, triage serious issues upwards. But when he tries to do just that, there is simply nowhere to send them. Toni, the physician charged with the thankless task of allocating doctors to calls, has no-one available. The caller is put on interminable hold. And Gary – an unqualified call centre worker – is asked to confirm that he has obtained every bit of relevant information about their situation.
Meanwhile Toni rushes around the room, constantly on her way to plug another hole in the rapidly sinking ship. Always on the move, Chanova conveys the frantic desperation of a woman under unsustainable pressure, forced to make decisions that can never please everyone. Gary expresses his frustration and panic in his own quiet way, head in his hands, seeking distraction in the occasional (forbidden) glance at clips of old films. At one point the two of them do a hilarious, terrifying, disco dance with their phones, ending up in a knot of confusion. Gary’s expression is blank; he is overwhelmed.
Macgregor based the play on his own experience of working for NHS 111. Not every call is a matter of life or death; many are ridiculous, some are abusive. It’s Gary’s job to weed these out and focus on the serious stuff; stuff for which his only training is a set list of questions, ones he plods through with diligence, often incurring the wrath of the person on the line. When he answers a call from the panicking son of a man slipping into a diabetic coma, he does everything he’s been told to do. When that turns out not to have been enough he is devastated, and hopes for time to process what has happened. Instead he is visited by his super smooth manager (Chanova), whose thinly veiled concern for his welfare (‘Have a cup of tea! Have a biscuit!’) is soon revealed to be a far greater concern for The Company than for its least valued employee. Liability, avoidance of, is all that really matters. Gary, who was only trying to do his best, will be the subject of intense scrutiny. If blame’s going anywhere, it’s going straight to him.
Whilst Hold the Line scrutinises the failings of an underfunded system, it also reminds us that front line NHS workers are still first and foremost dedicated to helping people, not crunching numbers. Despite all the pressures, they can still work miracles. Gary still tries to chat with people on non-urgent calls who enjoy a bit of banter (even if sometimes it turns out they don’t…); some of their conversations are very funny. Gary may not be perfect but he still cares. When he takes a call from a lonely suicidal man, he breaks protocol to hold out the hand of empathy in a way that is truly touching.
Johnny Phethean’s soundtrack to the show is well chosen, with tracks like Call Me, Staying Alive and HELP! all serving to underline the message.
At times Hold the Line can be a little too heavy-handed. Toni’s diatribe about the root causes of the NHS’s problems, while accurate, does border on a lecture. That aside, this is a fast moving, thought-provoking and entertaining play on a subject of vital importance to us all.
Next time you call NHS 111 remember Gary. Like all frontline workers, he’s doing his best.
Hold the Line, directed by Laura Killeen, is at Venue 33, Bunker at Pleasance Courtyard, at 4.25pm every day until 25 August. There is no performance on 18 August.
