Malpractice review: ITV’s new medico-crime drama is like Casualty meets Line of Duty

Niamh Algar plays a doctor caught in the centre of a scandal at an NHS hospital that’s under extreme pressure

In ITV’s Malpractice, (the title is a bit of a giveaway), a dedicated but stressed-out emergency doctor, Lucy Edwards (Niamh Algar), finds herself accused of negligence following the death of a young drug overdose victim, Edith Owusu. Edith’s treatment is temporarily sidelined when a blood-spattered kid and an armed man bust into A&E, and Lucy has to make split-second decisions about priorities. There’s not enough beds, and, as the duty nurse asks her, who’s she going to give the space to – the child bleeding to death, or the “junkie”, now stabilised? In this fast-cut busy opening sequence, Lucy delegates the routine task of looking after the overdosed girl to a fairly incompetent but devious junior (Priyanka Patel as Dr Ramya Morgan). We see that it is she, not Lucy, who gets mixed up about Edith’s dosages, with lethal results; but Dr Morgan is a more plausible witness than the troubled Lucy, who gets the blame dumped on her.

When Edith’s influential father demands an investigation by the NHS Trust, Lucy has no choice but to cooperate. But she starts to behave increasingly shiftily, covering things up, and generally living in fear of the pseudo-cops of the hospital Medical Investigation Unit – an unlikeable pair played with controlled bureaucratic menace by Helen Behan (as Dr Norma Callahan), and Jordan Kouame (as Lucy’s former colleague, Dr George Adjei).

Bad as things are for Lucy, challenging new questions keep cropping up, and these are what keep us interested, though it takes an overly long time to develop the storylines. How did Lucy apparently know that a drug overdose victim was arriving before the ambulance turned up? Who is “Rose”, who keeps calling her and wanting to meet? Why is Lucy on drugs (“stress pills”) herself? Why did she take a lengthy leave of absence in the middle of the pandemic? (A rare reference to Covid-19 in a drama, by the way.) Why does she seem so close to the senior consultant in charge of A&E, Dr Leo Harris (James Purefoy)? And what is the connection between her and the investigator George?

In the circumstances, it’s no surprise that she starts cracking up and that her relationship with husband Tom (Lorne MacFadyen) fractures as inevitably as a pensioner’s hip, but less easily repaired. It all adds to the sense of impending self-destruction, and Lucy’s lies begin to get the better of her.

Malpractice, then, has most of the necessary ingredients to be another Sunday night ITV drama success. The team (writer Grace Ofori-Attah, who used to be an NHS doctor, and director Philip Barantini, who made the brilliant one-shot film Boiling Point) successfully recreate the atmosphere of an NHS hospital under extreme pressure. Rather cleverly, they also manage to combine the classic elements of a hospital drama with those of a police procedural, as if Casualty found itself in a collision with Line of Duty. Malpractice is thus a sort of Sunday night medico-crime BOGOF offer for the viewer, and it works.

I do have a couple of gripes, however. I don’t mind the incomprehensible medical jargon that is standard procedure on these shows nowadays, but I do object to being subjected to an explicit, close-up shot of a syringe extracting blooded spinal fluid, just as I’m having my tea and biting into a plum tomato. This unfortunate coincidence left my kitchen table looking like Lucy’s operating table. But the more fundamental issue is that, for all her gritty determination, love for her family, and obvious good intentions, Dr Lucy Edwards actually doesn’t seem to be all that good at her job, and I’d have no compunction in firing her for the sake of patient safety. She’s just too scatty, undisciplined and prone to error to trust her with your life, or, indeed, a prime slice of your Sunday evening. Doctor Lucy is supposed to be a challenged, yet sympathetic, cool character, but I’m afraid she just leaves me cold – like too many of her patients, unfortunately.