Review
Ageing
Assisted dying
Culture
5 min read

For love there is no charge

Out of mind old people are at the centre of Allelujah! Sian Brookes reviews the film adaptation of Alan Bennett’s play.

Sian Brookes is studying for a Doctorate at Aberdeen University. Her research focuses on developing a theological understanding of old age. She studied English and Theology at Cambridge University.

In a hall decorated for a celebration a person stands in front of a seated group, all have their arms raised in celebration.
Jazz hands at the hospital.
BBC Films.

Spoiler alert – this film review reveals significant elements of the plot. 

Allelujah! is not a film that shies away from the big issues. In fact, you would be hard pressed to find a big issue this comedy/political commentary/drama/part-thriller doesn’t at least make reference to (and yes, it spreads itself across all of these genres too). With such an eclectic approach it is difficult at times to keep up with the narrative, and the deeper meaning of the film. Based on the Alan Bennett play, the plot centres around The Bethlehem, a small northern hospital for geriatric patients, which is facing closure due to the Tory government’s efficiency drive. It focuses on two members of staff, Alma Gilpin, a stoic and matter-of-fact but seemingly excellent nurse who has served the hospital her entire career, and a younger Dr Valentine. Other protagonists include an ex-miner patient and his son, a management consultant who has “made it” to London and is currently advising the Health Secretary to close hospitals such as the one in question for the sake of government finances. 

Whether it’s politics or the personal, this film has it all. It deals with levelling up, the cultural and economic gap between the north and south, the challenges of budget cuts in the NHS, the problems of a national health service claiming to 'care' but with managers more preoccupied by Westminster’s economic priorities. It depicts families waiting for older relatives to die in order to grab their inheritance, the broken relationship between an ageing man and his son, and those all-important stories of the older patients’ lives well-lived. And yet as the story line develops, a plot twist emerges which comes to overshadow the entire film, and in the process speaks to what is perhaps the most poignant of the many discussions it raises. Nurse Gilpin, who, until now has appeared consistently caring and committed to her patients, has been quietly administering fatal beakers of milk and morphine to those who she deems to be on “her list” of those who most need relief from their situation. When confronted by the doctor she justifies her actions with a multifaceted answer based on the requirement to provide more beds to a broken healthcare system, but also insisting “I had ended someone’s suffering”.  

When Dr Valentine remarks, “I like old people” a visitor responds “not even old people like old people”.

The manner in which Nurse Gilpin goes about what is effectively enforced euthanasia, is deeply chilling. And yet her reasoning is not entirely foreign to us – to end suffering could be deemed a noble cause. In fact, the need to simply delete the reality of suffering, particularly the suffering of the old is one that perhaps is not so uncommon. Throughout Allelujah!,we are reminded of our tendency to run from, to detest, to reject the suffering of the elderly in our society. When Dr Valentine remarks, “I like old people” a visitor responds “not even old people like old people”. A teenage intern declares to a patient “I hope I never live to be your age”. At the same time, characters look back on the days “when the elderly weren’t farmed out”, and questions are asked of families “if they love them, why do they put them away?”. A very good question. Of course, care needs are often too great for families to endure, yet it is still important to ask why the suffering of the old has become a professionalised service, which most of us avoid at all costs. Perhaps the answer to this is that we don’t like to watch the old suffer, we don’t like to watch them die, because their suffering and their death remind us of our future selves, our future suffering, our future death. In our sanitised, anything-is-possible-with-medicine-and-science society, death and the suffering that comes with it, is something from which we flee at all costs. Instead of acknowledging and working with it, we would rather pretend it wasn’t there at all.  

And yet, even as we try to avoid it, suffering and death are both certain parts of all our futures. 100% of us will die. For Nurse Gilpin, the solution to this is to bring on death prematurely, to erase the pain, overcome the misery by offering a false hope – that it doesn’t need to exist at all. In direct contrast to this, in a film which is littered with Christian references (Allelujah, The Bethlehem), there is a different approach taken by a messiah-type figure who seems to get everything right. Dr Valentine is compassionate and understanding. He not only challenges the political systems which undermine those most at the margins of society, but also has the kind of bedside manner we would all hope for in a doctor. In a closing monologue Dr Valentine utters the words of the doctors in the NHS, “We will be here when you are old, and we would die for you, we are love itself and for love there is no charge”.  

It is this suffering with which is so compelling, this suffering with which is truly sacrificial.

Nurse Gilpin and Dr Valentine offer two fundamentally different approaches to end of life care. One hastens the end quickly, deletes the suffering as efficiently as possible in order to make way for those in less pain. The other sits with those who suffer, holds their hand, gently cares for the human person that is in front of them. Even more, and perhaps most significantly Dr Valentine does not only watch from afar, but is willing to suffer himself for the sake of those in pain - working tirelessly, giving himself over day after day, fighting on with little sleep for limited pay just to make things a little less painful. It is this suffering with which is so compelling, this suffering with which is truly sacrificial, this suffering with which speaks of something much greater than politics, efficiency or inheritance, this suffering with which is indeed “love itself”, completely free of charge.  This is the logic that Christians see in the ancient notion of the incarnation, celebrated every Christmas, of God with us. This is what our older people need, this is what we will all need when we grow old. Let us only hope that when we get there, we find the one who is willing to offer it.

Article
Assisted dying
Comment
Politics
4 min read

The assisted dying bill is an undignified mess

Literally life-changing legislation needs a parliament at its best not its worst.

George is a visiting fellow at the London School of Economics and an Anglican priest.

A parliamentary committee meets, sitting at wooden raised desks in a wood panelled room.
The bill committee meets.

The first clue came when MP Kim Leadbeater’s private members’ bill passed in the House of Commons at the end of November. She came outside to greet pro-euthanasia campaigners like she was emerging as a winner from the Big Brother house, in tears of joy, whooping and hugging and high-fiving, with prime minister Keir Starmer gurning awkwardly in her wake. 

For her and her supporters, this was indeed great news. But these optics were far from great. It was as though she was celebrating the consequence of the legislation she’d introduced: “Whoa! Wonderful news everybody! We’re going to be allowed to help people to kill themselves.” 

It’s not a good look, even to those who may wish for such assistance. Where was the dignity, the key word that assisted-suicide lobbyists have appropriated for their cause? Not in this carefree triumphalism, this cork-popping celebration of the prospect of death-on-demand. 

Since then, the bill’s faltering passage through parliament has been characterised by this absence of dignity, a kind of cowboy rustler pushing a herd of supporters in a single direction, towards statute. And this lack of dignity matters. Not just because it is, literally, the most life-changing legislation any of us will see in our lifetimes, but because the dignity of parliament matters very much indeed. 

I don’t mean the ritual flummery, the state opening by the monarch, people marching about with wigs and sticks, Black Rod and all that. I mean dignity in the sense with which we honour our democracy, the way in which we frame our legislature seriously and with due process. 

Leadbeater presents as a good person and there is no apparent evidence to the contrary. But she is an inexperienced parliamentarian. Her selection for the seat of Batley and Spen, now Spen Valley, was rushed through in 2021, memories remaining acutely sharp of the murder of her older sister, Jo Cox, in the constituency in 2016. And, naturally, she has sat on the Government’s backbenches for less than a year. 

 Her inexperience of parliamentary process and scrutiny has shown. Committee hearings have been rammed with those who support assisted suicide and held in unseemly haste, such is the rush to get it into law. Before her bill’s second reading, she described it as having the strongest safeguards in the world, each patient requiring a sign-off from a High Court judge. When this proved impractical, the judge was replaced with a social worker, which apparently was “even safer”. So, safer than even the strongest safeguards in the world?   

But more worrying still is how the passage of the bill has been factionalised. Leadbeater has alienated the mild-mannered by calling opposing voices “noise”, which is a bit like lamenting that a debate should have two sides at all. And she’s called those who disagree with her “unconstructive” and complained that opponents have “mobilised”. Well, duh. That’s how parliament works. Indeed, it’s part of its dignity, rather than a simple inconvenience for an MP in a hurry. 

The media have noticed this lack of respect for procedure. I’m not sure that there’s ever been such resistance to proposed assisted-suicide legislation in the public prints before. Even the Guardian, which might be relied upon to see it as a progressive cause, has turned more than ambivalent. Only columnist and assisted-suicide flagbearer Polly Toynbee is available for a piece that amounts to saying we should move along, there’s nothing to see here and Leadbeater’s bill is doing just fine. 

She, too, claims absurdly that opposition is only coming from people who oppose assisted suicide. Well, blow me down. Try as I might, I can’t trace her complaining that Lord Falconer’s supposedly independent Commission on Assisted Dying of 2011 was both funded and packed with his cause’s supporters.  

In passing, it should be noted what an underminer of parliamentary dignity is Falconer too. He has claimed that justice secretary Shabam Mahmood’s opposition to the bill should be discounted because of her “religious beliefs”. Mahmood is a Muslim. For a constitutional lawyer, Falconer shows scant regard for our constitution. We might as well say that his views should be discounted because he’s a progressive secularist.  

One might expect PM Keir Starmer to bring some quality to this, as an alleged stickler for legal procedure. It remains a mystery, as a supporter of the principle, that he’s left assisted suicide to a private members’ bill. If he really wanted it, it should surely be a Government bill. Cynics among us wonder if he has honoured a promise given to the terminally ill Esther Rantzen with token support for a private members’ bill, but knows it will fail.  

Again, lack of dignity. If dignity in dying means anything since it was misappropriated as a campaign slogan for assisted suicide, then it should be accompanied by dignified debate and amendment in parliament. This bill has provided precisely the opposite. Let it die.

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