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
Comment
Romance
5 min read

Getting hitched should benefit more than the advantaged

Marriage’s decline impacts outcomes for all.
A bride dressed colourfully stands next to her groom, dressed similarly, as he sits in a wheelchair.
Ellie Cooper on Unsplash.

Of all the dramatic changes to Britain in the last half century, one of the least discussed is the extraordinary decline in marriage.  

The marriage rate has fallen by two-thirds in the last 50 years. It was just above six per cent in 1972 and has now been under two per cent since 2017. 

This remarkable decline has corresponded with a rise in a relatively new relation type: cohabitation. Cohabitation was extremely uncommon before the 1960s, and even by 1986 just 10 per cent of new mothers were cohabitants. It is, however, rapidly becoming the mainstream. Now 35 per cent of babies are born to cohabiting mothers, and the total number of UK cohabiting couples increased from 1.5 to 3.7 million between 1996 and 2022.  

Much of this is due to couples delaying marriage: 84 per cent of religious and 91 per cent of civil marriages are now between couples that already live together, and the average age when first marrying has climbed by 10 years since the early 1970s. But it is also due to many more couples not marrying at all. 

Opinions understandably differ on this social transition away from marriage and towards cohabitation. It is a point of progress worth celebrating that the previous societal shunning of those, especially women, who had children outside of marriage has been left in the past. However, such progress has not been without consequences. Cohabitations are less stable, on average, than marriages. Cohabiting parents are around three times as likely to separate in the first five years of their children’s life as married couples.  

This stability is not simply because wealthier, more highly educated people tend to have stable families and also tend to marry. Studies by World Family Maps and the Marriage Foundation have shown marriage to be a larger factor in family stability than either education or income.  

Nor does the stability come from couples staying together miserably.  Studies undertaken in 2017 and 2024 looked at the outcomes of couples 10 years on from considering their relationships to be ‘on the brink’. In the initial study, while 70 per cent of cohabiting couples had separated in the decade since considering themselves ‘on the brink’, 70 per cent of the married couples had remained together. Perhaps even more crucially, just seven per cent of those married couples that had stayed together were unhappy in their relationship a decade on. The 2024 study found none of the sample of married couples that had stayed together were still unhappy 10 years on. For those that had stayed together, things had improved. 

This family instability that the decline of marriage has caused is also unevenly distributed. Affluent couples – often those most likely to criticise the concept of marriage – are much more likely to marry than disadvantaged ones.  

Looking at socioeconomic groups, seven in ten mothers from the most advantaged group are married, while just a third of those from the two most disadvantaged groups are. The effect is geographic, too. Institute for Fiscal Studies research has found parents having children are more likely to be married if they are living in better educated areas. For the advantaged, it is compassionately affirmational to suggest that every relationship is equal, even though the advantaged themselves choose the most secure option of marriage: a hypocrisy only tolerated due to the potent fear of seeming judgemental. 

The consequence of this is deepening inequality: disadvantaged families are rendered more likely to breakdown, while children from affluent backgrounds are disproportionately likely to enjoy the ‘the two-parent privilege’, the substantial emotional and developmental advantages of growing up in a stable home. Melissa Kearney coined the phrase, and her evidence shows how children grow up, on average, to have better educational outcomes, better emotional and physical wellbeing, and higher incomes if they are raised in two-parent homes. 

Stable families are foundational to a stable society, and marriage is crucial to stable families.

So, why are marriage rates so much higher among wealthier couples than poorer ones, and why is this gap growing? 

We can isolate three reasons in particular, each more solvable than the last.  

Most challenging is the feedback loop effect: people whose parents, role-models, and friends have not married are unlikely to do so themselves. The demographic trend compounds itself.  

Second, and easily addressable if only the will was there, is the public messaging effect: politicians – and to some extent celebrities – have consistently told the public that marriage is unimportant. In 2017, Marriage Foundation research found that it had been a decade since a cabinet member had discussed marriage in a speech. This has hardly changed in the years since. In 2024, the only major party whose manifesto even mentioned marriage was Reform; even then the focus in the relevant section seemed to be less on marriage and more on getting ‘people trapped on benefits back into the workplace’. 

Third is the cost of weddings. A quick flick through top wedding magazines suggests that the average wedding costs upwards of £20,000. Survey evidence from both Marriage Foundation and the Thriving Center of Psychology have found that most young people view weddings as unrealistically expensive. 

This financial problem is solvable: much of the costs relate to venue hire. Unless they are having a religious marriage, a couple will need to find a venue that has gone through the bureaucratic process of becoming an ‘approved premises’. The cheapest of these are register offices which, including all expenses, still cost about £500. 

This is eminently mendable. The Law Commission proposal to reorganise wedding law around the officiant, not the venue, opens the door for a future of more affordable weddings by removing the regulatory barrier. It will also bring the law in line with that of other home nations. 

This proposal will not work by itself, though, it will need to be supported by creativity in wedding planning.  

Wedding costs can be substantially reduced by taking a DIY approach. Food, drinks, and decorations can often be coordinated amongst enthusiastic (and appropriately competent!) guests.  

Booze free weddings are a growing phenomenon, and especially good for weddings with children.  

Such ‘group-effort’ approaches often have a unique feel thanks to the high participation of guests, and people are more likely to remember events that they feel a sense of ownership of, having helped make them happen. 

Alongside this is a recommendation by the Centre for Social Justice. It proposes subsidising the necessary statutory fees for the poorest couples, up to £550 per couple. An inexpensive and hugely beneficial adjustment to improve wedding accessibility for the least fortunate.  

Stable families are foundational to a stable society, and marriage is crucial to stable families; perhaps it is time for all of us to make tying the knot easier.  

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