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A nation divided

Operating Theatre is a charity that specialises in telling stories about health through drama. Artistic director ALEX ELLIOTT explains how this year they’ll focus on questions of health inequality — such as why low income has a direct impact on life expectancy

PLACE matters. Don’t take my word for it. It’s there in the Marmot Review, 10 Years On, a document that revisits some of the causes and effects of health inequalities in Britain.

In this far-reaching report, there is a lot to absorb, so I recommend that you take some time out to read it.

When I first opened the document, I was immediately struck by a quote that appears in the introduction.

“…living in a deprived area of the north-east is worse for your health than living in a similarly deprived area in London, to the extent that life expectancy is nearly five years less.”

I read the quote a couple of times to make sure I had got it right. Five years. That’s a lot.

Professor Michael Marmot decided to return to the subject that he and his team had invested so much time investigating 10 years earlier because, as he stated on a recent Radio 4 programme, all of the promises made back then about addressing the causes of health inequality had simply not been kept. 

In the light of the plethora of half-truths, baseless claims and downright mendacity we as a nation have been subject to in the last decade, should we really be surprised that measures which would not only prolong life and increase prosperity but save the government money have simply been ignored? 

Operating Theatre works wherever and whenever we are needed, though we are based in north-east England and recognise the grim realities highlighted in the report.

We present our work in medical schools, health conferences, stakeholder meetings, schools and just about anywhere where people gather to discuss health and wellbeing.

We use film, theatre and workshops to foster discussions, with the aim of making them as resonant and powerful as possible.

Of course, like so many artists and practitioners, we have seen our work dramatically curtailed due to the pandemic, but we are still working, carrying out research and development and planning for a better future in which we can continue to deliver what has been described as transformative work.

We have reached thousands of people and many have told us how much our work has affected them.

Quite often, our performers are approached afterwards and spoken to as if they are the person they have been interpreting.

In some cases, we have not been able to convince the audience that the performer is not the carer they have portrayed or the young woman struggling to come to terms with the paucity of mental healthcare provision.

We take this as a sign that what we are doing does reach others.

This year, we are embarking on a wide-ranging and ambitious programme centring on the vital subject of health inequality.

We are reaching out to educators and clinicians and other organisations involved in this field — unions, charities, anyone who needs to get their message to a wider audience, reinforce existing messages or form part of a campaign — in a unique and engaging way.

We want to work with anyone who feels that the time to confront the challenges of health inequalities is long overdue.

We anticipate that much of our delivery will be increasingly online, and much of our repertoire can be already be viewed on our website.

It is clear that the pandemic has affected practically the same demographic that has been most affected by health inequalities the past and if we are to really going to “build back better,” then we need to act now to ensure that when the virus has abated, we are not faced with the same inequalities present before this seemingly endless contagion. 

Overcrowded accommodation, trains and buses stuffed full of commuters, people carrying on in low-paid jobs when it would have been safer for everyone for those workers to stay at home, healthcare staff stretched beyond all human endurance: these things have not happened by accident.

We need to highlight the injustices created by postcode, locality and income bracket all over the country.

It cannot be right that you can expect to live sometimes 10 or 12 years longer than someone a handful of miles from you.

It cannot be good for society that access to services, information and recreation is inconsistent and can sometimes disappear practically overnight because of short-term government policies created to do little more than garner votes.

It is a disgrace that in 2021 we are not able to provide adequate resources for our young people to learn and grow and go on to become parents and providers and contributors to a society that should consider all of its members a valuable addition, rather than a burden to the taxpayer.

As Prof Marmot points out, life expectancy among some parts of the population has actually declined for the first time in 120 years.

With Britain being one of the richest nations in the world, alarm bells should be sounding all over the country, and while there are many thousands of people going above and beyond to support those for whom life is getting worse, it is a sad reflection of our direction of travel.

We believe problems like this are best tackled by working together and have already proved that making that connection can be effectively achieved through drama.

We think a teaching tool previously used primarily for medics and students offers a unique way of helping all workers at a time when health services and issues like stress and mental health in the workplace have never been more of a concern.

If you would like to learn more about us, please do check out our website by following the link below.

If you are involved with an organisation you feel could work with us, please do get in touch. We need to work together.

For more information, visit or contact [email protected].


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