‘You can’t sort out the NHS without sorting elderly care’: Richard Eyre on his new geriatric ward film and the government’s state of ‘panic’

I used to think that directing was all about commanding – about knowing the answers to all the questions,” says Richard Eyre. “Now I feel the opposite.” Eyre, one of the titans of British theatre since the 1970s, has of course done his share of commanding in the past. Of Ian McKellen in one of the definitive stagings of Richard III. Of Daniel Day-Lewis in Hamlet, which saw the actor walk off stage mid-performance and never return. Of the National Theatre, throughout his 10-year stint as creative director between 1987 and 1997, when he championed the work of firebrand artists such as David Hare and Howard Brenton.

On screen, he cut his teeth on Play for Today before moving on to films such as 2006’s Notes from a Scandal and the BBC’s 2018 King Lear starring Anthony Hopkins and a cusp-of-stardom Florence Pugh. Now 79 years old, Eyre speaks to me over video chat from his house in west London about his latest project, Allelujah, which focuses on the geriatric ward of an NHS hospital threatened with closure. It is, fittingly, a film that does not profess to have all the answers, only weary questions and bittersweet musings on the slings and arrows of old age.

Allelujah started life as a play, which debuted at London’s Bridge Theatre in 2018, with Nicholas Hytner directing. Written by the Leeds-born satirist Alan Bennett, Allelujah is set around a fictitious Yorkshire hospital known as the “Beth” – short for Bethlehem – and the colourful characters that populate it. On one side, we have vaunted nurse Sister Gilpin (Jennifer Saunders) and idealistic newcomer Dr Valentine (Bally Gill). On the other, the ailing patients. Russell Tovey plays a ministerial aide whose worldview is upturned when his father (David Bradley) is admitted to the Beth’s care. The film is both a love letter to the NHS and a dark indictment of government cuts; the callous push to “move on” patients and free up beds for new ones hits disconcertingly close to home.

The challenge, for Eyre and screenwriter Heidi Thomas (the creator of Call the Midwife), was to take the stage play and make it “realistic” while retaining the “Bennett-ness of it”. “Here was a film that was about hugely important subjects: the care of ill people and the care of old people,” Eyre says, “which to me are absolutely central to our society. But because it’s Alan Bennett, it’s not heavy-handed and polemical. It’s humane, and witty, and makes its points without banging you over the head.”

For Eyre, the film holds particular personal significance. “My mother was very ill for many years,” he says. “She had Alzheimer’s, and she was brilliantly looked after in an NHS geriatric ward quite similar to that in the film. The nursing staff actually turned up at her funeral, which was incredibly moving.” According to Eyre, his mother was taken out of the ward for “precisely the reasons you see in the film”: the demand to constantly free up beds. “She was put in a care home and she died a week after,” he says. “Because there was no longer someone looking after her.”

The venerable line-up portraying the Beth’s patients includes Judi Dench, Derek Jacobi (unforgettable in the title role of the BBC’s classic I, Claudius) and Bradley (known to TV audiences as Game of Thrones’s Walder Frey). Eyre and Dench have collaborated repeatedly down the years, dating back to his 1981 film debut The Cherry Orchard. “She’s just a really old friend,” he says. “You don’t have to direct Judi, just point her in the right direction.”

Dench, 88, has recently spoken about being unable to read scripts because of her deteriorating eyesight: for Allelujah, she had someone read the script aloud to her and she learnt it by rote. Eyre says: “She’s just so incredibly skilful that however handicapped she might be, she can somehow sense everything – without being obviously conscious of where the camera is, she’ll always be in a position that is interesting and expressive.”

There is no glamour in the roles inhabited by Dench, Jacobi and Bradley. One scene sees Bradley’s character stripped naked in a shower; another sees him rendered incontinent. I can’t help but wonder how it feels for these revered stage actors to be so feeble, so exposed, on film. “If they accept the part, they accept that they’re of an age where you’re all too aware that dignity is a luxury commodity,” Eyre says. “But it’s all a matter of how you’re treated. This was a very caring environment – not least because I’m of the same age. It’s in my interest as much as theirs.”

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The dearth of strong film roles for older actors is well known at this point; it is something Eyre has noticed from the director’s chair. “I think my generation is guilty of ageism,” he says, “in that we were the generation – the Sixties generation – who fetishised youth. The young people, we had a contempt for old people, and that’s proved to be a very corrosive attitude.”

It is hard to discuss Allelujah without mentioning its twist – which came at the midpoint of the stage play but is deployed as a late rug-pull in the film – so be warned that spoilers follow. Near the end of the film, it is revealed that Saunders’s character, Sister Gilpin, has in fact been operating as an “angel of mercy”, euthanising patients to cut short their indignity and ensure a constant supply of empty beds. “It raises a complicated question of morality,” Eyre says, “and provides what they call a ‘fridge moment’ – when something detonates later. That moment after seeing a movie where you get home, open the fridge, and suddenly think, ‘Do you think she was all wrong?’”

There are, says Eyre, ethical shades to Sister Gilpin’s actions. The director is supportive of efforts to legalise assisted dying, and has written a play about the subject, yet to be staged. But in Allelujah, the character’s crimes are nonetheless the result of pressures from the top down – stemming from the Conservative government’s fiscal and ideological assault on the NHS as an institution.

“You think that this Sister Gilpin is managing to make the best of a bad job, given that she’s got this endless demand for beds to put old people who are ill into a geriatric ward,” Eyre explains. “And the consequence if they get better is she has to vacate the bed, and send them to what David Bradley’s character describes as a ‘s***hole’ – a bad care home. So she is trying to make things work, do what is asked of her by the system. I hope that it actually provokes people to say, ‘[Her actions] are clearly wrong... but why does this have to happen?’

“And yes, she’s taking the wrong solution,” he adds. “But you could say that she’s putting people out of their misery.”

In the UK, assisted dying legislation has been repeatedly thrown out of parliament, despite support across party lines. With euthanasia legal in several European countries, calls for the law to adopt a more compassionate approach have continued to mount. An underlying problem is our nation’s ageing population, the fact that there are a “substantial number of people who are older and yet not fitter”, Eyre explains. “That can’t be ignored. I just pray that some government will take a view of this and not offer short-term solutions. It used to be said that a week was a long time in politics. Now, it seems like an hour is a long time. You have to stand back and say, how do we deal with these things? I don’t know, but it sure as hell isn’t happening.

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“The current government is just in a state of total panic,” he continues. “From day to day, from hour to hour, they’re just trying to keep pieces stuck together. The NHS is clearly underfunded. It’s clearly overstretched. And it’s not an isolated problem. You can’t sort out the NHS without sorting care of the elderly, social care – they can’t be separated.”

One solution, Eyre argues, would be in a hypothecated health tax – that is to say, a standalone tax siloed off from the rest of the budget, in the vein of the TV licence fee. “Of course, the Treasury absolutely hates the idea of fixed taxes because it means they can’t move stuff around – taking away their power,” he adds.

Despite the graveness of its subject matter, there is a defiant edge to Allelujah; it is not so much a dirge for a vanished institution as a rallying call to save it. Does Eyre have optimism about the future of the National Health Service? Sort of. “I hope if a Labour government does get into power – they almost certainly will – that they stand back and say, ‘The NHS is a priority.’

“Instead of just trying to shore up leaks in the ship, they’ve got to take a holistic view of healthcare, and care of the old,” he adds. “If they don’t do that, I despair.”

‘Allelujah’ is released in UK cinemas on 17 March