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16 April 2015updated 17 Apr 2015 4:33pm

Theatres of the absurd: the unadulterated horror of Harley Street

Six months of treatment for cancer? A mere £30,000 at London's most exclusive clinics.

By Rachel Cooke

Inside Harley Street
BBC2

Don’t be misled by the outwardly jaunty tone: in her new films about Harley Street (Mondays, 9pm), the documentary-maker Vanessa Engle has opened a vein of unadulterated horror. How desperate people are, and how deluded. I suppose we all know that human beings will cough up almost any amount of cash in pursuit of hope. But it’s surprising and rather devastating to find that they also write vast cheques in exchange for hugs, handshakes and empty blandishments. “You look great!” trills a plastic surgeon to her seventysomething-year-old patient as she arrives at her consulting room post-facelift, looking like something out of a Channel 4 drama about domestic violence. Beneath her gaze, the patient, bruised and battered, blooms like a flower. It seems not to occur to her that the doctor is merely praising her own (very expensive) handiwork.

Engle (Jews, Women, Welcome to the World of Weight Loss) has a satirical eye and is known for asking her interviewees blunt questions (“What’s your worst fear? That he might die from cancer?”). But what I like best about her technique is her swift, minimalist way with folly. So deftly does she lay it out – she is the surgeon here – that we’ve no option but to fall into line in the matter of judgement. Will a hair transplant change a young man’s life? It seems unlikely, and perhaps his mother is weeping because she already knows that it won’t. Will a husband appreciate, or even notice, his wife’s umpteenth cosmetic procedure? Well, anything for a quiet life; but no. Is it really possible to believe that, as a doctor, you were put on the earth to perform liposuction on sad young women? Definitely not, for all that you might well have a carefully prepared line about making people “feel” better.

Engle’s series is in three parts. The first film focuses on those who visit Harley Street because they are sick and the doctors who treat them. The second (airs 20 April) is about plastic surgery (I watched a preview because once I’d seen the first film I couldn’t bear not to). The third is about complementary therapies (ditto). The last two films are, I think, better than the first, and you should certainly try to catch them; I can’t remember a bit of observational TV that made me feel more disapprovingly Protestant, feminist and, above all, rationalist. But the first film had its moments, too. I do see that if you have cancer, and enough money, you might want to opt out of the NHS. Then again, if the highly qualified professional I was paying hundreds of quid an hour addressed my mother with the words “Hello, Mum!” I think my fear would temporarily shade into indignation. Equally mystifying was the young woman who wanted to be treated for breast cancer by the same clinic that had cared for her father. She wanted, she said, to share the same cancer “journey”. This dear dad, by the way, had since died.

The sums involved made your eyes pop. Six months of treatment for cancer? A mere £30,000. I tried to unpick the complicated mathematics of risk, faith and profit, but it was tricky. All the doctors involved confessed to having private insurance. Then again, the leading urologist Professor Roger Kirby admitted that the NHS had the same equipment as his clinic; the difference is that he offers a more personalised service (for instance: making the effort to learn the Norwegian word for “cured” while treating a patient from Oslo). How did they feel about working in the private sector? Not too conflicted, I would say. Only one, Professor Justin Stebbing, who runs a cancer research unit in the NHS alongside his Harley Street practice, said it sat “badly” with him.

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And how did the patients feel about handing over their credit cards? Pretty good. One woman, pterodactyl-like behind glasses as big as television screens, had no idea how much her medical bills came to. “This is like asking Cameron how much a bottle of milk is,” she said, en route to her Bentley. Still, in the matter of serious illness (as opposed to the chap who rings his private GP at 2am and demands to have his blood pressure checked on returning from the casino), pity usually trumps politics, or so I find. Save your outrage for the next two films, which are Engle at her very best – and that’s really saying something.

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