Prescribing change: How ITV’s Malpractice and message-driven dramas are shaping public consciousness

In a time when real-life scandals often rival fictional plots, the line between drama and documentary has never been more blurred. ITV’s Malpractice recently returned for a gripping second series, doubling down on its signature blend of medical thriller and moral dilemma. As with its first outing, series two pushes into even murkier ethical territory, drawing viewers into a tightly woven narrative of institutional failure, personal accountability, and the cost of care under pressure.

Beyond the compelling performances and sharp writing lies a deeper resonance. Malpractice, like ITV’s recent phenomenon Mr Bates vs The Post Office, is part of a growing wave of socially charged dramas that don’t just reflect society, but interrogate it too. These are stories designed to entertain, inform, provoke, and, in some cases, mobilise.

(Don’t worry, there are no spoilers ahead.)

The power of fictional truth

In series two of Malpractice, the show pivots from the individual investigation of Dr Lucinda Edwards to a broader systemic critique. Without spoiling key plot points, the narrative widens its scope to include whistleblowers, mental health crises among patients and frontline workers alike, and the bureaucracy that far too often stifles reform. 

It’s a continuation and an escalation of series one, but more ambitious, more claustrophobic, and more willing to shame the institutions that prioritise reputational management over human lives.

This fictional lens offers something documentaries and news coverage sometimes struggle to achieve: emotional immediacy. By humanising the victims and the accused alike, Malpractice grants the audience access to the grey zones — those ethically complex spaces where policy and humanity collide. And this is where the real power of drama emerges.

It’s easy to be dismissive of shows like Malpractice. It has the feel of other shows like Bodyguard, Vigil and Trigger Point, where everything gets a little too ridiculous to be believed. But the thing that really unites these examples is that they’re watched by millions of people. The amped up drama is compelling to many, so they’re a great way to bring crucial issues to the public consciousness. 

Using drama as a catalyst

Mr Bates vs The Post Office is perhaps the most striking recent example of TV drama igniting public outcry. Chronicling the harrowing miscarriage of justice faced by hundreds of sub-postmasters who were wrongly accused of theft due to flawed Horizon software, the series dramatised the facts and galvanised the nation.

The emotional authenticity of the performances, the clarity of storytelling, and the refusal to let the system off the hook culminated in renewed political pressure and legal reviews. It’s rare for a television series to directly influence government proceedings, but in this case, the impact was tangible. 

This isn’t an isolated case. It’s a Sin, Russell T Davies’s searing depiction of the AIDS crisis in 1980s Britain, rekindled discussion around historic negligence and prompted a spike in HIV testing across the UK. Similarly, Three Girls, which dramatised the Rochdale grooming scandal, reignited national debate about institutional failings in safeguarding vulnerable children. These dramas illustrate that when storytelling aligns with social relevance, the results can be seismic.

Why now?

The resurgence of message-driven drama reflects a broader shift in how audiences engage with media. We’re living in a time of institutional distrust — public services strained to breaking point, legal structures perceived as impenetrable, and politics increasingly polarised. In such a climate, audiences crave more than escapism. They seek narratives that reflect the dissonance of their lived experience and stories that ask the difficult questions.

This doesn’t mean these dramas are didactic. The best of them (Malpractice included) resist easy answers. They portray flawed individuals, ambiguous choices, and the complexity of real change. They also remind viewers of the human cost of systemic failure, and crucially, they do so through emotionally engaging storytelling.

An ethical balancing act

Of course, message-driven drama walks a tightrope. There’s always the risk of exploitation and reducing real suffering to narrative devices. Critics have rightly called out shows that oversimplify or sensationalise for the sake of ratings. Authenticity requires more than good intentions. It demands rigorous research, consultation with affected communities, and a commitment to nuance.

In this regard, Malpractice has earned praise for its handling of complex medical and ethical issues. The series creator and writer, Grace Ofori-Attah, is a former NHS doctor and addiction specialist, so she has first-hand knowledge of the mental health crisis in this country. The producers also worked with healthcare professionals to ensure accuracy, and this grounding gives the show its moral weight. It’s not about heroes and villains — it’s about systems, pressures, and people pushed to their limits.

A role for broadcasters

It’s no small shift that ITV, traditionally known for more populist programming, has become a home for such hard-hitting content. The broadcaster’s willingness to invest in serious drama signals a recognition of the public’s appetite for substance. It’s also a reminder that public service isn’t the exclusive remit of the BBC. Commercial networks can also wield cultural influence just as potently.

In addition, these dramas are often more accessible than investigative journalism or academic analysis. They reach millions, including those who might not engage with a newspaper exposé or parliamentary report. In doing so, they democratise information, providing a gateway to awareness and, potentially, action.

Where do we go from here?

If series two of Malpractice builds on its previous momentum, it will entertain, educate, and resonate in equal measure. It could spark conversations in living rooms, staff rooms, and perhaps even in boardrooms.

It might embolden whistleblowers and put pressure on policymakers. And it will certainly continue the long tradition of television as not just a mirror to society, but a lever with which to shift it. As one character reflects in episode four, “The psych unit is falling apart. We house our most vulnerable patients in the most rundown buildings. It is impossible to keep them safe.” Something needs to change.

In an age where content is king, message matters more than ever. Dramas like Malpractice and Mr Bates vs The Post Office remind us that television (far from being the ‘idiot box’ of old) can be a tool for empathy, education, and empowerment. These aren’t just stories — they’re statements of intent. Sometimes, they’re the spark that lights the fuse of real-world change.