Call The Midwife's Stephen McGann on the real-life NHS drama that inspired the BBC series

Presented by McGann, Call the Midwife: the Casebook is a documentary that explores the events and issues behind the drama, from a potted history of midwifery to the story of public health in the postwar period. And if Sigmund Freud might have something to say about McGann’s career path, the man himself is inclined to enjoy the coincidence.

“As a very mature student – I was in my 40s – I took a break from acting to a do master’s degree in science communication at Imperial College,” he explains. “So to suddenly find myself playing a doctor at the centre of a highly rated medical drama was really useful.”

McGann now has a flourishing second career as a public speaker – in 2015 he addressed the Cambridge Science Festival on the relationship between medicine and the media – but plans for a PhD were shelved when it became clear that the success of Call the Midwife was no flash in the pan.

Six series, plus Christmas specials, have enjoyed top ratings and another three series have been commissioned, taking the action through from the postwar period to the mid-1960s.

“I think part of the reason Midwife is so fascinating as a historical drama is that the history is recent enough that we can still touch it. I was a kid in Liverpool when the slum clearance was going on, and there was terrible poverty, very similar to London’s East End as portrayed on Midwife. We lived on a terraced street and our house was nice, but the ones they were knocking down were terrible, and I played in those slums.

“It’s easy [for TV producers] to think, ‘Right, it’s the 60s now, it’s all going to be like James Bond’, but those worlds changed very, very slowly in my living memory. And I jumped at the chance to make this documentary because there are people still around who can talk, for example, about the early years of the NHS, who can tell us why things were put together in that way, what it meant to people then, and what it still means now.”

One of McGann’s interviewees is Aneira Thomas, the first baby of the NHS era, born just after the stroke of midnight on 5 July 1948, and named after Aneurin Bevan, Minister for Health in Clement Attlee’s Labour government.

McGann with Aneira Thomas

The documentary points out that, unlike McGann’s screen character, who embraces Bevan’s “great and novel undertaking”, the majority of doctors at the time vehemently opposed the creation of a national health service.

The public, however, signed up to the new service in such numbers that the British Medical Association had no choice but to fall in line. “It’s not terribly surprising to think that there were many people, many professionals, who thought that the status quo was fine,” says McGann. “What’s more remarkable, when I look back, is how this great monolith, the NHS, could ever have been attempted in the first place.

"I think it speaks to the great political consensus of the postwar years, and the attitude that pervaded the generation who had come home and wanted something different, a different social settlement, so that even with the disagreement of the doctors, it was pushed through.”

But McGann believes that half a century of health care free at the point of delivery has bred not just complacency, but contempt.

“We more than take the NHS for granted; we now see these structures simply in terms of their challenges and problems. So it’s nice to take a trip back, to ask people, ‘What were you thinking? What was it all for?’”

Is he confident of a future for the NHS as we know it? “I can be as confident as I am confident in other people. It’s not a privately authored entity. Like any good thing or any bad thing that has been collectively built, the NHS can vanish tomorrow if we want it to.

“It’s not immortal, it’s a social construct, and if we choose to proceed in a different way, it can go. We get our choices in elections and we live by what we’ve chosen, so we’ve got to decide, all of us, whether we think it’s a good or bad idea. I think it’s a great one.”

The documentary does not shy from the failures of public medicine, and nor does the drama. The severe birth defects caused by prescription of thalidomide as an anti-sickness drug for pregnant women in the early 1960s appeared as a storyline in series five, and for McGann, interviewing thalidomide survivor and disability rights campaigner Rosaleen Moriarty-Simmonds was a highlight of working on the documentary.

Thalidomide, he argues, marked a watershed in our relationship with medical science. “Up until thalidomide, Big Medicine – if you want to call it that – had scored a series of home runs. Penicillin knocked out infections that used to kill, X-ray machines were catching TB.

“We were winning and winning until thalidomide happened. Now we’re living in more hardened times. We don’t necessarily trust authority in the same way.”

Married to Call the Midwife creator and writer Heidi Thomas, McGann sees popular drama as the ideal medium to confront social issues. “Heidi and I come at it differently – I see the science, she sees the human stories – but really the core of drama is the same as the core of science; it’s a truth-seeking exercise.”

Given the social flashpoints documented by Midwife – women’s rights, gay rights, immigrant rights, racism – McGann is bewildered by the image the series has that it’s a kind of Sunday night nostalgia-fest.

“Nostalgia is such an easy word to bandy about, but I don’t think we really unpick it very much. You can’t be nostalgic for backstreet table-top abortions, you can’t be nostalgic for a world where a woman is sent on the road to ruination by an affair with a married man. I’d suggest that what people connect to is the idea of people caring for each other. They don’t watch so they can think, ‘Oh, I’m so nostalgic I’m going to burst into tears.’ They burst into tears because they’ve felt something.”

How does he feel about the argument that midwifery in our era has been over-medicalised, that the caring side of the job has been squeezed out by paperwork and time constraints? “I can’t speak to the state of midwifery right now,” he says, “but I know that when I attended the birth of our son, almost 20 years ago, I couldn’t believe that this incredible, terrifying momentum could be managed so cleverly. And when I chat to midwives about what they feel the one centrally important task of the job is, they always say the same thing: it’s making the mum feel safe.

"It’s not the medical side – they have to do that, and they’re trained to do that – but the real skill is pastoral. In the middle of this most important moment of a mother’s life, there’s this voice and this hand saying, ‘I’m here. It’s going to be OK.’ And that’s a beautiful thing.”

Call the Midwife: the Casebook is on 5.05pm Sunday, BBC1