In this consultation, we see a patient caught up in the poverty trap, depressed, anxious, lacking sleep, confused and worried about her future. She explains to her Doctor the difficulties she is having with her husband, the damp housing and the unruly children.

Previously she had been sent to see the Psychiatrist. She reportedly explained to them that she is “not going mad”. She also saw the social services but needed more confidence in their experience and powers. During the video, the Doctor gently listens to her outpourings of sorrow, then gently challenges her by asking her about her expectations of the system.

The Doctor outlines the problems and produces a variety of suggested solutions for her to try. Specifically, he offers the possibility of financial help via his health advisor, who he believes is experienced and mature enough to help in this particular case. The patient initially rejects this solution and makes a hasty comment that she “feels that she might hit the children if something isn’t done” The Doctor immediately challenges this. They reach a tacit agreement that this is an implausible thing to happen.

Furthermore, the Doctor underlines this by challenging the patient’s desire to have her children removed. The general practitioner draws from his own experience, expressing in words that this is quite a common difficulty in the area and that he would see what he could do: uses the agency of his health visitor. He finally extracts a promise he will do his best and draws the consultation to a close.