National Health Service

The National Health Service becomes a point of access to psychological care for Queenie Jenkins at a time when she is struggling and unsure whether she should seek help. The novel presents the service through her correspondence, referral, and counseling rather than through an account of its structure: for Queenie, its significance lies in making treatment possible and affordable amid family stigma and personal distress.

Access to Care

A letter bearing the National Health Service header prompts Queenie to acknowledge that she needs help, even as she anticipates disapproval from Veronica. Queenie explains that a nurse referred her for support, a step she had not wanted to take because she had absorbed the expectation that she should simply endure her difficulties. The letter therefore marks an institutional route into care, but also a personal threshold: accepting help means resisting the idea that suffering must be borne in silence.

The referral is connected to a sexual health clinic. In her first conversation with Janet, Queenie recounts that Elspeth, the nurse, initially suspected that she was being pimped out, then understood that Queenie was having sex with multiple partners. The episode shows the circumstances through which Queenie entered care, while her dismissive account of the referral hints at how difficult it is for her to discuss her situation without belittling herself.

Counseling and Affordability

By her fifth session with Janet, Queenie describes counseling as a regular part of her week. The sessions take place in Janet’s small flat in Golders Green, reached after a journey Queenie finds burdensome. They address her friendships and dependence on others’ validation, her use of casual sex to seek validation and control, her fear of dependence on Tom, and her discomfort with affectionate touch. The work also turns toward her mother, a subject Queenie had tried to avoid.

The National Health Service matters materially as well as symbolically. Queenie is grateful that the sessions are available through it, because she doubts she could pay for enough appointments herself to make substantial progress. Her recovery is not immediate or effortless: at the fifth session she feels that it is advancing less miraculously than she had imagined. The service’s role is thus presented as sustained access to care, not a quick resolution of her difficulties.

Family Attitudes and Significance

Queenie’s attempt to accept treatment meets resistance at home. Veronica treats psychotherapy as a failure to endure hardship, invoking the pain she herself carried and the expectation that earlier generations would have regarded seeking such help as madness. Wilfred intervenes in support of Queenie’s appointment, suggesting that his generation might have borne less if people had learned to talk about their troubles. Their disagreement places access to care within a family history of silence and stoicism, rather than presenting the decision as a purely individual one.

The National Health Service is therefore significant to Queenie’s story as the practical means by which counseling becomes reachable, and as a counterweight to the shame surrounding psychological help. The novel links that access to the slow work of naming problems Queenie has tried to manage alone, while keeping the limits of the support visible: sessions offer a setting for that work, but recovery remains difficult and ongoing.