THE state of the National Health Service is no laughing matter, least of all to award-winning comedian Adam Kay whose diaries of his days as a junior doctor have been been turned into a stage show and now a best-selling book.

Kay will be signing copies of This Is Going To Hurt after tomorrow evening's 7.30pm performance at York Theatre Royal, his service in the other form of theatre now behind him.

"I've not been a working doctor since 2010, but it wasn't so much comedy taking over as that I had a very bad day at work where I realised I didn't have the emotional skeleton to cope with what happened that day," says Brighton-born Kay, recalling the case of a woman with a condition not showing up on a scan; in labour, her baby already dead; losing 14 litres of blood; ending up in intensive care.

"It's a job of highs and lows, but it's a real privilege being a doctor, where you could go home still covered in blood, winding down the window to stay awake as you drive home," he continues.

"Whatever the Government say, you don't do medicine for money, but for the love of money....but on that day it all happened at once and the worst part of it is that I couldn't have done anything differently, and no-one talks about this at medical school or how, when you work as a doctor in that stiff-upper-lip culture, you do in fact have to consider that there are sad parts of the job that are tough to deal with.

"When you are 16, and it's a bad age to decide to do anything, let alone decide what you should do between your 20s and your 60s, to be a doctor is not talked about as a cultural thing, so you don't know if you can cope with the sight of blood or how you're going to deal with matters of life and death, having sad days, when more days are likely to be bad rather than good."

Kay, now 38, developed a second skill set as a comedy writer for television, with Crims, Mrs Brown's Boys and Mitchell And Webb among his credits. "That's led to this show, revisiting my comedy roots, alongside writing the book," he says.

"I'd kept a record of the good stuff, the bad stuff; I didn't know why I was doing it at the time, but, looking back, it was a form of therapy, looking for glimmers of light in the dark. Then, when I'd left and got my teeth under the table in another job [as a comedy writer], a couple of years ago, when junior doctors were working 100-hour weeks and I realised that doctors tend to have a quiet voice, I decided to do the show with 50 minutes of good stuff and then ending with that terrible day."

York Press:

The book cover for Adam Kay's This Is Going To Hurt

Kay then transferred his thoughts from stage to page. "I just thought a book would be a more efficient way of telling people the story than performing to 200 people in a basement in Edinburgh," he reasons.

At the time of this interview this spring, This Is Going To Hurt had spent four weeks already atop the best sellers' chart. "It's a day-to-day account of my life when you have to move each year and you're routinely coming home two or three hours late because of work, so friends stop contacting you about going to things and relationships deteriorate," Kay says.

The stage show is not political, he says. "Rather than saying, 'oh, the bl**dy Government', it talks about working those long hours; about working conditions; patient safety; patients' best interests, and I can say that it's a huge privilege to have had this book published.

"But we are at a point where the NHS is stretched to the point of breaking; it never had much slack when there was an increase of four per cent a year in the budget, but in the last ten years it's been one per cent, so how can we provide the same services?

"Wards are running at 50 per cent capacity of nurses and some doctors will eventually burn out. There needs to be better resources; 1.4 million people work in the NHS, making it the largest employer in the country, and it's the 70th birthday of the NHS this year but without major investment, it won't be a happy birthday.

"The NHS is our national 'religion' – we all believe in it – and it's bigger than party politics, so it's heartbreaking that short-termist politicians are always making decisions thinking about the next election."

After all this serious comment, Kay was keen to make one last point: "I know it doesn't sound much like a comedy show from what we've been talking about, but it is," he says.

Adam Kay: This Is Going To Hurt (Secret Diaries Of A Junior Doctor), York Theatre Royal, tomorrow (Friday), 7.30pm. Box office: 01904 623568 or at