Malpractice season 2 ending explained: what does the MIU unearth, and what happens to James?

James in a suit as he sits at a hearing with the medical board
(Image credit: (C) WORLD PRODUCTIONS)

Malpractice season 2 sees Dr Norma Callahan (Helen Behan) and Dr George Adjei (Jordan Kouamé) from the Medical Investigation Unit (MIU) return for a brand new case - this time looking into the actions of Dr James Ford (Tom Hughes), a Psychiatric Registrar in a North Yorkshire hospital.

James finds himself torn between a new mother attending a routine postnatal check-up and the sectioning of a psychotic woman during a hectic on-call shift - and soon a devastating turn of events leaves new mum Rosie dead and James fighting for his job. Is he a doctor with a God complex or the victim of wider problems?

Here is everything that happened in Malpractice season 2 episode 5...

The final episode opens with James at Maria's house again, just after finding her dead on the sofa. He sees Sophia calling Maria's phone and uses Maria's lifeless hand to open the phone with her fingerprint. He deletes all his missed calls from her phone and wipes his own fingerprints off her phone before searching her house for evidence against the hospital trust.

As he slips some paperwork into his back pocket, the police arrive. They ask James when he last spoke to Maria, and he tells them they talked the day before and he came over today because he was worried about her as she was stressed because of the investigation. As the police officer talks to him, James is distracted by a calendar on the fridge behind him, which has 'Victoria Hall, 4pm' written on it.

James looking upset as he is questioned by a police officer in Maria's kitchen

James is questioned by the police after he found Maria dead. (Image credit: (C) WORLD PRODUCTIONS)

James goes to see Kate, but she won't answer the door. She is inside contemplating calling the police as James gives up and drives off.

The news of Maria's death spreads, and Sophia learns the tragic news from a radio report at home, while Norma and George see it in the newspaper. Norma asks George if he has ever felt like Maria did, and he admits that investigations go on for so long that you often feel like there is no other way out.

George tells Norma that he is meeting Doctor Armitage the next morning, while Norma tells him that she is going to do a deep dive into the maternity ward's history and will let him know if anything turns up.

James visits Sophia at the hospital and is surprised to learn she isn't working, so he corners Arun and asks who Victoria Hall is. Arun demands that he get off his ward or he will call security.

James looking wound up as he grabs Arun's arm in a hospital corridor

James corners Arun. (Image credit: (C) WORLD PRODUCTIONS)

James is a man on the edge as he tries to find out who Victoria Hall is... but all his searches on various sites come up blank. His sister knocks on the door of his room and is worried about him, but he lies that he is working and she leaves, confused, as it is 3 am.

The next morning, Norma is struggling to get hold of her daughter, Ruby, and she tells George that Ruby isn't speaking to her because she thinks Norma is to blame for Ben, her uni lecturer, who she was having a relationship with, being suspended. George asks if she reported Ben, and Norma admits she looked him up on their database, and George points out that it is a breach of data.

George meets with Doctor Armatige and he tells him that he worked with Maria on a maternity unit and that she was 'one of the good ones', while Norma meets another doctor who also worked with her. Both say that they made complaints about the maternity unit, but they were rejected and then the process of making a complaint was made much harder, putting busy doctors off and therefore meaning the hospital had fewer serious complaints to report to the government. But while both doctors admit that the maternity unit is toxic, neither is willing name name individual consultants on record.

Back at the office, Norma tells George that Eric was made the new Chief Medical Director about 10 years ago after the hospital trust needed an overhaul following the maternity unit almost going bankrupt. Arun was also brought in as Chief Obstetrician, and soon they were winning awards for having one of the lowest C-section rates in the country.

Norma on the phone in the corridor of a smart office, she is wearing a green blouse and cream tailored trousers

George makes a shocking discovery that will change their investigation completely. (Image credit: (C) WORLD PRODUCTIONS)

George has found the trust's serious incident data and it tallies with what they have been told about the hospital trust covering up their complaints. But Norma says it isn't solid evidence and they need more. However, as she is talking, she notices George is distracted and he tells her that his girlfriend, Gina, has been covering something that is linked to their investigation. He tells Norma that if he tells her what he has found out, he will be breaching Gina's client confidentiality, which will almost certainly mean the end of their relationship.

George admits that Gina's architecture company is working on plans for a redesign of the psychiatric unit at the hospital. Norma is shocked becasue at no point has anyone said the psychiatric unit is up for sale, but George says Gina's client has put in a bid to purchase the psychiatric unit to make it into luxury accommodation. Norma is confused as there has been no public consultation, and something like this would take years to set into motion. George admits that Gina has all the paperwork for the acquisition that goes back years, detailing how much the land is worth once it is sold. Norma thanks George, telling him she knows how hard this must have been for him to share, as it puts him in an impossible situation, but he has done the right thing.

At home, James wakes to hear a knocking at his bedroom door and finds his sister is with the adult care team. Everyone has been worried about him and they are there to asses his mental health, concernred that Rosie and Maira's deaths are causing him mental health issues.

James is adamant that he is fine and starts to tell them about how the hospital trust is framing him and that Maria was in the same situation. He tells them about Victoria Hall and that he is trying to track her down, but when they question where she works, they're concerned he is imagining things.

James tells them that if they don't believe him, they should speak to Kate, but is stunned when they tell him she is the one who requested this assessment in the first place. He gets angry and the team says he needs respite somewhere quiet, and ask if he will come with them voluntarily, or whether he needs to be sectioned. The fight goes out of James and he agrees to go with them, but can't believe this is happening to him.

James looking stressed and tired in a grey hoodie sitting at a dining table.

James is assessed by a psychiatric team. (Image credit: (C) WORLD PRODUCTIONS)

As they are driving to the unit, James sees a sign for Martin's Hall and realises that Victoria Hall is a place and not a person. He gets them to pull over by pretending to have a panic attack. While the woman is getting water in the car, he does a runner and she is forced to call the police.

Eric and Arun call Sophia into a meeting and she is told that they have covered their backs with the Baby Patel incident and that as long as she signs an NDA, then she can return to work. Meanwhile, George and Norma have requested the hospital trust's financial records, but when they arrive, there are more boxes than they ever imagined.

Norma reveals that when she was looking into the trust's finances earlier she found that the psychiatric unit needed urgent repairs that were going to cost £7 million, and while they got a grant for £2 million and raised £4 million in fundraising, but it looks like the work was never carried out. It later turns out the money was spent on the maternity ward instead, ensuring the psychiatric unit was even more run down and so easier to sell.

Meanwhile, James gets home after escaping en route to the psychiatric unit and is grabbing his car keys as his sister catches him. She tells him the police are looking for him and she is really worried about him. He asks her to trust him, and she lets him go.

James heads to Victoria Hall and finds a couple there who are meeting Maria. James explains what has happened to Maria, and they tell him that they were meeting her after she offered to help them take legal action against the hospital after the traumatic birth of their son was covered up by the trust.

Later, James asks Sophia to meet him at a pub, telling her he knows she cancelled Rosie's psychiatric referral. He is surprised when she turns up and he tells her he needs her to come to the MIU with him and tell them what is happening at the maternity unit and put a stop to anyone else being hurt.

After sleeping in his car, James wakes the next morning and calls Sophia to arrange the meeting with the MIU, but she is on the ward and is upset after seeing Mr and Mrs Patel crying after visiting their poorly baby that she helped deliver.

Sophia in her work scrubs crying with her hand to her mouth as she looks at a tiny baby in an incubator

Seeing Baby Patel makes Sophia realise she needs to take action. (Image credit: (C) WORLD PRODUCTIONS)

Meanwhile, Kate catches up with Eric and asks if she can take some time off before she starts her new job. He scoffs at her and tells her there is no job, and she is stunned. Kate tells him that she did all he asked her to do, including recommending James be sectioned against her better judgment, but he tells her that he was never going to give her a job after she slept with a colleague, and she realises she has been used.

At the meeting with MIU, James is agitated as he tries to explain his findings about Maria's investigations to George and Norma. They say they need someone on the inside to confirm that notes have been falsified, but Sophia hasn't shown up, which James is cross about. However, she eventually turns up and tells George and Norma that she should have done this years ago, and is ready to tell the truth. George points out that she could implicate herself and get struck off, but she says the trust needs to be held to account, and she will be their whistle-blower.

Kate in a fluffy green jumper and jeans sitting on the floor and looking upset

Kate is used by Eric to do his dirty work. (Image credit: (C) WORLD PRODUCTIONS)

We don't see the meeting between Sophia, James and the MIU play out, but instead it cuts to George and Norma at the next trust board meeting, where Eric thinks they were there to report their findings on Rosie's death.

Instead, Eric's world is about to fall down around his ears as George and Norma tell the rest of the board that Eric has been running the psychiatric unit into the ground to make it easier to sell, and that the land it is on is worth £32 million. But the big shock comes when they reveal the company buying it to renovate it into luxury homes is owned by Eric's sister-in-law. Norma points out that the development would be worth over £60 million once it is completed, and the profits were due to be paid into a parent company, which is owned by Eric and his brother, Rupert. There is disbelief all around as the trust members all realise they have been duped by Eric, and Norma promises the trust will be tied up in legal action for years to come.

Back at home, George faces Gina, who tells her she has been fired from her job and is moving out. Meanwhile, James goes to see Rosie's husband to apologise for everything, and while he doesn't welcome a full conversation, he seems to accept the apology.

James goes to a hearing with the international medical board and makes a plea to keep his job. His speech is passionate, and he accepts his wrongdoings, which the board takes into consideration. All his colleagues are there, along with Norma and George, and they are all relieved when James learns he won't be struck off, but instead will have a 12-month suspension from practicing medicine. He is thrilled to be given just a suspension, and when he sees Kate outside the boardroom, presumably there for her own hearing, he walks past her without any acknowledgement, highlighting the fact that their relationship is well and truly over.

Kate watching James leave the court as he ignores her, both in smart clothes and looking stressed

Kate sees James at his hearing with the medical board. (Image credit: (C) WORLD PRODUCTIONS)

George goes to meet with Liam's parents, and he tells them how sorry he is for what happened to their son. But they say they haven't asked him there to make him accept the blame, instead, they tell him they were upset how the hospital pushed all the blame on him instead of looking at the bigger picture. He is moved to tears as they tell him they don't blame him for their son's death and, finally, he can make some peace with what happened.

At the end of the episode, Eric is arrested for his fraud of the hospital trust, Sophia is struck off, and we see her packing up her work belongings and handing in her pass as she leaves the hospital.

We also see Norma make up with her daughter, while James goes back to Willow Ward to see his colleagues. They all give him a warm welcome and a happy send-off as he heads off to start his 12-month suspension.

All episodes of Malpractice season 2 are available on ITVX as a box set now.

The series will air on ITV1 on Sunday, May 4, Monday, May 5, Tuesday, May 6 all at 9pm. The final two episodes will air on Sunday, May 11, and Monday, May 12 also at 9pm on ITV1.

CATEGORIES
Claire Crick
Assistant Managing Editor at What To Watch

Claire is Assistant Managing Editor at What To Watch and has been a journalist for over 15 years, writing about everything from soaps and TV to beauty, entertainment, and even the Royal Family. After starting her career at a soap magazine, she ended up staying for 13 years, and over that time she’s pulled pints in the Rovers Return, sung karaoke in the Emmerdale village hall, taken a stroll around Albert Square, and visited Summer Bay Surf Club in sunny Australia. 

After learning some tricks of the trade at websites Digital Spy, Entertainment Daily, and Woman & Home, Claire landed a role at What’s On TV and whattowatch.com writing about all things TV and film, with a particular love for Aussie soaps, Strictly Come Dancing and Bake Off

She’s interviewed everyone from June Brown — AKA Dot Cotton — to Michelle Keegan, swapped cooking tips with baking legend Mary Berry backstage at the NTAs, and danced the night away with soap stars at countless awards bashes. There’s not a lot she doesn’t know about soaps and TV and can be very handy when a soapy question comes up in a pub quiz! 

As well as all things soap-related, Claire also loves running, spa breaks, days out with her kids, and getting lost in a good book. 

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