Cost of Living, Hampstead Theatre, London review: Adrian Lester heads a crack cast in this sharp-talking Pulitzer-winner

Edward Hall and Greg Ripley-Duggan's hundredth production at the theatre is worthy of congratulation

Katy Sullivan and Adrian Lester in the Hampstead production (Manuel Harla)

Martyna Majok’s Pulitzer Prize-winning play gathers four people of a type we rarely encounter on the stage: the disabled and the carers who are paid to make their lives feasible. It’s not a piece that’s bent on swathing its subjects in ennobling sentiment. John, a student with cerebral palsy, snaps at Jess, whom he has just recruited to shower and dress him each morning, that the expression “differently abled” is “f**king retarded”. Cost of Living is a rare combination of matter-of-fact candour and watchful empathetic insight – plaited qualities found in abundance in Edward Hall’s production which sees the superlative Adrian Lester head a crack cast.

The play alternately follows two pairs in stories that eventually intersect. The gloriously foul-mouthed Ani is struggling to come to terms with the fact that a motor accident has left her quadriplegic. Who better than her estranged truck-driver husband Eddie to lift and wash her (he already has intimate knowledge of her body)? And who worse? The baggage from years of wedlock; his new girlfriend; the sense that – though he was in no way to blame for the accident – he’s using the situation to do penance for the past.

Meanwhile, Jess (Emily Barber), a recent Princeton graduate and first-generation immigrant who has fallen on very hard times, is trying to augment her paltry income (from working in dubious late-night bars) by acting as carer to John (Jack Hunter), the moneyed PhD student with cerebral palsy. The play in no way depicts John as a bad person but, as the title suggests, we’re not allowed to forget that the US is the only industrialised nation that does not offer its citizens universal health coverage. So, given the pervasive anxiety about insurance, John’s explanation to Jess of why he doesn’t hire from agencies feels rebarbatively luxurious, self-serving and privileged: “They don’t appreciate my lawsuits. If their people mess up, I can sue them so agencies limit aides to just doing the basics.” And, of course, he does have some right on his side.

Katy Sullivan, the American actor who created the role of Ani – and who is a bilateral amputee and Paralympian – is tremendous as this ferocious motormouth figure. She tries to ward off the eager, slightly clumsy solicitude of her ex-spouse with volleys of New Jersey invective. In vain. Lester wonderfully conjures Eddie’s capacity for loving warmth and his deep, underlying loneliness. There’s an extraordinarily beautiful scene in which Eddie is giving Ani a bath; below the waterline, he is trying to ascertain how much feeling she still has down there and she warns him that she still feels that kind of feeling but in a different part of her body. In a way that connects several references to music and disability, he drapes her arm along the bathtub edge and plays it like a piano to a dreamy Satie tune on the radio. It’s one of the most tender and sensual things that I have seen.

Emily Barber and Jack Hunter are also very good as the other two – she gives him a complete shower at one point – and there’s a line, delicately blurred, between the awkward eroticised intimacy of their encounters and tensions between them caused by nationality, class, expectation. But it’s with this pair that, to my mind, the play goes astray. For the final scenes to work, there has to be an excruciating misunderstanding between them about a Friday evening date: I can’t bring myself to believe that it would have played out like this. A pity because, up to that point, I had been impressed with Majok’s piece.

Cost of Living marks the hundredth UK premiere that Edward Hall and Greg Ripley-Duggan have mounted at Hampstead since they started there in 2010. Averting my eyes from the very odd dud, I pass on my congratulations. Which other theatre would be so hospitable to an unapologetically highbrow plays like Tony Kushner’s The Intelligent Homosexual’s Guide to Capitalism and Socialism, or Rajiv Joseph’s Describe the Night?

Until 9 March, hampsteadtheatre.com