King’s College Hospital currently has an appeal for funds which urges us to text a five pound donation to ‘improve the life-saving care we provide for our patients’. Hospitals used to be state funded. As insidious as the implication that hospitals ought to have top-up funding via individual donations, is an added caveat that the appeal is enhanced by interviews with clinicians from Channel 4’s ’24 hours in A&E’ (The second series was first broadcast in the summer of 2012 in the UK, currently showing on More4 , and, with subtitles, the series is presently being broadcast as ‘Akuten’ in Sweden).
Channel Four’s documentary is ground-breaking in that 91 fixed cameras filmed round the clock, in various locations in the A&E ward. Occasionally a small white camera lens attached to a gurney or a wall comes into shot. Some of the cameras were positioned over the trauma bays where patients are assessed and treated on arrival. Interspersed with the documentary material are talking heads: staff; patients (if they survive the trauma); family and friends. The episodes convey the uncertainty and anxiety of patients and their supporters and the compassionate professionalism of the staff, as well as the endless waiting, frustration and human absurdity of work in an emergency ward.
’24 hours in A&E’ offers glimpses of people in the direst of straits, who often recover thanks to the skilled support of health care professionals. The elegant editing of these stories, told from the point of view of patient, carer and clinician, makes for moving and uplifting viewing. The professionals provide us with insights into their work and, with good humour, offer a positive account of NHS care at its best.
This harnessing of these highly telegenic professionals to encourage us to donate funds (beyond routine tax contributions), in support of their work is unsettling. The smiling faces of Sister Jen du Prat and Dr Matthew Mak, together with Nurse Laura Higgs’ trade-mark red lipstick, encourage us to ‘Donate Now!’
Televisual representations of medicine are influential. Dr Matthew Mak himself reports that Hoby City was responsible for his application to study medicine. ’24 hours in A&E’ is reality television at it’s best, in terms of the representations on offer. But what should we know about the financing of the programme and how this relates to the current appeal for funds? Are we donating funds for a specific piece of equipment, or for the general running costs of the hospital, including Sister du Prat’s salary? Is this a renegotiation of the contract between tax payer, patient and healthcare provider?