24 Hours in A&E: Public Service and the Fixed-Camera Documentary
Last week the award-winning 24 Hours in A&E returned for a second series, illustrating how amidst the gawking of Embarrassing Bodies and Big Fat Gypsy Wedding Channel 4 manages to balance on the tightrope of its dual identity as a commercially funded, public service broadcaster. One of the channel’s many fixed-camera documentaries, the series deploys both technological innovation and audience-pleasing storytelling, whilst in the process educating the audience about emergency medicine and affirming the value of Britain’s NHS, currently under not-so-veiled attack by the Conservative government.
Series 2 sees 91 high-definition cameras fixed throughout the Accident and Emergency ward at London’s Kings College Hospital each episode chronicles a single day in one of the UK’s biggest trauma center. Able to turn and zoom in any direction, these cameras are controlled by remote control from a mobile gallery parked outside. 168 production team members filmed for a month, accumulating 7600 hours of footage, to produce 14 episodes. It is a mammoth technological undertaking, illustrating how Channel 4 likes to do things big – it’s a public service broadcaster, but one funded through adverts, so it has to reel its audience in.
Each episode of 24hrs in A&E (which airs in the US on BBCAmerica) assembles a series of central stories and surrounding vignettes. We have victims of road traffic accidents, gang stabbings and massive strokes. But we also have the little old lady who fell out of bed, or the man who left in that splinter way too long. It’s often a masterpiece of storytelling, confronting us first with the injury and the team’s attempts to treat and diagnose before slowly building up the picture of the patient and what happened through retrospective interviews with friends, families and medical staff. It illustrates Channel 4’s public service remit in action, working as a flagship ‘state of the nation‘ documentary, and a chronicle of multicultural Britain through its patients and staff. Yet at the same time it demonstrates technological innovation through its filming processes.
In recent years Channel 4 has built a stable of these fixed-camera documentaries, chronicling daily life in model agencies, hotels, maternity wards and high schools (and even a houseshare of dwarves during panto season). The form debuted with The Family in 2008, where Paul Watson’s groundbreaking 1974 BBC documentary serial was updated for the Big Brother age. The observational camera crew were absented in favor of 40 fixed cameras fitted around the Hughes family home, with a live gallery in the house next door, filming for 100 days to build up a picture of ‘everyday’ family life. Creatives and executives were careful to highlight the program’s ‘normality’ in contrast to the pictures of dysfunction and conflict painted by previous Channel 4 hits Wife Swap and Supernanny. This was serious, 9pm, ‘event’ documentary. Its title suggested universality – ‘The’ family – a chronicle of the institution, featuring white, British-Asian and British-Nigerian families. Building on Channel 4’s remit to ‘appeal to the tastes and interests of a culturally diverse society’, the programme established the fixed-camera format as a distinctive (another remit buzzword) feature of a new era of Channel 4 observational documentary.
The Family’s success helped signal a way forward in the imminent post-Big Brother era, with Channel 4’s defining reality TV series slowly limping towards its cancellation in 2010 (since revived by channel Five). These fixed-camera documentaries utilized Big Brother’s surveillance technology to present a new spin on the classical ‘fly-on-the-wall’ style. By making its camerapersons invisible, the documentaries attempt to reduce the observational documentary paradox, with their around-the-clock filming and all-seeing cameras bringing connotations of directness, immediacy and transparency.
You can see the value for Channel 4: a standardised format, deployed across a range of subjects, producing a string of new programming, for a limited development spend. The accumulation of vast tranches of footage allowing relatively lengthy runs compared to a single-authored documentary series or one-offs. From One Born Every Minute to The Hotel to Educating Essex – they all unfold the same way. A fast-paced opening montage introduces the concept and location, foregrounding the technology and the breadth, yet intimacy it allows. Highlighting the combination of the spectacular and the mundane that will unfold. Then they settle down to tell 2 or 3 main stories through observational footage and contextualizing interviews from participants. You could set your watch by them. As with any success story, this boom tipped over into a glut of fixed-cam documentaries chronicling the emergency services at the beginning of the year, leading to grumblings from the press.
However, as I noted, these programmes have particular value for Channel 4’s public service remit, though they are distinct from the majority of the channel’s socially-focused factual programming. The channel has a tendency towards livening up complex political issues within a challenge format, which offer more than a hint of neoliberalism – the need to ‘provide access to material that is intended to inspire people to make changes in their lives’ is literally written into the channel’s remit. Series like Benefit Busters or Fairy Jobmother, with their tough love and use of NLP strategies on the long-term unemployed, seem to come straight out of a government press release. Whilst Secret Millionaire and its search for the ‘deserving poor’ and community volunteers to hand a cheque to (whilst going on weeping personal ‘journey’) is a virtual blue print for Cameron’s ‘Big Society’ – someone will surely step in to provide these public services we’re cutting.
In contrast – perhaps because the technology provides the high concept – the medical (and school-based) fixed-cam documentaries step back and let us view the daily work of the public services. Of course there’s the hand of a master storyteller behind this, shaping those thousands of hours of footage into linear stories and perfect moving moments. But whilst the programme depicts the cost of timewasters and drunks, the long waiting times, and the struggle to provide care, this is soft political advocacy. A heart-rending personal story (nearly always) wrapped up in a warm hug. All this technology allowing television its small-scale intimacies, and the NHS its moments of grace.