TV docs: intensive care for ailing institutions

It’s becoming increasingly hard in today’s ‘let it all hang out’ culture to know which way to look. Every time you turn on the TV you’re presented with a Great British institution exposing itself to the public glare, wanting you to strip back the layers and glare at it in the altogether. Whether your taste is for a man in uniform, a woman on top or a civil servant in their element, everything is catered for in today’s documentary world. The only question that remains, it seems, is whether you can look them in the eye afterwards.

Keeping Britain Alive: The NHS in a Day is the most recent example of a public institution opening its doors and inviting camera crews in to capture its day-to-day operations. The eight-hour series, currently halfway through its run on BBC2, is certainly a suitably ambitious attempt to offer a snapshot of the world’s fifth-largest employer: shot over the course of one day (18 October 2012) by 100 cameras placed in hospitals across the land, it seeks to document a typical day of public health provision.

With 1.5million patients to cover, there’s certainly no shortage of material to cover, and it makes for compelling viewing. Whether it’s watching daring brain surgery, an ex-boxing champ fight a losing battle against alcoholism, one of nearly 2,000 new lives in a neonatal clinic, a cheery tetraplegic grappling with family life or a transsexual celebrating passing as their new gender, it is a rich tapestry. The staff are, almost universally, hard-working and dedicated, balancing their difficult jobs with the added burden of government cuts and trying patients. It’s heartwarming and powerful stuff.

Surprised? Probably not. That hospitals are sights of great human drama is hardly a revelation; neither is the thought that most healthcare professionals are hard-working and dedicated human beings, doing their best in difficult circumstances. For the most part, despite its epic scope (and being produced with the Open University), Keeping Britain Alive is curiously uncritical for an eight-hour primetime documentary series on a beleaguered institution, currently weathering the crisis of the Mid Staffs scandal and in the midst of complicated and highly controversial reforms.

Instead, we are encouraged to see the NHS as a busy mum, rushed off its feet by the endless travails of its scrape-ridden children, in urgent need of a nice lie down and a cup of tea. Or, as the voiceover informs us, if we fully understood the daily feats of the NHS, perhaps we would value it more. Yet it does not ask us to consider, as an indication, whether the healthcare professionals in non-NHS countries are notably more barbaric or whether the citizens of other similarly developed Western countries are dropping like flies without free-at-the-point-of-delivery health provision.

While particularly ambitious in scale, however, programmes such as Keeping Britain Alive are increasingly common on our screens across all broadcasters. As previously mentioned, we have been treated to similar fly-on-the-wall docs on areas of British life, including the police force (Coppers); the justice system (Britain’s Supreme Court) and even elite army-officer training (Sandhurst). Even Britain’s famously opaque civil service opened its doors to documentary crews back in 2011, with Michael Cockerell’s The Secret World of Whitehall. This week, on the BBC, Keeping Britain Alive was complemented by a new series, The Prisoners, promising another groundbreaking view of inmates as they cope with life in and out of jail.

The appeal of many of these programmes is obvious: with British institutions undergoing an unheralded crisis of purpose and increasingly mistrusted across society, these formats offer the rare opportunity to present their inner workings to the public at a level between subjective personal experience and scandal-ridden headlines. For the viewer at home, it offers that unusual depiction of normal decent people (such as our good selves) engaged in the simple nobility of honest public service.

All of which was perfectly illustrated The Tube, one of the surprise hits of last year. Over six hours, we were treated to an absorbing portrait of the London Underground from the staff’s point of view, from the logistical marvel of how the Victorian-built transport network withstands the morning rush hour of a twenty-first-century metropolis to the prosaic details of dealing with those who dozed off on the last Tube home, via the grim details of how they respond to people going under the trains. For the many at home whose experience of Underground staff tends to be a more fractious one based around being the locus of commuter frustrations and the demonisation surrounding strikes and union militancy, it was a charming and enthralling attempt to humanise the workers and depict the (often highly skilled) work they actually do.

Yet while the appeal for institutions for these collaborations is evident, it’s difficult to escape the nagging sense that these are primarily public-relations exercises masquerading (more sinisterly) under the banner (and resources) of documentary. Both The Tube and Keeping Britain Alive afforded enormous airtime to major institutions without offering much serious systematic analysis of their failings, perceived or otherwise: inasmuch as criticism is handed out, it is to the swarming masses who place these institutions under such strain by, well, using the services and finding them wanting. A recurrent theme of Keeping Britain Alive, when presented with one patient who called an ambulance and then sent himself home after being faced with a long wait for treatment, was as one nurse commented that ‘I don’t think we’re very stoical any more’. Perhaps, but then is there an argument to be had that the National Health Service has had a significant role in undermining that sense of stoicism? That some services which are being cut may deserve to be?

Of course, the failure to debate properly both the present and future of the NHS can hardly be blamed solely on Keeping Britain Alive. There is also much more to good investigative journalism than undercover hatchet jobs. But ultimately, no matter how heartwarming and refreshing they seem, the fact that major documentaries are now devoted to collaborating with rather than scrutinising our major institutions seems itself worthy of a critical eye.

David Bowden is spiked’s TV columnist. He is chairing a public lecture The Letters and Poems of John Keats at London’s Goodenough College on Tuesday 23 April.