Prime Time tonight; investigative journalism or fishing for a drama?

It’s pretty unnerving to see yourself on film when you didn’t realise someone was filming you. Which is why several nurses, doctors and administrators are going to be a tad distracted, all day today, by the expectation that tonight, RTÉ’s Prime Time Investigates may show footage surreptitiously filmed in the A&E units of three or four hospitals.

From RTÉ’s point of view, it’s an opportunity to show pictures of the reality that’s been talked about on one radio programme after another. An opportunity to present in human terms an emotive issue often discussed in structural or resource terms. An opportunity to show the real suffering of real human beings as opposed to staging yet another discussion about trolleys, step-down facilities or transit units. An opportunity to do real front-line investigative journalism under cover.

From the hospitals’ point of view, it’s a nightmare and an outrage to find that on several days in March, cameras were sneaking around their Casualty wards. Hospital managements’ view the activity as infringing patients’ privacy and confidentiality, as amounting to trespass and as constituting fraud, since the camera operators had to miss-represent themselves and their purpose by letting on to be sick or by letting on to be related to patients being treated.

One should not, of course, assume all hospitals filmed are equally outraged. The ones which don’t have a high trolley count and which can move patients quickly into beds may tut-tut a bit, but their upset is mild, compared to that of the major acute city hospitals (it’s proper to state, at this point, that neither I nor my company is retained by any of the hospitals involved. I do, however, receive the odd little cheque from RTÉ). The acute hospitals are well aware that when they protest about their duty to safeguard the most vulnerable patients visiting A&E, and their matching duty of care to staff going about their tasks, the reflex response of the general public is that they’re only complaining as a way of hiding what’s going on in casualty. Which brings the management of those hospitals out in a florid rash as they point out that it’s difficult to hide a reality experienced at first hand by thousands of citizens every day, every week, and when a substantial proportion of those citizens have told their story or the story of their loved ones to media already. Every aspect of the problem, whether it’s patients stealing each other’s chairs or pillows when one of them has to visit the toilet to a grievously sick old person suffering on a trolley for days, has been played out in media, so what, they ask, is there to hide? The programme makers probably got great footage, and many viewers will remember great covert footage putting an end to the Leas Cross nursing home. The hospitals will say that getting great footage just adds dramatic impact to programming, but could not illustrate the kind of scandal revealed by the Leas Cross investigation, because everybody in the country already knows, not just the pressure under which the major acute hospitals have to operate their A&Es, but the kind of incidents which result from that pressure. Their take on the surreptitious filming is that it was fishing for drama, rather than investigative journalism.

I understand some of them have protested to RTE that the filming contravenes the national broadcaster’s own guidelines, which state, inter alia, that: “On extremely rare occasions an investigative report may call for a degree of deception to enable an investigation to take place in the public interest. An example would be where a reporter investigating dishonest practices in the motor industry pretends to be an ordinary consumer and asks a garage to repair a car...The Division Head [however] must be satisfied that such deception is in the public interest and that there are no other methods of making the report available.”

RTÉ’s Guidelines in this regard are unequivocal. They indicate that covert filming may be justified when the activity filmed is anti-social. So if a programme maker goes to the director general, (the DG being the one who has to authorise surreptitious filming) they may have to show him they’ve good grounds to believe that secretly

filming a meeting within a particular company, for example, will demonstrate bullying or racism or ageism. Or that covert filming in a garage will establish substitution of cheap and dangerous car parts for the parts for which the customer is paying.

In addition, the programme makers have to demonstrate that broadcasting the footage surreptitiously made will be in the public interest, and RTÉ gets elegantly specific on this one.

“Programme-makers should note,” say its guidelines, “that the public interest is not the same thing as interesting to the public.”

The hospitals do not doubt that the footage covertly filmed will be interesting to the public. What they do not accept is that it is in the public interest.

Covert filming can reveal truths which cannot be revealed in any other way. It has been used within healthcare to expose mothers suffering from Munchausen-by-proxy, the syndrome which causes them to seek the sympathy of healthcare workers by bringing their grievously ill children repeatedly to hospital, when in reality the children’s illness has been caused by maternal poisoning or other malign meddling.

Used by media, covert filming is a double-edged sword. Patients filmed must have their identities concealed (unless they sign a waiver) which involves breaking up the picture by pixilation. Even that doesn’t always work. A patient filmed without permission in a TV programme in another jurisdiction had his face pixilated. But when he watched the TV programme, an arm escaped the pixilation and he recognised it as his own. He sued, on the basis that if he knew that arm at a glance, other people knew that arm, ergo his privacy had been invaded. He won.

The other group whose privacy is at risk is staff. Last week, in this column, I infuriated one reader, who wrote to the Letters page, posing a number of pertinent rhetorical questions about A&E.

“Who listens to patients’ and relatives’ complaints regarding the inadequacies of the health system?” the letter-writer asked. “Who advises them to complain to budget-holders and policy-makers?”

Nurses, is the short answer. Now, let’s imagine that a nurse happened to be telling an infuriated patient to complain to the hospital Finance Officer (who presumably is the budget holder involved) or to the Tánaiste (the policy-maker) on the night RTÉ happened to be filming in her A&E, unknown to her. That nurse might not be happy, today, thinking about the career consequences if her politicising of patients were to appear on Prime Time Investigates.

In the hours (or days) before the programme is transmitted, those in the hospitals filmed can do nothing but wait. And worry.

RTÉ has an equally difficult task: to satisfy itself that broadcasting covert footage is in the public interest, as opposed to simply being interesting to the public.

Keeping in mind that the end does not always justify the means...