A 1: Original submission: ‘A tax on illness?’


Assignment 1: The non-familiar: ‘A tax on illness?

1. Introduction

Title: ‘A tax on illness.’

Subtitle: Portraits of people with cancer, or their carers, who have views about car parking fees at NHS hospitals in England.

Short summary: Car parking fees for people with cancer, and their families, has been branded as a “tax on the sick.” The cancer charity MacMillan have a campaign for NHS parking to be free or reduced, as in Scotland, Wales and Northern Ireland. These portraits and stories show and voice their experiences and feelings about this issue.

Topic or theme – why? My daughter has cancer and has been in hospital for a few months; we pay a lot of hospital parking fees. This has sensitised me to this issue. What do other people think about this, and is it just?

Intention: To produce a series of portraits of ‘strangers’ with or affected by someone they love who has cancer that illustrate their views about hospital parking.

Audience: OCA, personal and local social media, McMillan charity.

Approach and methods– technical, experiments, collaboration, management: Recruitment was through local and national social media (Facebook, Twitter, personal databases) and email via my personal photographic website morris-gallagher.format.com which carried an advert for this project. I negotiated the interview and shoot by phone or email. Most people were happy to be seen at home but one person elected to meet in a local cafe. I interviewed the person or people and took images using natural light. I used a money signifier in some images, but there are other signs in most images.  I sent each participant a copy of the interview text and preliminary diptychs which I used to present text and image (respondent validation).

I used diptychs as I though that the voices of the people were as important as the portraits and wanted to give image and text equal weight.

Access, consent, confidentiality, legal: All participants consented to their stories and images being put into the public domain.

Presentation, publicity, social media piece: OCA, Low Fell Local Facebook page, Twitter feed, participants, McMillan charity.

What is the images purpose? To give patients with cancer and their carers a voice about hospital car parking fees in England.

Theoretical underpinnings: My personal beliefs about social justice and Marxist theory is applicable here where the monetisation of the illness experience feeds into the means of production and controlling ideologies of health (D’Alleva, 2013).

Photographic influences: My approach is related to that of Martin Parr and Eric Kim (Parr, 2016; Kim, 2016). My presentation is influenced by ‘Humans of New York,’ Martha Rosler and others using text and images (HONY, 2016; Rosler, M. 1974-75;  Slemmons, R. 2014).


Macmillan (2012). Out of order: the hidden cost of hospital parking. http://www.macmillan.org.uk/documents/getinvolved/campaigns/hospitalcarparking/hospital-parking-charges-reportb-2013.pdf.

BBC (2012). “NHS hospital parking fee rises criticised. .” Retrieved 1st August, 2016, from http://www.bbc.co.uk/news/health-17394126.

Massey, R. (2016). NHS’s £350 parking goldmine: Trusts collect average of £950,000 each in the past three years which receiving £2.8m in fines. Daily Mail. Mail Online, dailymail.co.uk. http://www.dailymail.co.uk/news/article-3653594/NHS-s-350m-parking-goldmine-Trusts-collect-average-950-000-past-three-years-receiving-2-8m-fines.html.

Parr, M. (2016). “The Rhubarb Triangle.” Martin Parr. Retrieved Ist August, 2016, from http://www.martinparr.com/recent-work/recent-work-2/.

Kim, E. (2016). Street Photography 102. http://erickimphotography.com/blog/2016/04/04/street-photography-102/. Eric Kim Photography.

D’Alleva, A. (2013). Methods and Theories of Art History. London, Laurence King Publishing.

HONY (2016). “Humans of New York. .” Retrieved 12th August, 2016, from http://www.humansofnewyork.com.

Rosler, M. (1974-75). “Tthe Bowery in two inadequate descriptive systems.” from http://collection.whitney.org/object/8304.

Slemmons, R. (2004). Conversations: Text and Image. Columbia College of Chicago: Museum of Contemporary Photography. Retrieved from http://www.mocp.org/exhibitions/2004/02/conversations-text-and-image.php

2. Commentary and reflections

Much of my time on the shoots was spent having cups of coffee, listening to people and asking questions. I had heard similar stories before but am always impressed by the variety and intensity of responses to serious illness.

I used a Nikon D810 with a 50mm  lens with natural light and settled on a depth of field of f8-10 to ensure that enough of the background was in focus to provide context – their chosen environment. The one exception was ‘Josh’ where I used a 24mm lens with flash as we were in a confined space. I made contemporaneous notes in my diary and took photographs. The precise expression of the ‘money’ signifier came from our discussions. These included the parking ticket and pass, the money bag, the £100 of notes. It did not seem appropriate to use this signifier in the other two images.

Most of the time the natural light was effective and I experimented with fill flash. I could have experimented more especially with ‘Maureen’ where there was a very bright background. This would have given me more choice of images although adjusting the images for differential exposure in Photoshop was not difficult.

The interviewees talked about the financial and emotional cost of cancer. I decided early on that the text was very important to the project. The issue was how much to use and how. I experimented diptychs of image and text, but after feedback from OCA colleagues elected for a much simpler presentation.

I approached this project from the point of view of parking fees for cancer patients is an injustice. I still think it is but the debate and people’s views are more nuanced.

3. Portraits


Stranger 6 josh  jpegs final selections (1 of 1)

Joshua preparing to visit his sister Rosie in isolation, in hospital, where she is having chemotherapy for Non-Hodgkin’s Lymphoma. He has travelled from Japan to be tested to see if his is a potential stem-cell donor for his sister.

“I think that on balance health care is free then it’s not that bad to be charged. I think I’d rather pay car parking fees than have to pay the medical fees for cancer care which you would have to do in other countries. The question is who gets the money? Is it going to the hospital or a private company? Do I think that it is fair? That is a different question, as I don’t think it is fair for some disadvantaged people to be paying.”


Stranger 1 Karen jpegs final selections (1 of 1)

I met Karen through a contact on social media. We met a local supermarket cafe where she talked about her father who died of stomach cancer.

“Dad died two years ago from stomach cancer. It’s an awful, awful disease. They took away two-thirds of his stomach. He recovered really well and had a run until it relapsed a year later. He just couldn’t do the chemo and had to stop.

His uncle used to take him in his car the hospital as he was not happy with heavy traffic. His doctor’s surgery arranged a taxi for him and his girlfriend to hospital. He didn’t have much money either.

“We eventually got a blue badge for free parking and it arrived two days after he died. He did not want to fill in the forms


Stranger 3 Maureen jpegs final selections (1 of 1)

Maureen had just completed surgery then chemotherapy for anal cancer. I met her in her home where she was in pain and had to sit on a soft ring. She wanted people to know about her rare form of cancer.

“The whole treatment process has been traumatic for me. I found it difficult, particularly seeing so many people who wanted to do things to you – its a shock. Not a lot of people know about anal cancer and I want people to know so that they can catch it early like mine (stage 2). I had been constipated at Christmas and then had a lot of pain going to the toilet at Easter. I then had two big bleeds, went to see my GP who said she could feel something and that was it – I’ve been lucky catching it early. It’s not an even battle (cancer) and people don’t want to say what it costs. We (me and my husband) are in it together.

I have pain when I walk so parking near to the hospital is a must. I have a wheelchair and a disabled badge now which hopefully I won’t need for much longer. One time we had to stay late and did not have the change for the meter but went to the reception, they took the car details, they phoned parking and we were let through – you can’t fault them there. We now bought a parking pass which has been a big help and it expires in a few days time. We will then have to pay the ordinary fees.

“In the last five and a half weeks we have been in hospital for 2-3 hours every day and spent 2-3 hours waiting for or having treatment…That adds up to about £100 in 5 and a half weeks which is a lot of money especially if you don’t have much.


4srranger 4 stuart (1 of 1).jpg

Stuart is Maureen’s husband. I did not plan to interview him but he wanted to give his views about paying for hospital parking.

“The fear when you go to hospital is that you are going to take two or three hours to get sorted and at £1.10 or £1.20 an hour it’s going to mount up to be very expensive…

We keep a money bag in the care of change so that we are prepared…

I remember you  saying to me one day about hospital parking fees that “It’s a tax on being ill,” which I think it is.

It’s not just the money that you’re dealing with but the enormous trauma of cancer. I mean you have that and all you are thinking about when you go to the hospital is ‘Have a got a pound coin?’ It’s ludicrous.  I can understand why people smash the machines out of sheer frustration.


Sue final (1 of 1)

Sue had cervical cancer and wanted to talk about her experiences of having the condition so that others would recognise the early symptoms.

“I’d had lots of smears but then noticed just a few spots on my pants when I went to the toilet, just the three times, and I knew something was not right.  In fact my tip to the ladies would be lighten up your pants so that you can see if something’s not right…

I had chemo, radiations and brachytherapy which is where they put you in a metal tube with metal tube with radiation inside you to treat the cancer. It was like being in a strait-jacket and it hurts your back – I was counting down the hours with the nurses so that they could take in off!

I would rather that they (the Hospital Trusts) spend money on hospital care than have to also pay for the parking. They don’t want to give up the parking charge and it depends on what the money that is saved is spent on; there is a lot of wastage in the health service…I realise that there are issues such as who owns the land or who it is leased to but they have to make money from parking.”

These are now on my personal website morris-gallagher.format.com