I was charged a total of £20.00 for for 4 months Apple TV subscription which I did not use as I was in hospital.

Subscriptions continue as long as you are subscribed. Subscriptions do not depend on active use of it. Same as your regular TV bill, electricity, home internet, or even rent. You can request a lot of things, but they’re not obligated to refund, per the terms that you agreed to. Request a refund for apps or content that you bought from Apple - Apple Support

for 4 months

That’s some serious coma care. I’m glad you got out of that.

few companies really use emails in such a way anymore because the wast majority of mails being sent today is spam

the first link in the link you got is this  reportaproblem.apple.com