Casualty: A History Of...

“In 1945 a dream was born in the National Health Service. In 1985 that dream is in tatters.”

That was the challenging opening proclamation in a pitch for a new BBC hospital show from young script editor Jeremy Brock and theatre director Paul Unwin just over 20 years ago.

Now, two decades on, that programme - Casualty - is the UK’s longest-running emergency medical drama and this weekend celebrates its milestone anniversary with an exciting two-part special to launch the 21st series.

After 20 years, this still highly popular, top quality, “best of British” TV drama continues to hold a special place in audience affections.

For millions of viewers, Saturday night simply would not be Saturday night without the urgency, the unexpected, the sensitivity and the spectacular that go to make up this graphic window on our wounded world.

Initially, the idea was for a drama set in a large, inner-city hospital, staffed by unglamorous people with untidy lives.

The emergency department was seen as an extension of street-life – into which would flock the drunk, the addicted, the careless, the desperate, the unlucky, the mad and the bad.

This pitch became Casualty.

Brock and Unwin researched the show with the help of Peter Salt, a charge nurse in the emergency department of Bristol Royal Infirmary, who inspired the character of charge nurse Charlie Fairhead, played by the show’s longest-established actor, Derek Thompson.

Both Derek and Pete are still key players in Casualty – set in the Accident and Emergency Department of the fictional Holby City Hospital - after 20 series, Pete having worked on every single episode!

Although it has undergone sea changes, at core it’s still a contemporary, compassionate, hard-hitting drama – just as it was in the beginning.

And that beginning was on 6th September, 1986 when the first episode was broadcast - at a time when the National Health Service was under increasing financial and political pressure.

The central storyline for the first two series was the campaign to keep the night shift open at Holby in the teeth of funding cuts – a shadow that has prevailed over hospitals throughout Britain to this very day.

Unbelievably, a similar shadow briefly fell over the programme itself.

For despite a second series already being in production, by the end of that inaugural year there was serious discussion about Casualty being axed.

There had been criticism of the show's stress-laden relentlessness and press coverage of protests from the medical professions about the disreputable image of staff conduct, although there was considerable support for the series' representation of health service conditions.

However, as audience figures for the second series began to climb to eight-million, the BBC started to invest more in it. New characters were introduced and a sharper style began to emerge, particularly in the cross-weaving of storylines and the greatly honed humour.

By 1991, Casualty had an audience of 12/13 million and the formula was securely established.

Its success had so impressed BBC1 Controller Jonathan Powell – who, in his former capacity as Head of Drama had approved the original concept – that he put forward a proposal that the show should go out twice-weekly on an early evening slot. Regrettably, for many, this was rejected.

But there was to be no eroding of its popularity. By 1993, audiences were peaking at almost 15.5 million - with the programme the lynchpin of the Saturday evening schedule.

A year later, viewing figures exceeded 17 million.

Now, as it celebrates with an almighty birthday cake this weekend, there's a special reunion in the opening two-parter of the series, which revolves round a special plea to Charlie to help set up a new clinic in Cambodia.

But why Cambodia?

Series producer of the show since August 2004, Jane Dauncey, doesn't hesitate for a moment: "We wanted to do something special to mark the 20th birthday. Sending our team to Cambodia seemed a good way to celebrate the traditional values of Casualty, while highlighting that the show is still very keen to break new ground."

With 48 episodes each year, the filming of Casualty is, says Jane, “a phenomenal undertaking”.

She commented: “Two crews are shooting all the time and it has to run like a fast and well-built train set."

For millions of TV viewers, it is firmly established on the right lines.

Indeed, Casualty is a classic which has passed the most rigorous of medical checks and would appear to be assured of a continuing healthy future.

Sticking plasters, it seems, will not be required!