Since
it was launched in Autumn 1986 as a 15-part series, the hospital
drama Casualty has grown into one of the BBC's most successful
programmes. Eventually running to 24 episodes a year (plus a repeat
season), and with ratings second only to those for soap operas Eastenders
and Neighbours, it was to become a linchpin of the schedule
and crucial to the corporation's confidence in the run up to the
renewal of its charter in 1996.
The
series began as the brainchild of Jeremy Brock, a young BBC script
editor, and Paul Unwin, a director at the Bristol Old Vic Theatre.
A visit to a Bristol accident and emergency ward and conversation
with one of the charge nurses prompted the idea of a series which
would deal with the working lives of casualty staff but which would
also have a campaigning edge at a time when the National Health
Service in Britain was under increasing financial and political
pressure. The proposal was taken up by the Head of BBC Drama, Jonathan
Powell, who was convinced that a medical series was essential to
a healthy schedule. The Bristol hospital became Holby General and
the nurse, Peter Salt, one of the programme's medical advisors and
a model for the longest serving central character, charge nurse
(later nursing manager) Charlie Fairhead.
The
foregrounding of a male nurse was one of several ways in which
Casualty set out to contest the traditional values of hospital
drama. The gender stereotyping associated with sluice room romances
of popular medical fiction was inverted (if not always subverted)
in storylines such as Charlie's passionate involvement with a female
house officer, and the protracted consequences of nursing officer
Duffin's pregnancy by a feckless doctor. The series has also attempted
to address racial underepresentation by placing black characters
at the centre of the drama and has carried storylines on racial
prejudice and abuse.
What
Casualty sought to achieve in its first series was a gritty
realism bordering on documentary authenticity, capable of dealing
with the day-to-day stresses of front line emergency care and the
further difficulties of working in a system coming apart at the
seams. Brock claimed to have been influenced by the high-octane
style of MTM shows, especially Hill Street Blues, with their
overlapping narratives and dialogue, their rapid cutting and their
wry humour, though the series never went for the sort of élan found
in its U.S. counterparts. It began on a modest budget, and was shot
exclusively on video, with lightweight cameras to give it pace and
fluidity: the technique of following dialogue down corridors and
picking up on several overlapping conversations within the same
take was to become a hallmark of the emerging production style.
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. The
shift also provided the setting and time frame for each episode
and, improbably, a justification for focusing on the same eight
members of staff. By the end of the first series, although another
was in production, there was talk of 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, though there was considerable
support for the series' representation of health service conditions.
The programme also came under attack from the ruling Conservative
Party for its stand against such key Thatcherite policies as funding
cuts and the contracting out of services and, along with news coverage
of the bombing of Tripoli and the drama The Monocled Mutineer,
was held up as an example of alleged left-wing bias at the BBC.
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
brought in and a sharper style began to emerge, particularly in
the cross-weaving of storylines and the more honed gallows humour.
By 1991, Casualty had an audience of 12-13 million and the
formula was securely established; a basic structure created by the
ten main characters' continuing stories, a major accident interwoven
with six to eight further parallel storylines and up to 80 short
scenes per episode, a real-time feel based on the single shift setting,
sharp cutting, mobile single camera work, no background music, realist
lighting, an army of trauma-specific extras and models, and a range
of 30-40 guest actors per series. The casting of familiar, high-caliber
performers in cameo roles was for some time one of the series' main
attractions, along with its growing reputation for graphic authenticity
in the depiction of injuries and their treatment. The series also
shed its regional identity: although still shot in and around Bristol,
this was no longer its ostensible setting and the characters came
to reflect a more general population mix. A proposal by Powell,
by now Controller of BBC1, to go to a twice weekly, early evening
slot was rejected but by this time, many would ague, the show had
already softened into a standardized predictability. By 1993, audiences
were peaking at 15.47 million and the programme was tentpoling the
Saturday evening schedule. A ruling in that year by the Broadcasting
Standards Council concerning the pre-watershed unsuitability of
a storyline about rent boys and male rape and further controversy
over an episode showing teenagers rioting and burning down the ward
forced the new BBC1 Controller, Alan Yentob, into a promise of greater
"responsibility" in the handling of topical material. A year later,
audiences stood at 17.2 million.
Against
the claim that Casualty has lost its earlier political abrasiveness,
the producers would argue that public opinion had caught up with
the programme, that the once controversial claims had become fact
and the issues were more subtly woven into the fabric of the stories.
By 1995, however, the series seemed to reach a final transformation
into soap opera. It was the human interest vignettes imported with
each casualty case which now dominated, along with the lives and
loves of the regular medical staff. Yet the storylines have never
fully lost contact with the fabric of contemporary life, one of
the series' recurring concerns being the social cohesion of the
world beyond the hospital doors.
Casualty
is a classic example of the intergeneric development of formula
based television fiction. All the attractions of hospital drama
are there: life, death, and human vulnerability; institutional hierarchy;
the personal and professional tension. The show also chimes in with
the ascendancy in the 1990s of a new genre of emergency service
narrative on British television, from Carlton's drama London's
Burning to reconstruction programmes like the BBC's 999. Beneath
the surface, however, the fictional structure rests on foundations
tried and tested in the cop-shop police drama, and it is no coincidence
that the background of founding producer Geraint Morris lay with
series such as Softly Softly and Juliet Bravo. The
accident and emergency ward, in particular the waiting area that
provides the focal point of the production set, operates here as
a classic front line--a site of friction between the hospital community
and life on the street, and a liminal space into which hundreds
of individual cases are drawn, to be returned, in varying states
of social and psychological repair, to the world beyond.
-Jeremy
Ridgman
CAST
Charlie Fairhead Derek Thompson Dr. Mike Barratt Clive Mantle Martin
Ashford Patrick Robinson Josh Griffiths Ian Bleasdale Rachel Longworth
Jane Gurnett Kate Wilson Sorcha Cusack Valerie Sinclair Susan Franklin
Megan Roach Brenda Fricker Alison McGrallis Julie Graham Kiran Joghill
Shaheen Khan Dr. David Rowe Paul Lacoux Sadie Tomkins Carol Leader
Keith Cotterill Geoffrey Leesley Cyril James Eddie Nestor Lisa Duffin
Cathy Shipton Shirley Franklin Ella Wilder PRODUCER Geraint Morris
PROGRAMMING HISTORY BBC 1986- FURTHER READING Kerr, Paul. "Drama
Out of a Crisis." The Listener (London), 4 September 1986. Kingsley,
Hilary. Casualty: The Inside Story. London: BBC Books, 1993. Lustig,
Vera. "Emergency Ward Tenable?" The Listener (London) 20 September
1990. Saynor, James. "Doctor, It's Something Up My Nose." Guardian
(Manchester), 22 February 1993. Smith, David James. "Close to the
Bone." 7 Days (London), 3 September 1989.
Kerr,
Paul. "Drama Out of a Crisis." The Listener (London), 4 September
1986.
Kingsley,
Hilary. Casualty: The Inside Story. London: BBC Books, 1993.
Lustig,
Vera. "Emergency Ward Tenable?" The Listener (London) 20
September 1990.
Saynor,
James. "Doctor, It's Something Up My Nose." Guardian (Manchester),
22 February 1993.
Smith,
David James. "Close to the Bone." 7 Days (London), 3 September
1989.
