Formula: A medical Hill St Blues. Six fresh 'accident and emergency' storylines a week are woven into the well- established fabric of the Casualty Ward at Holby City Hospital (a permanent set on the outskirts of Bristol). The staff is led by the only two characters to survive from the very first episode: tough but tender Sister Lisa 'Duffy' Duffin (Cathy Shipton), and tough but tender Charge Nurse Charlie Fairhead (Derek Thompson - Bob Hoskins' treacherous sidekick in The Long Good Friday).
Frequency: One series a year since 1986. This year's has 24 episodes.
Early symptoms: In 1985, then BBC1 Controller Michael Grade expressed a desire for a new hospital series, a mainstay of American schedules. Then Head of Drama Jonathan Powell selected a proposal for a series called Front Line by struggling twentysomething writers Jeremy Brock and Paul Unwin. Brock's catchline was: 'In 1945, a dream was born in the National Health Service. In 1985, it's under great threat.' The writers' gritty, campaigning approach had been inspired by the work of Charge Nurse Peter Salt, who became an adviser to the show - along with an ambulance driver, a doctor and the Senior Charge Nurse at the Bristol Royal Infirmary, as well as representatives of the social, fire and police services.
Initial diagnosis: Most people liked it, but not Conservative Central Office which called it 'left-wing propaganda . . . like a Labour Party meeting.'
Is it too unflinching? For some. The final episode of the last series featured an inner-city riot followed by an arson attack on the hospital. It attracted 17m viewers, but also 700 complaints. Other episodes have covered incest, female circumcision, queer-bashing, racial attacks, child abuse and gang rape. Even the titles include a nasty motorbike accident.
Why do people watch it then? Because they get a vicarious thrill from watching others deal with such crises. As with detective drama, great enjoyment can be derived from viewing an emergency - and its resolution - from the outside. Those who can, do; those who can't, watch it on Casualty.
Is it as popular with the BBC as it is with viewers? Are you kidding? The BBC loves it: it's shot on video, costs a relatively cheap pounds 300,000 per hour and attracts an average of 15m viewers. BBC1 is not in such robust health that it can turn its nose up at that sort
of audience figure, the channel's best for a non-soap. But the love affair
does not yet stretch beyond one assignation a week - despite Powell's best efforts to make it bi-weekly.
What do they say about Casualty in the biz? The joke is that every member of Equity has at some time been in either Casualty or The Bill. Officer-class luvvies to have rubbed shoulders with the foot soldiers include Dorothy Tutin, Rula Lenska, T P McKenna and Dame Peggy Mount.
Flaws: The admissions sometimes have 'issue' stamped too clearly on the forehead, while the management is unfailingly evil. The humour - perhaps inevitably in such life or death situations - tends towards the gallows variety: 'When do I get to to meet Jimmy Savile?' a newly paralysed man laughed blackly last week.
The bottom line: is it good? Yes, mostly. It brings out the drama inherent in any casualty department without resorting to the mini-series tactics of sex and schmaltz. 'It is a classic piece of BBC popular drama,' asserts Powell, who is now at Carlton, 'It does a job on two levels; it makes you think at the same time as entertaining you.' The regulars are warts'n'all characters who inspire affection - the nation is already mourning the Christmas departure of Duffy. Powell points out that she and Charlie 'manage to express both emotionally and politically the concerns people have about the NHS - without being sanctimonious'. Casualty also looks and sounds authentic (all the writers have to spend time on an A&E ward) - in 1991 a Royal College of Nursing report named it as the only series to depict nurses as skilled professionals rather than 'exploited angels'. Not all experts are in favour, though: in February, a survey in Nursing Times found that Casualty is putting children off the profession - it's too realistic. James Rampton
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