Casualty: In rude health

Jonathan Owen looks back over 25 years of the drama that launched so many stars

It has been the dramatic heartbeat of the NHS, full of gory emergency operations, fires, explosions and an ever more inventive array of gruesome accidents. For the past quarter of a century Casualty has fascinated and appalled fans while providing a launchpad for a generation of home-grown talent, including Oscar winners Kate Winslet and Brenda Fricker, as well as Minnie Driver, Orlando Bloom, Ray Winstone and Helen Baxendale.

Part of the series' appeal for fans has been its realistic depiction of the aftermath of major disasters. A catastrophic train crash that marked the start of the 18th series in September 2003 topped a poll of favourite episodes that was conducted to coincide with the show's anniversary.

The one constant on the show, set in a busy accident and emergency department, has been the reassuringly calm figure of laid-back charge nurse Charlie Fairhead, played by Derek Thompson.

The 63-year-old actor is the sole survivor from the show's original cast, somehow surviving being shot, run over, suffering a heart attack and almost drowning.

Now, with the Bafta-award-winning show celebrating its 25th anniversary last week, the real-life inspiration for Charlie has spoken out, warning that there are signs of the NHS returning to the state it was in a quarter of a century ago.

Pete Salt, 54, a former emergency nurse at Bristol Royal Infirmary who is the nursing adviser for the series, said: "The NHS was under huge pressure from all directions when Casualty started. From what I gather now talking to people around the country, those pressures are creeping back up again."

Recruitment freezes, cuts to clinical posts and pressure on staff to take unpaid leave or reduce their hours represent "insidious changes" to the NHS, he said. And patients' lives are at risk if people attempt to run the NHS as a business, according to Mr Salt, who remains an adviser to Casualty. "The NHS can't ever be run as a business because at the end of the day they are not getting that much money coming in at the other end. It's completely patient driven. If the quality goes down you don't end up with a duff product – you end up with dead patients if it's not maintained."

But he defends most hospital managers as "absolutely necessary" and is unconcerned by the closures of small A&E departments. "If you get seriously injured you want to be treated in an all-singing, all-dancing A&E department, not a little casualty department in the sticks somewhere."

Casualty was commissioned in 1986 for a run of only 14 episodes, but has gone on to become the world's longest running prime-time medical drama. It remains one of the BBC's highest-rated shows and pulls in more than six million viewers a week. Last night marked its 786th episode. It continues to reflect current issues in its storylines, with themes of gang culture, conflict and co-operation between the police and emergency departments, and racism towards NHS staff among those featured in the current series.

After 25 years, the show is no longer filmed in Bristol. Last week, the cast and crew moved to a new set in Cardiff, where the series will now be made. "The brand-new purpose-built studio in Cardiff is a fantastic show of faith in both Casualty's resilience and its future," said John Yorke, the BBC's controller of continuing drama. "Very few television shows last two or three series, and only a tiny handful last 25 years. During that time hundreds of medical dramas have come and gone, but Casualty has outlasted all of them."

Did you blink and miss them?

Some of Britain's most successful actors took their turn in blink-and-you'd-miss-them roles in Casualty. Take Alfred Molina. Now living in LA, he was a little-known actor when he popped up as a rogue journalist in the first series. Only one year later he starred alongside Gary Oldman in the 1987 film Prick Up Your Ears, and has gone on to appear in Spider-Man 2 and The Da Vinci Code.

Others who made brief appearances on the show include Christopher Eccleston, who played an Aids patient back in 1990, before making his breakthrough in the film Let Him Have It a year later; Pete Postlethwaite – a fireman in Casualty three years before he was nominated for an Oscar for In the Name of the Father in 1993; and Minnie Driver, who had a cameo role in 1991 – six years before she was nominated for the Best Supporting Actress Oscar for 1997's Good Will Hunting.

Only four years before she starred alongside Leonardo DiCaprio in Titanic, Kate Winslet played a girl with an abusive boyfriend. Helen Baxendale appeared as a religious cult member involved in a car accident in 1993 and went on to star in BBC hospital comedy drama Cardiac Arrest before finding fame as Rachel in ITV's Cold Feet. Orlando Bloom and Ray Winstone both had small roles before becoming Hollywood A-listers.

Aaron Johnson was still a teenager when he played a small role in an episode five years ago. He is now hot property after playing the lead in last year's superhero hit movie Kick-Ass.

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