A distinctive yellow VW Beetle is making its way across Bristol’s suspension bridge when a sudden disaster strikes.
A huge explosion can be seen in the distance with billowing plumes of smoke, and doctors at Holby City Hospital must prepare for the worst.
This is the opening scene of Casualty’s two-part 40th Anniversary special and reflects the show’s very first episode on September 6, 1986, when the Beetle’s driver was Charlie Fairhead, who would later become the hospital drama’s longest-serving character.
The people on the ground may have changed in the last forty years and the camera work is a little more advanced.
But as the world’s longest-running medical show celebrates its historic anniversary, the special double bill is a reminder of why the show has been so loved for so long.
For George Clooney and ER, and more recently the critically acclaimed The Pitt, there was Casualty.
It followed the stories of both those who came to the emergency department and those who treated them.
In 1986 this was groundbreaking and immediately controversial because it dared to show in all its gory detail the chaos of an NHS emergency department.
Victim at age 40…It’s amazing! The much-loved history of the BBC hit as the world’s longest-running medical show celebrates a historic anniversary (photo by Kate Winslet in 1999)
But as the world’s longest-running medical show celebrates its historic anniversary, the special double bill is a reminder of why the show has been so loved for so long.
“You watch The Pitt and it’s set in one of the few hospitals in America that is publicly funded,” says William Beck, who stars as Dr. Dylan Keogh.
“It films in the same aesthetic, has the same metronome as our show. It’s brilliant, but it’s there thanks to the people who created Casualty.’
Those people were script editor Jeremy Brock and theater director Paul Unwin – two politically driven 25-year-olds who met at Bristol University.
Both had spent time in hospitals – Unwin after a serious car accident, Brock with ulcerative colitis – and wanted to write something that was both a love letter to the NHS and a warning about what was happening in the service.
Inspired by American multi-strand dramas like M*A*S*H and Hill Street Blues, their original pitch opened with the line: “In 1948, a dream was born. In 1985-1986 that dream was shattered.’
They labeled the emergency department – then known as the Casualty Department – as ‘the front line in the battle for the soul of the NHS’.
A primetime Saturday evening was immediately ordered and in preparation they spent time shadowing staff at Bristol Royal Infirmary.
The hospital’s real Charge Nurse, Peter Salt, became the main inspiration for Charlie Fairhead (played by Derek Thompson), who drove that Beetle in the first episode where the hospital suffered a gas explosion.
However, that first episode sparked controversy. Some scenes showed staff drinking and smoking while on duty – no longer the angels previously depicted on TV – and the NHS itself was depicted as a flawed institution struggling to cope.
It was as if no one had noticed this before. Edwina Currie, then Health Secretary, attacked the show in the House of Commons, calling it ‘anti-NHS propaganda’ and ‘left-wing nonsense’.
But the crowd lapped it up and still does.
“We’ve all been to A&E, so there’s a sense of recognition,” says series producer Liza Mellody.
In 1986 this was groundbreaking and immediately controversial because it dared to show in all its gory detail the chaos of an NHS emergency department.
Other big names to appear early in their careers include Martin Freeman (pictured), Nicholas Hoult, Tom Hiddleston, Minnie Driver, Ray Winstone and Orlando Bloom
However, that first episode sparked controversy. Some scenes showed staff drinking and smoking while on duty (Photo Minnie Driver)
‘You don’t go out there for a day. You go at your worst time because someone is sick. You need help. You see people at their worst and hopefully meet people who are heroes – doctors and nurses – but also just normal people.
‘Besides, everyone likes a little blood and a little medicine. Then we have our series in there. The background is that we got to know these doctors and nurses so that we are connected to them, while every week you get great stories played by guest actors.
‘In some ways that hasn’t changed in forty years, but just as the NHS has had to modernise, so must we.
‘We can’t be political, we are the BBC and we have to be honest. We want to be realistic about what happens in hospitals, but we also need to let the public form their own opinions.”
Not only has the series spawned two spin-offs – Holby City (about the wider hospital, which lasted 23 years) and the short-lived police procedural Holby Blue – it has also been a springboard for some of Britain’s brightest talent.
Kate Winslet, who played a teenager dealing with an abusive boyfriend in a 1993 episode, said: ‘In England it almost seems to be part of an actor’s training. Appearing on the show taught me a big lesson about how to be natural in front of the camera.”
Other big names to appear early in their careers include Martin Freeman, Nicholas Hoult, Tom Hiddleston, Minnie Driver, Ray Winstone and Orlando Bloom, while Brenda Fricker, who won a Best Supporting Actress Oscar for her role in My Left Foot in 1990, played staff nurse Megan Roach.
The show has tackled big topics, from murder and train accidents to riots, sexual assault, mental health issues and highway congestion.
Four times a year, before starting work on a new series, the show’s writers meet with experienced NHS medics.
“We have guest days and our writers sit in a room with doctors, nurses and paramedics,” Liza explains.
“We’ll say, ‘We’re thinking about doing this,’ and they’ll share their experiences. The key is to be entertaining but absolutely authentic.”
The 40th anniversary episodes start with heartthrob Doctor Flynn Byron, played by former Call The Midwife star Olly Rix, jogging across the bridge when a huge explosion occurs, believed to be a terrorist attack, so he quickly heads there.
Flynn is an ex-special forces doctor who arrived in Holby last year and is now the clinical lead, bringing with him a military drive for change and efficiency.
First he helps the injured on the spot and then gets into trouble when he is involved in an accident that leaves his ambulance submerged in water.
Olly reveals that he filmed these scenes for two weeks on the underwater stage at Pinewood Studios, where James Bond is filmed.
“I trained a lot with this extraordinary diving team,” he recalls. ‘We didn’t have to use much imagination because we were actually in the water, but luckily it was safe enough that I could do all the underwater stunts myself. It was a bit nerve-wracking at times.’
Incidentally, Olly has found love on the show and recently revealed his engagement to co-star Anna Chell (who plays paramedic Jodie Whyte).
We also follow what’s happening at the wider Holby City Hospital, as the team grapples with the injured and tries to find out if there is more danger ahead.
It is a particularly difficult situation for Dr. Dylan Keogh, who is in charge, as he personally knows one of the seriously injured.
“He has a lot to deal with and a bomb goes off for him,” says William Beck.
The producers hope that the specials will not only be a boon to the show’s three million devoted fans (from a peak of more than 15 million in the 1990s), but also a showcase for those who may not have seen the series in years.
“Victims fans are so loyal,” says Melanie Hill, who plays nurse manager Siobhan McKenzie.
“A lot of them have seen every episode. And I would like to see the fact that it is the 40th anniversary as a way for a new audience to join in.”
Longtime fans of the show will be pleased with a series of nods to the past in the two episodes, while producers also see it as a showcase for the future, as it’s all change for Casualty.
From the next series, the show will be set in Cardiff (with largely the same cast), where the show has been filmed since 2011, rather than the fictional Holby.
“We’re moving our fictional world to Cardiff,” says Liza. ‘In practice, there is a lot to be said for not having to pretend we are somewhere else. We can actually be in Wales and then we can show the beauty of it, and on top of that we have a new set, a new hospital.’
So it was really a time to look back as well as to the future.
“We want to remind people that Casualty is warm and funny, but also full of entertainment and adrenaline,” says Liza.
‘People may talk about the American series, but they should remember that we are here, reporting with just as much drama what is real for us in Britain.’
Special episodes of Casualty 40th Anniversary, Saturday from 8pm, BBC1 and BBC iPlayer.
