Truth: the first Casualty of TV drama?

This is not the first time the BBC has been accused of liberal bias; it is not even the first time its flagship hospital drama Casualty has had the charged levelled at it. This week, it was announced that Casualty is to drop a storyline featuring a terrorist attack by Muslim extremists, instead substituting for them animal rights extremists. It transpires that the original plot, devised by senior drama executives, was blocked by guideline staff who oversee the corporation’s editorial and ethical standards, fearing it would perpetuate the perception that most young British Muslims were radicalised hotheads.

Voices on the right were understandably livid. The Daily Telegraph opined: ‘We live in a world in which, although the vast majority of Muslims are not terrorists, the vast majority of terrorists are Muslim. Younger BBC programme-makers are aware of this awkward fact; the problem lies with an older generation of executives stuck in a PC timewarp. Casualty is fiction, but that is no excuse for constructing a politically acceptable parallel universe. To ban a storyline featuring Islamic terrorists not only misrepresents reality; it is also an insult to licence-payers whose family, friends or colleagues were blown to pieces on 7 July – and not by animal rights activists.’

Elsewhere, Lord Tebbit, the former Conservative Party chairman whose wife was paralysed by an IRA bomb in 1984, remarked: ‘People were perfectly free during the violence in Northern Ireland to produce dramas about terrorism for which presumably they might have been accused of stereotyping IRA terrorists or even suggesting that all Catholics were terrorists. What is the difference here? The BBC exists in a world of New Labour political correctness.’ (Oh dear, it’s that expression again.)

From its very beginnings back in the autumn of 1986, Casualty has periodically been the victim of likewise accusations. Only weeks after it first hit our screens, by which time the Saturday evening show had already commanded an audience of nine million viewers, senior Conservatives attacked the programme, accusing it of ridiculing the then government’s record on the National Health Service (NHS). Casualty depicted a cash-strapped NHS, pitifully paid ancillary workers and the contracting-out of hospital services (a key Thatcher policy of the time). Nurses and doctors were shown either chain-smoking, popping pills or groping one another as the needs of sick patients were left unattended.

‘Casualty is upsetting a lot of people,’ one Conservative Party member told the London Times in November 1986. ‘The whole tone of it is anti-government. It takes the side of ancillary workers against the authorities, it is disparaging about the contracting-out of hospital services, and it harps on about cuts. A lot of our supporters reckon it’s pure left-wing propaganda.’

In 1994, Casualty again came under attack, when David Congdon, then Conservative MP for Croydon North East, pointed to ‘all the usual propaganda’ in nearly every episode of the programme that showed an NHS chronically short of money and with far too many managers. A year later, an episode showing a fundholding GP whose patient dies after a 50-mile trip to a contract-holding hospital, passing two other hospitals en route, was attacked by Dr Rhidian Morris, chairman of the National Association of Fundholding Practices. He remarked that the storyline was ‘inaccurate, suggests serious political bias by the BBC and casts a slur on the integrity of British GPs’.

Of course the BBC and Casualty promote liberal-left propaganda, as anybody with a brain and a television set and no social life on a Saturday evening will comprehend. The peculiar thing about Casualty is how for 21 years it has managed to be true to life medically, but socially and politically, fictitious propaganda.

The programme, set in an Accident and Emergency department, was devised as a more authentic take on the American series St Elsewhere, which would eschew its American counterparts’ sentimentality and weakness for giving patients unrealistic survival success rates. For instance, a study by the British Medical Journal revealed that while American medical soaps such as ER convey a 75 per cent survival rate for cardiac arrests, Casualty had a far more realistic 25 per cent survival rate for heart attack victims. The show, as with its sister programme, Holby City, has its own medical equipment and set of full-time advisers, and is said to be respected in the medical profession for being true to life – at least, in terms of the science stuff.

When it comes to politics, however, matters are rather different. The most obviously irritating aspect of the show is its unrelenting didacticism. Nurses and receptionists suspiciously always seem to stand in front of signs reminding patients and relatives not to use mobile phones. Patients and relatives in turn are now mysteriously reminded habitually that smoking is ‘not permitted on these premises’. And, if you didn’t know by now, a member of the public who has been knocked unconscious should never be moved.

Private contractors, management and members of BUPA are naturally always portrayed as callous, supercilious, lip-curling, money-grabbing bastards. They are always white, male, middle-class and possessing a skin complexion as green as Gollum from Lord of the Rings. The person who saves the day normally hails from an ethnic minority, or from the lower classes –the hospital porter is invariably the hospital’s sweet, unsung hero. It would be tempting to say that Casualty represents ‘political correctness gone mad’ or is ‘a waste of the taxpayers’ licence fee’, but were I to say as much, you’d have to kill me.

There’s nothing wrong with being left wing. Some of my best friends are left wing. But it is wrong to seek to represent reality so conscientiously (in terms of medical realism) but be so devious and proselytising at the same time (in terms of social realism). Casualty’s fundamental flaw from the outset is that it does not seek to portray hospitals as they are, but rather that the programme’s makers use it as a vehicle to transform the NHS into something they think it should be. As the Financial Times, reviewing the first series, remarked on 8 October 1986: ‘The leading nurse is a man. The person who tracks down the mystery chemical harming the dockers is not some smart medic but a porter. This week the Samaritan who rescued the girl drug addict was a young black, and so on. Even suppose for a moment that there is something to be gained from replacing the boring old stereotypes (which at least reflected some reality) with boring new ones which amount to little more than hopeful lies, it would still be more interesting to dramatise the honest convictions of one individual than to experience the compromises reached by a team of propagandists.’ This observation remains as true today as it was then.

Oh, and I almost forgot to mention. The most unrealistic thing about Casualty is that it is set in a city that does not exist.

Patrick West is spiked’s TV reviewer.

Read on:

spiked-issue: TV