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The hospital’s future is in doubt following DHA's decision not to sanction a financial package to repair the Casualty department. The hospital is only offered an authorised high interest loan, that doesn’t cover all the costs of the everything that needs to be done. The hospital's budget for the year ahead has also been cut so that the Royal will need to dip into the Middleditch trust fund to keep the hospital open. Jean ends up announcing that the only way forward is to consider a a complete closure of Casualty. Ralph ends up taking some secret action to rectify the situation but also ends up bringing up some difficult issues in his past. Carol and Ralph finally end up getting together.

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