1. Medicine and Surgery
The 20th Century

2. The First World War
Some have argued that WW1 improved surgery because army surgeons got lots of practice
On the other hand they did not have the time or conditions to do much more than amputations because there were so many casualties – in this respect surgery went backwards
The war led to the development of Blood Banks
The war led to the discovery of stronger antiseptics
X-rays were developed
Prosthetics – (artificial limbs)- were improved
Because of the large numbers of soldiers who suffered Shell-Shock a lot of research went into Mental Health

3. “Magic Bullets” - Sulphonamides
By 1900 there were many vaccinations to prevent illness but there were still no cure for many germs
Scientists were looking for a “magic bullet” to kill infection inside the body
The German, Paul Ehlich found Salvarsan 600 in 1910 – after a lot of experimentation
Other “Magic Bullet” drugs were found in the 1930s
Gerhard Domagk experimented with a red dye – Prontosil – on his daughter and cured the blood poisoning that was killing her
These drugs became known as Sulphonamides

4. Penicillin
Wounded soldiers in World War One often died as a result of infection from the mud and filth of the trenches
Dr Alexander Fleming looked for a cure for these bacterial infections
He made his great discovery by accident
In 1928 he noticed some mould which had grown on a dish and realised that the mould had killed the bacteria
This mould was “Penicillin”
But little notice was taken at the time

5. Manufacturing Penicillin
Fleming found it difficult to make large quantities of penicillin
The government funded two scientists at Oxford, Florey and Chain, who succeeded in finding a method of making concentrated penicillin
The Second World War , produced a great demand for a drug that could kill infection inside the body
Penicillin was not used on a human until 1941 when a policeman made an amazing recovery from infection after being given the drug – but he died within weeks because the supply ran out
When the USA entered the war in 1941 its government gave $80 million to help drug companies mass produce penicillin
By 1944 penicillin was being used to save the lives of thousands of soldiers
This was the world’s first antibiotic and it was seen as a wonder drug
Since 1945 many other antibiotics have been developed to treat a vast range of diseases

6. The National Health Service
WW2 changed attitudes in Britain
There was a desire to improve people’s lives – the idea that the whole nation was fighting the war for a purpose
The Beveridge Report of 1942 said that the government should take responsibility for tackling the 5 great social evils or “giants” – Want, Disease, Squalor, Ignorance and Idleness
Before the war health care was very patchy
Doctors charged fees, very few people had health insurance, most doctors worked in well off areas, hospitals relied on charity

7. The Labour Government 1945-51
In 1945 Labour won the election
They created the modern Welfare State
The Health Minister, Aneurin Bevan, created the National Health Service in 1948
Suddenly everyone was entitled to free medical care
Millions now demanded treatments, false teeth, free spectacles . Surgeries were overrun as people now sought treatment for illnesses they would previously ignored

8. NHS Difficulties
The NHS was not popular with doctors who did not want to work for the state, but wanted private paying patients
Bevan managed to achieve a compromise with the doctors and allowed some private “pay” beds in NHS hospitals
The NHS was very costly and became more expensive as demand from patients increased
This meant a great increase in taxation to pay for it – this caused opposition
In 1951 prescription charges and charges for dental and eye care were introduced – this was controversial- and still is!
The cost of the NHS remains a great problem because the demand grows, people live longer, more old people tend to have more illnesses, and new treatments, which people expect, are very expensive

9. Recent Trends in Health Care
X-Rays were the first of the modern way of screening and diagnosis – modern scanners and ultra-sound technologies allow doctors to make diagnoses very early
Surgery has continued to make major strides – Transplants(including heart), Key-hole surgery, and artificial organs
Better housing (slum clearances), cleaner air –The Clean Air Act 1956, and Health and Safety at Work Laws have also improved the nation’s health
Life expectancy has improved from about 45 on 1900 to about 75 now
Child mortality has fallen dramatically

10. Threats to Health at the end of the 20th C
Because people tend to live longer other diseases like cancer and heart disease are now the main killers and the targets of medical research
Smoking, drug abuse, lack of exercise, pollution are now considered to be the main threats to health – so a lot of focus is on prevention
New diseases have appeared that are as frightening perhaps as smallpox and cholera must have been – AIDS (Acquired Immune Deficiency Syndrome) and CJD
The antibiotics are losing their effectiveness as germs develop their own resistance to them
Living conditions are still poor for many and the quality of health care tends to vary from area to area
Costs continue to rise