Topic 9 – Modern Public Health

Topic 9 – Modern Public Health
Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Modern Public Health Public Health
Living Conditions In the nineteenth century more and more factories started to be set up and town developed around them as people moved to be near their work Poor quality housing was made quickly for all the new workers and houses were very overcrowded—some might have five or more families in. Health was poor: with such unhygienic conditions and so many people living in such close proximity disease spread very quickly, including typhus, typhoid and tuberculous. The government did not feel that it should become involved in people’s everyday lives, continuing its policy of lassiez—faire. This led to little or no provision for removing sewage from the streets. It also meant that fresh water was generally not provided. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Disease These conditions led to the spread of endemic disease. There were constant outbreaks of smallpox, tuberculosis and fevers. However, this period also saw the introduction of the epidemic cholera in 1831. The volume of deaths forced the government to decree that cholera victims were buried immediately after death in a grave to a specified depth. Over 21,000 people had died in Britain from cholera by the end of When it seemed as if cholera had gone, the advance in public health that had been set up to prevent cholera, such as boards of health, were removed. Cholera continued to return throughout the mid nineteenth century. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

How did the Government React? The cholera epidemic led to a published Report on the Sanitary Condition of the Labouring Population of Great Britain by Edwin Chadwick in 1842. Many of the upper classes who read the report were shocked , having no idea about the living conditions of the poor. Chadwick believed that being poor caused the sickness, and Dr Southwood Smith gathered the information on areas of London with most cases of fever. His findings showed that Whitechapel had the highest at 14,000 cases, seemingly supporting the idea that poverty causes sickness. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

This report led to a mass interest in cleaning the cities and in 1844 the new Health of town Association was set up to focus on achieving better and more healthy conditions in town and cities. Theses were set up throughout Britain. Their findings were so grim throughout the country that they demanded an Act of Parliament on it. This led to a Public Health Bill in Many of the government were still against helping the public. The Bill was put off because no one could prove that the poverty of the public had aa link to disease. When a new cholera epidemic hit Britain in 1848 the government finally published the Bill. The Bill became a Public Health Act, the first in British History. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Public Heath Act 1848 A Board will meet in London for 5 years Local Boards in towns can be set up if 10% of ratepayers allow it They can improve sewage and water issues No one has to do the above. It is not compulsory Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

As the Act shows, it could only make few improvements with the creation of the Boards who held such limited power. Also, Local Health Boards were only taken up in 182 towns, resulting in little change for the rest of the country. However, sewage and water were heavily improved in towns that did adopt the act. Mistakes were made as Chadwick wanted the water flushed into the Thames Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

The Central Board of health closed in 1854 due to pressure from those who opposed it such as private companies concerned with water and sewage and politicians still allied to the policy of lassiez—faire. The second Public Health Act was compulsory and also forced councils to consult medical inspectors before any changes were made. However, the Artisan’s Dwelling Act was not compulsory and so few council acted upon it. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Public Heath Act 1875 Compulsory All councils had to provide clean water, sewers and drains Medical officer had to be appointed to inspect conditions Banned the building of poor quality housing (slums) Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Around this time—1853, soap tax was removed. Additionally flushing toilets emptying straight into the sewers were invented. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

John Snow Trained as a surgeon and is famous for being the physician who administered chloroform to Queen Victoria whilst she gave birth However, Snow also worked on the outbreak of chorea in 1848 He investigated the cause of the disease and tried to locate similarities between cases. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Snow discovered that the group of people he had tested all drank from the same water supply; the River Thames There were some people in the same area who were not ill and had taken heir water from a pump supply of fresh water. He therefore made the case that cholera was caught through water and not the air as people had believed up until then Few people accepted this view Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

In September 1854, after close observation of people with cholera in Broad Street in London, Snow realised that they all consumed water from the same pump. He took the handle off the pump so that no one could use it. There were then no more cases of cholera in the area. This proved that water caused cholera. He struggled to convinced doctors that it was water not miasma. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Bazalgette The Great stink occurred in It had been a very hot and dry, and the Thames began smelling so badly that even parliament had to be abandoned. This convinced the government they had to act. Additionally, there were constant recurring instances of cholera, killing tens of thousands at a time. Therefore the government employed Joseph Bazalgette to build a new London sewer system to try and funnel waste away from the river. This acted as a trial fro Government, to see whether paying for Public Health improvements would reduce disease and consequently death. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

It was officially opened in 1865 and was technological marvel with nearly 1500 miles of sewers directly under London’s streets. The plans for this were devised by Bazalgette. He worked obsessively over the plans to ensure every last detail was correct. As a result his health unfortunately suffered. He was very forward thinking, as he built the sewer's diameter much larger than it needed to be in order to cope with future population growth. In fat, his sewers are still in operation today. His sewers drastically reduced cholera outbreaks in London. The government trial was very successful, and helped to convince Parliament that public health measures did indeed work. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Life in the Early Twentieth Century Living conditions in the early twentieth century were still very poor for some people. Charles Booth decided to conduct a survey about the living conditions in London’s East End between 1866 and He found that over a third of its population were living below the poverty line on around £1 a week wage. He also found that these people did not have enough food or eat a healthy diet and lived in below—standard housing. People could not be healthy as there was extreme overcrowding and those who were ill could not afford a doctor, increasing the spread of illness. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

This research was backed up by the findings of Seebohm Rowntree who investigated living conditions in York. With two surveys it was hard to ignore the evidence. At this time there were no pensions and so old people had to go to the workhouse to support themselves. Only skilled labourers had the option of insurance and s most had no protection. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Improvements Living conditions were addressed in 1902 when volunteers were asked to sign up to fight in the Boer war. When these men were inspected, everyone was surprised to discover that 40% of them were malnourished or suffering from an illness such as rickets (which is also linked to a bad diet). The Labour Party had just been formed and the Liberals were so scared that they would lose the people’s votes that they agreed that poverty was linked to poor health and issued many reforms championed by the Liberal David Lloyd George. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

The laws passed in the 1870s were a start, but the problem of poverty and illness still remained. Social researchers like Charles Booth and Seebohm Rowntree published inquiries about the living conditions of the poor in London and York and found that many people were living below the poverty line. In 1902 it was revealed that nearly half of the men fighting Boer War had diseases caused by their bad diet. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Opposition to reform: The House of Lords didn’t want to pay a tax which the then Chancellor of the Exchequer David Lloyd George introduced to fund the pensions Insurance businesses thought the Insurance Act would make them lose out Doctors disliked the Ac because they feared they would be controlled by the government. This was because they had to register on a list, receiving six shilling per client. They also feared that medical standards might fall because of it. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

In 1919 the Ministry of Health looked after all health matters, and the then Prime Minister Lloyd George promised better quality housing for soldiers returning from the Frist World War. By 1919 housing was in a neglected state. The war had caused a shortage of acceptable housing and food, and had significantly reduced the population of workers. There was still no legislation to deal with the sick, unemployed and elderly population, which was only increasing in number. The government now directed money towards this problem, with the Minister for Health creating the Housing and Town Planning Act. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

To address poverty the Ministry extended insurance to nearly all workers who earned below £250 a year in the 1920 Unemployment Insurance Act. By 1939 health care was provided by a mix of public and private companies. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

The Second World War The Second world War started to change people’s minds that the government should provide more health care because: Children: food rationing meant it was even more important that children were fed well, so more milk and free school meals were given out. Town evacuees were often considered to be in bad state by the people they stayed with in the country. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Hospitals: the government had to provide free treatment in hospitals after Britain was bombed which people agreed worked well. Evacuated children also showed the deprived state of living conditions in London, and when they arrived in the country the families who took them on were surprised by their condition, displaying to all the state of public health. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

In 1942 the Beveridge Report was published by the economist William Beveridge. Beveridge recommended that a welfare state should be set up to get rid of the ‘giant evils’ in society which were squalor, ignorance, want, disease and idleness. The Labour party started to implement Beveridge’s welfare state when they came into power in 1945 Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

The Minister of Health Bevan introduced the national Health Service which came into effect in The NHS: Made healthcare free for everyone Made hospitals come under the government’s control Originally gave doctors a fixed salary but after opposition from the British Medical Association to the government increased control gave doctors fees for every registered patient. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Impact The NHS was popular with people from the start There was a decrease in diseases like TB It had particularly big impact on women as it focused on women’s and children’s health and I vastly reduced the number of women dying at childbirth Doctors now worked as a team rather than as individuals Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

However, when it was created it was doctors themselves who were most opposed to the introduced of the NHS. In a survey taken by the British Medical Association they found that around only 4700 doctors supported the NHS whereas approximately 40,800 did not. Their work was restricted to the demands of government and instead of payment depending on an individual case they were forced to take a fixed wage. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

This did not improve doctors’ morale and led to disenchanted practitioners and poorer medical treatment. By mid 1948 the Minister of Health had won over 92% of doctors who had agreed to work for the NHS. He had done this by allowing each doctor to take a fee from the government for each patient treated as well as allowing private patients to pay doctors for their services outside the NHS. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Long term impact of the NHS system The developments of the twentieth century have meant that people live to an older age and so there are more people to treat. This has caused the NHS financial difficulty. Although this lack o funds often results in a long waiting list to be seen or treated This has resulted in higher prescription charges to generate more funds and attempts at encouraging patients to pay for private treatment to lessen the number of people with the NHS. Some people fear this will lead to a regression in medicine where the wealthy receive better treatment than the poor. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Treatment is often refused by the NHS if they feel the illness is self—inflicted, for example through smoking At the end of the century, Labour was elected to office again and reduced some of the waiting times, as in the 1990s it was claimed that the wait was so long for surgery that many hundreds of people before they go to their turn. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

The ability to receive free vaccinations was a massive achievement in the history of medicine, however, and one that dramatically increased the level of public health. Nearly all children are vaccinated now against disease that less than a century ago were killing large numbers of the population. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Florence Nightingale Who was she? Florence Nightingale ( ) was an English nurse from a wealthy family In 1851 she trained as a nurse in Germany In 1853 she became a superintendent at a London hospital In 1854 she went o Sutari hospital in Turkey to treat soldiers wounded in the Crimean War where she headed a team of nurses. In 1856 she returned to England In 1859 she published her theories in Notes on Nursing In 1860 the Nightingale School of Nursing was set up in London Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Why is she important? Nightingale helped nursing become a respected profession ad she was a heroine of the Crimean War Conditions were very bad in the Scutari hospital before she arrived. She and her team dramatically decreased the death rate there (to 2%). She cleaned the hospital properly, became known as lady of the lamp as she worked during the night to care for patients. Her Notes on Nursing laid out her methods for everyone else to use Her school trained nurses to a high standard Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Mary Seacole Who was she? Mary Seacole ( ) was a nurse from Jamaica She learnt her nursing skills by helping her mother’s boarding house for invalid soldiers In 1864 she went to England and asked the War Office to send her to the Crimea to nurse, but she was rejected due to her race She funded a trip there herself In 1856 she returned to England bankrupt In 1857 the press organised aa music festival to help her In the same year she published her memoirs, The Wonderful Adventures of Mrs Seacole in Many Lands. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Why is she important? Seacole was, like Nightingale, a heroine of the Crimean War, but Nightingale didn’t want her on her nursing team. Despite the racism she was a victim of, Seacole was undeterred and set up a medical hostel in the Crimea and treated soldiers on the battlefields. Unlike Nightingale she was forgotten for almost a century after her death, but now her bravery and dedication have been rediscovered. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

The Nursing Profession On Florence Nightingale’s return to England in 1859, she wrote book the book Notes on Nursing, which quickly became the textbook for all women training to enter the nursing profession. It explained in detail her views on hygiene and sanitation. This led t a public fund raising £44,000 to train nurses. She used it to open the Nightingale School of Nursing inside St Thomas’ Hospital London. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

This led to the creation of many more training centre for nurses throughout Britain. By 1900, 64,000 nurses had been trained. This led to the acceptance of nursing as a profession and in 1919 the Resignation of Nurses Act was passed, making the qualifications and training needed for the job much stricter. This abolished the view of nurses as lazy and untrained. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Female Doctors It was not just the nursing profession that women were entering the medical profession through. Two British women became the first women to be trained doctors in both Briatin and the USA. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Elizabeth Blackwell Blackwell was born in Bristol, England and emigrated with her family to the USA as a child. She showed an interest in the medical profession fro an early age and after saving for a place at a medical college, Blackwell applied to Geneva College in New York. She was given a place after the lecturers put it to the male student vote and the students, thinking the application was a joke, offered her a place. Despite entering the college as a joke, Blackwell graduated in 1849 at the top of her class and became the first woman to graduate from a medical course in the USA, becoming the first female doctor in the country. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

She was treated badly by her peers however, and was unable to find a job in medicine in the USA. As a result she formed the New York Infirmary for Indigent Women and Children training many nurses. She then travelled to England where she became the first female member of the General Medical Council’s medical register. Blackwell then opened the Women’s Medical College London with Florence Nightingale and co—founded the London School of Medicine for Women where she continued to teach until her retirement. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Elizabeth Garrett Anderson Garrett Anderson applied to many medical schools, all of which she was turned down for. At this time t was not seen as decent for a woman to be a doctor in London. She then pursued anatomy privately at the London Hospital with the help of professors there. Unfortunately for Garrett Anderson, the medical boards would not her take the final exams to qualify as a trained doctor. Instead she took the only test offered to her from the Society of Apothecaries in This allowed her to be a member of the General Medical Council’s medical register, only the second woman to ahve done so. The first had been Elizabeth Blackwell. It did, however, make her the first British trained woman to qualify in medicine.. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

She then found a job as General Medical Attendant at the St Mary’s London Dispensary which allowed poor women to be treated by qualified women. This became the New Hospital for Women where Garrett Anderson worked for over twenty years. In 1870 she had been awarded the degree of MD by Paris University. She was given various positions on boards and as visiting a professional. In 1873 she became the only female of the British Medical Association, and remained the only woman member for a further 19 years. She then set up the London School of Medicine for Women and Elizabeth Blackwell to train other women to become doctors. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Examination Practice Part A’s They are worth 5 marks. You should spend 5 minutes on this question. You should identify 5 key points/ideas. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Briefly describe nursing in the first half of the nineteenth century.
not trained poorly educated and paid Often worked in people’s homes neglected patients got drunk Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Briefly describe the work of Florence Nightingale.
went to the Crimea cleaned –up the wards cut the death rate of soldiers in the hospital set up Training School for Nurses in Britain Introduced standards for nurses turned nursing into a proper profession helped designed new hospitals Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Briefly describe the career of Mary Seacole.
worked as nurse/doctor in Jamaica worked as a midwife dealt with cholera in Panama went to Britain and volunteered to go to Crimea went at own expense set up the 'British Hospital‘ nursed soldiers retuned to Britain bankrupt newspapers held an appeal for her benefit concert held for her Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Examination Practice Part B’s They are worth 7 marks. You should spend 10 minutes on this question. You should identify 3 reasons why. Each reason should start a paragraph. There should be another 2-3 sentences explaining the reasons. Remember to include a WOW fact! Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Explain why Florence Nightingale is important in the history of medicine.
improved care of wounded soldiers in the Crimea kept the hospital clean Made ordering of equipment more efficient wrote Notes on Nursing reformed training of nurses set up a nursing school introduced new ideas for the siting and design of hospitals turned nursing into a proper profession with standards Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Explain why Florence Nightingale is important in the history of medicine.
For example Florence Nightingale was important in medicine because she set up a school for nursing and made sure that nurses were trained properly. Nurses were trained to be hygienic. This was important because before anybody could become a nurse and the standard was dreadful. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

ran hospitals in the Crimea
Explain the contribution made to the development of hospitals and nursing by Florence Nightingale. ran hospitals in the Crimea improved the organisation/cleanliness of these hospitals death rate fell Designed hospitals wrote ‘Notes for Nursing’ set up a Training School for Nurses reformed the whole profession and training of nurses Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Explain the contribution made to the development of hospitals and nursing by Florence Nightingale.
For example Florence Nightingale is very important because she went out to the Crimea War and completely changed how wounded soldiers were being looked after. When she got there she found dirty conditions, bad food and no supplies. She was a very good administrator and soon had supplies of essential things to look after the soldiers coming in. She also insisted that everything was kept clean. Within a few months she had cut the death rate of wounded soldiers. This is why she was important. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Examination Practice Part C’s They are worth 8 marks. You should spend minutes on this question. You need to produce a balanced answer with two sides. It is an argument, so pick one side, even if you do not believe it! Think of 2-3 reasons for each side and remember the WOW factors! To achieve the highest marks, you must come to a justified conclusion. The examiners will reward anyone the marks, as long as you explain your judgement. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

‘The most important development in medicine in the twentieth century was the introduction of the National health Service.’ Explain how far you agree with this statement. For example The introduction of the National Health Service was very important indeed. This was because before it was introduced most people could not afford health care. They could not even afford to go to the doctors when they were ill. This was because doctors and hospitals charged people for treatment. Only some people had health insurance. The situation was made worse in the 1930s when lots of people were out of work. This meant they could not pay their insurance contributions. The situation was desperate as the death rate of infants grew higher and higher. Little was done until the Second World War. Evacuation made well-off people see how unhealthy the working classes were and a National Health Service was planned. It was important because it gave people health care free. It was paid for by taxes. Hospitals were nationalised and doctors joined the NHS. Millions of people now saw a doctor for the first time and the health of the nation was dramatically improved. This is why it was important. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

‘The most important development in medicine in the twentieth century was the introduction of the National health Service.’ Explain how far you agree with this statement. Another development that was vital was the development of penicillin. Doctors had nothing to protect people against deadly staphylococcus germs that killed a lot of people. When Fleming discovered penicillin and it was later mass produced, it became very important in the Second World War. Over a quarter of a million soldiers were treated and saved. After the war it was developed more and it was now used to treat a whole range of diseases such as syphilis. There are not many people in this country that have not had penicillin at some stage in their lives. However, I think the NHS is far more important because without it most people would not be able to afford penicillin and so it would not have had the effects it has had. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Who was most important in the history of medicine, Florence Nightingale or Mary Seacole? Explain your answer. Nightingale helping soldiers in the Crimea set up a nursing school turned nursing into a respectable profession Redesigned hospitals emphasis on sanitation ventilation and the right food Trained midwives Seacole helped soldiers in the Crimea carried out surgery had a lot of practical experience regarded as a hero in England when she returned no more use made of her expertise Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Who was most important in the history of medicine, Florence Nightingale or Mary Seacole? Explain your answer. Possible conclusion Nightingale started long-term developments such as the development of nursing schools but Seacole had no long-term impact as she did little after caring for Soldiers in the Crimea. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

helping soldiers in the Crimea set up a nursing school
‘Florence Nightingale was more important than James Simpson in the history of medicine.’ How far do you agree with this statement? Explain your answer Nightingale helping soldiers in the Crimea set up a nursing school turned nursing into a respectable profession Redesigned hospitals Simpson discovered chloroform led to further developments in anaesthetics. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

‘Florence Nightingale was more important than James Simpson in the history of medicine.’ How far do you agree with this statement? Explain your answer Possible conclusion No matter how good nurses were there were limits to how much they could help patients without developments such as anaesthetics. Learning Outcomes By the end of this lesson you will be able to… Describe the key features of an exam questions and the time period. E-D Explain how to answer an exam question and the technique required. C-B Judge the significance of key features in the time period. A-A*

Topic 9 – Modern Public Health

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Topic 9 – Modern Public Health

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