Medicine Flashcards
1
Q
Why were strong stubborn theories a barrier to progress in Britain?
A
Some people thought that the outbreak if disease was a divine punishment for sinful living.
Others believed in the theory of the four humours, which was an ancient concept.
They also believed in miasma, which was drifting clouds in air that carried rotting matter, in the form of a bad smell.
2
Q
What was the theory of four humours?
A
Blood, phlegm, yellow bile and black bile, They thought that disease was caused by an imbalance in the humours, and could only be restored by restoring balance.
3
Q
Why were these theories widespread and deeply held?
A
People did not devote time and thought to studying. They thought that they already knew what was causing disease.
Training and treatment of doctors based on these theories of causation, so discouraged young doctors from questions flaws/assumptions, which led to little progress
Existing attitudes were a barrier.
4
Q
Why was there a lack of progress in identifying and developing cures?
A
Lack of funding - no consensus that government should fund research in 1848
Lack of development in technology- no macroscopic by 1848
Ignorance of human body - small number of dissections, but religion objected to performing dissections.
5
Q
Who is Florence Nightingale and her significance (at Scutari)?
A
Florence nightingale was a nurse during the Crimean War (1853-6)
Because of a scandal concerning high death rate in Scutari, she was asked to take a team of handpicked nurses to improve matters.
6
Q
When was the Crimean war?
A
1853-56
7
Q
Conditions of medical wards in Scutari before Nightingale?
A
Soldier died due to infection in unsustained numbers rather than due to the severity of wounds.
Disease spread easily in wards
8
Q
How did the death rate change in Scutari due to Nightingale?
A
After nightingale, death rate fell from 40% to 2%
9
Q
What were Nightingale‘s innovations?
A
Hygiene, Ventilation, food and organization
Systematic and regular cleaning of hospital wards and equipment
Frequent cleaning of wounds and changing dressings.
Regular washing of patients and changing of dressing.
Ventilation of wards allowed fresh air to enter and circulate/
Insistence on restructuring the layout of hospitals, with space between beds.
Sub-division of hospitals into different wards
Establishment of kitchen to provide fresh food
Rating of money to ensure fresh medical supplies sent from Britatin
10
Q
Why is it important not to mythologize Florence Nightingale?
A
She believed in miasma
She did not realise that the hospital was built on a cesspool (affected water supply and air quality)
In 1855, gov sanitary commission improved drains and water supply (could be argued that it helped with the death rate)
11
Q
What were the 3 main problems in surgery by 1848?
A
Pain - alcohol was used as a painkiller, or patients were knocked unconscious
Infection- Ignorance of causes of infections, so doctors did not clean hands sterilise equipment or change clothes. This meant operations were very unhygienic, and most people were more likely to die due to infection.
Bleeding - The surgeons can not see what they are doing.
Blood loss - by 1848, methods for restriction were harmful, tourniquets clamps caused nerve damage when left too long (cauterization) and ligatures led to infection if applied with dirty hands.
12
Q
Who was James Simpson and what did he discover?
A
He discovered Ether as an effective anaesthetic had had problems with dosage and side effects so discovered chloroform and chloroform mask.
13
Q
What is chloroform and how was it democratised?
A
An anaesthetic and was democratised when Queen Elizabeth used it for childbirth and recommended it public good example of how persistence of individual and prestige of another individual can result in lasting change.
14
Q
What were the problems with anaesthesia?
A
Dosage - before chloroform mask had been invented safe dosages could not be determined as it depended on factors.
Confidence of doctors - death rate increased as a result of anaesthesia. Doctors could perform more evasive and complex surgeries which were fatal, as blood loss and infection had not been solved.
15
Q
What were the problems with public health in 1848?
A
Rapid industrialisation had led to overcrowding in cities as people left countryside for work in cities.
Poor quality of housing and poor sanitation in cities as toilet facilities were basic and sewers ran into rivers.
16
Q
What were the consequences of the problems in public health in 1848?
A
Promoted spread of disease, high death rate, short life expectancy among industrial workers.
17
Q
Who was Edwin Chadwick and what did he do?
A
Tasked by government to produce report on sanitary conditions.
His report in 1842 recommended local authorises provide clean water, build proper drains and sewers, and collect rubbish from houses and streets. He achieved limited success because he was stubborn and arrogant.
18
Q
What really lead to the Public Health Act 1848, and what did it do?
A
The cholera outbreaks due to poor hygiene and unsanitary conditions, would have even middle and upper class people dying.
It could no longer be ignored, so an Act of a Board of Health was created and towns collected rubbish and built sewer systems.
19
Q
How significant was the Public Health Act in 1848?
A
Local authorities were only permitted to make improvement if they wished to they were not forced. This is because actions required money which required local taxes, so some authorities were unwilling to pay; there was no link between hygiene and disease.
The board of health was not permanent and lasted 5 years, Chadwick was forced out in 1854
20
Q
Why was cholera a major threat?
A
The persistence of outbreaks (1842, 1848) which killed 50,000 people.
Cholera was a major killer with typhus, but it was most feared because prevention did not work (miasma)
21
Q
What was the significance of John Snows work on cholera?
A
Snow hypothesised that cholera was caused by food or liquid taken orally and tested this theory.
He was right but his finding did not lead to rapid change, because people did not believe that dirty water caused cholera (miasma beliefs)
It showed that to break a harmful change of continuity and caused lasting change an important individual had to make a related breakthrough.
22
Q
What leads to Snows work gaining greater acceptance?
A
Pasteur‘s germ theory proved water carried disease.
23
Q
What factors contributed to Pasteur‘s germ theory?
A
Advancement in technology; powerful microscopes
Role of individuals and funding
24
Q
When and what was Pasteur‘s germ theory?
A
1861 theory proposed that germs caused disease.
1878, book published on germ theory with specific application to medicine.
25
What is the significance of Pasteur‘s work?
Significance became apparent with massive, lifesaving advances in human understanding of the causes of disease, treatment, surgery and public health division.
Directed the nature of subsequent scientific and medical research.
Significantly increased funding from both private and government for medical research.
Institutions were now willing to provide money.
26
Who is Joseph Lister, and what did he discover?
He observed that infection remained a major killer.
He observed cattle feeding on grass with carbolic acid did not fall ill, so he spray carbolic acid on the wounds and bandages of a boy with a broke leg.
It was a successful experiment
Practiced and advocated more generally the use of carbolic to wash surgeon‘s hands and instruments before surgery and its use on bandages post surgery as well.
He developed a device for spraying solution, reckoning it would kill airborne microbes during surgery.
27
What was the significance of Lister‘s antiseptic breakthrough?
Short term- ideas not accepted immediately many people even within medical community rejected ideas on invisible microbes and when he was not carrying out the operation himself methods did not work.
Long term - due to additional weight of Pasteur‘s advances, Lister‘s antiseptic breakthrough gained wider acceptance.
This was a historical significant change and a life saving device.
28
What is the significance of the Public Health Act 1875?
Why - due to the reform act of 1867 that let more people vote for parliament to pay more attention to medical issues.
This meant governments had to change their laissez-faire attitude, due to attitudes changing due to medical advances and fear of another outbreak.
Significance = first time parliament had passed national laws to enforce public health standards nationwide. This showed how reliant the national government was on local authorities, who had to raise taxes.
The acceptance of higher taxes, helped pay for improvements.
29
What did the public health act of 1875 make local authorities responsible for?
Supplying clean water and dealing with sewage
Building public toilets and lighting the streets
Regulating new housing standards and inspecting conditions in rented accommodation
Employing health and sanitary inspectors to enforce the new rules including food quality
30
Who is Elizabeth Garret and what did she do?
Determined to qualify as a doctor, wealthy
When society of Apothecaries refused to accept her as a member did not explicitly exclude women as made sexist assumption that none would apply, threatened them with a lawsuit which they new her father could afford. After changed rules to ban any other women from joining
Same thing applied with British Medical Association in 1873
Opened st. Mary’s Dispensary for medical treatment for women in 1866
Taught herself French to gain medical degree in Paris
London School of medicine for women was renamed the Elizabeth Gareth Anderson hospital after her death 1918
31
What was impact of Elizabeth Garret for role of women in medicine?
Other women became inspired by her who were harassed and taught separately and forced to pay additional few but 1876 Act of parliament forced universities and medical societies to accept women it is one thing to pass a law another for attitude and prejudices to change
32
What and when was the act of parliament for women and its limitations?
1876 Act of parliament forced universities and medical societies to accept women it is one thing to pass a law another for attitude and prejudices to change
number of female doctors increased after 1876 but it remained very low
33
Who is Robert Koch and what did he do?
German Doctor
significant in researching anthrax using technology funded by German government
developed new methods to maximise the efficiency of his research e.g use of Petri dishes and agar jelly to grow cultures
Used industrial dyes to stain microbes to be more easily studied under microscope
Identified with team in Berlin and government funding the microbes that caused tuberculosis and cholera
34
What is the context for the work of Koch and Pasteur?
Franco-German rivalry created international competition even in medical advancements
German government funded creation of Berlin Institute of Infectious diseases where Koch and team provided worked
35
What is Koch impact and was it long term or short term?
Impacts were not immediate or short term but in long term Koch played significant role in bringing about change in medicine because his discoveries helped others within same field develop magic bullets and antibiotics
36
What were the key impacts of the public health act(1875)
Better sewage system - reduced contaminated water and therefore reduced spread of diseases like cholera
Clean drinking water - reduced spread of cholera and typhoid
Better housing conditions ensure healthy ventilation so fewer airborne illnesses
Improved street lighting- people could avoid rubbish and dirt
Compulsory medical officers - people placed in charge of public health in every local authority
37
Who discovered the blood groups and when?
Karl Landersteinetin in 1901
38
What were the blood groups and what did they allow?
A B O AB
Doctors realised that if patient gave wrong blood group could die so knowing group reduced risk of incompatible transfusions so increased success rate of surgeries
Saved way for safer blood transfusions and laid foundation for modern blood typing techniques
39
When was it discovered type O could be administered to anyone?
1907
40
Limitations of blood transfusions?
Despite improvements in surgery the blood donor had to be present for transfusion to take place as blood clots once it leaves the body so until scientists discovered how to stop blood clotting there was no significant improvement in surgery
41
Who discovered the Magic bullet and what did it do?
Paul Ehrlich a member of Koch’s team
Magic bullet concept was where specific chemicals could target and destroy disease causing agents without harming healthy cells
42
What was Salvarsans 606?
A magic bullet that targeted syphilis
43
When was Salvarsan’s 606 created and why was it historically significant?
First chemical cure for a diesease 1909
44
Who discovered X- rays and when ?
Wilhelm Conrad Roentgen in 1895
45
Significance of x-rays?
Allowed doctors to visualise internal structures of the body with our invasive procedures enabling earlier and more accurate diagnoses
Improved orthopaedics dentistry and surgery
Valuable for locating fractures tumours and foreign objects aiding precise treatment planing
46
What were scientists slower to comprehend with X-rays?
potenital safety measures and harmful effects of radiation
47
What was Marie Curies impact on medicine?
Her research laid groundwork in the field of radiation therapy in cancer treatment
Her work inspired development of techniques for targeted radiation to treat tumours
Received second Nobel Prize in chemistry
48
When was the liberal government in power?
1906-11
49
What is the context for the public health measures of the liberal government of 1906-11?
Despite rapid advancements in science and medicine millions of British citizens were living in poverty with a poor diet and poor general health, often with growth stunted as a result of bad nutrition and cramped living conditions
Government shocked and alarmed when heated that more than 1/3 men volunteering to fight in Boer Wars were unfit for military service British empire ruling 1/4 of the world
In major cities like Manchester as high as 75% so survival of army depended on improvement of public health
50
When was the Educational Act and what did it ensure?
1906
Aimed to provide school meals and gave government grant to pay 50% of the cost of the meals other 50% BY TAXES
One thing to raise money another compel local authority to provide meals
51
Was there progress in real terms due to the educational act?
General health of many children as a result of having ablest one meal a day but many children were still left malnourished and vulnerable to disease
52
Was there progress in real terms due to the school medical service(what date)?
1907
School Medical service set up to identify children disease and treatment but did not provide money for treatment and many children and often conditions were left untreated so no progress in real terms
53
When was the Children and Young persons act and what did it ensure?
1908
It became illegal to sell alcohol and tobacco to children under 16 or send child out to beg on the streets or to neglect a child
All childminders had to register with authorities so subject to inspection
Children could not be found guilty of crimes and receive same punishment as adults
54
When was the labour exchanges and what did it improve?
1909
Improving and maintaining the health of the working population because breadwinners in the household meant proper food and shelter and reduced risk of disease
55
When was the National Insurance Act who was associated with it?
1911
Prime minister David Loyd George at the time chancellor of exchequer
56
What was the aim of the National Insurance Act?
Create a system of national insurance that would protect workers from crippling loss of income they would suffer if they fell ill or lost their jobs.
57
Opposition to National insurance act?
Trade unions who ran their own health insurance schemes
Some labour MPs who thought his proposals did not go far enough
Many working class people
Press barons like Lord Northcliffe argued scheme was too costly for small businesses to participate in and might ruin them if they were forced to participate
Medical establishment who calculated that their standard of living would fall considerably if they could no longer charge fees for treating all patients
58
After what did the National Insurance Act become law and its limitations?
After several amendments to take account of objections which had weakened it
Limitations - NIA did not apply self employed or family members and even the working benefits were stopped after several weeks
59
Significance of the National insurance act ?
The act had been introduced so it could be builded on
1920 its provisions were extended
1946 legislation relating tov creation of NHS made this pat of health provision a part of a greater and more comprehensive whole
60
What were the medical problems in WWI ?
Normal warfare ones but on a much larger scale and many unprecedented problems
Artillery shell caused 58% of wounds
Bullets from machine guns or rifles caused other wounds - damage to organs shattered bones blood loss shock and tetanus gas gangrene
Bacteria - entered wounds causing infection, rats bred uncontrollably on the western front and crawled over troops at night increasing risk of infection
61
What was the role of women in medicine during WWI?
World War One created opportunities for women to practise in Britain, because the government had to take into account the shortage of doctors on the home front.
62
Examples of role of women in medicine during WW1
Examples - Number of trained nurses within queen Alexander imperial military nursing service rose from 300 in 1914 to 10,000 in 1918
Other women went to France with Red Cross in voluntary aid detachments VADs
Shortage of doctors in Malta forced war office lead to change of attitudes towards female doctors
Several women set up their own stations. By 1916. shortages forced the War Office to soften its attitude towards female doctors.
63
limitations of role of women during ww1?
Female doctors never given officer status unlike male doctors
One thousand women qualified as doctors but few who worked in hospitals that treated men
Old stereotypes persisted so many women as well as men could not accept the idea that their doctor might be woman
Long term - after ww1 old prejudices and stereotypes reasserted themselves and the number of female doctors fell again
64
What was the impact of medical improvements during ww1?
WW1 was the first major war in which the British Army lost fewer men to disease than to death in battle
65
Why was there focus on medical treatment during ww1?
The side that could not return as many of its wounded soldiers was certain to lose
66
what were the stereotypes against women doctors?
Stereotype - hysterical and quesy at sight of blood not mentally capable to perform surgery
67
Why was there a change of attitude during the war towards medicine?
The determination of the army to win to avoid a repeat of the Boer wars scandal so army proved ailing to overcome deeply ingrained attitudes
Because it was needed for soldiers, women were now needed because there were not a sufficient number of doctors.
68
What is war a catalyst of?
Supreme catalyst of change
69
What were the improvements in brain surgery ?
Brain - before few doctors were specialist in surgery because it was easier to do more damage during surgery because the brain swelled under anaesthesia dangerous
Brain surgery improved as other areas such as.
70
What were the improvements in surgery(x-rays)?
X-rays and fighting infection improved so doctors could now locate metal precisely and use magnets to extract, more specialist doctors and nurses emerged during warn Brian surgery
71
What were the improvements of plastic surgery in WW1?
Plastic surgery - soldiers survived head wounds but left with disfigured faces so needed to improve their appearance so that they could reintegrate into society after the war
72
What were the three areas surgery improved in WW1?
Brain surgery
Plastic surgery
X-rays
73
Consequence of trench warfare during WW1?
Trench warfare increased number of injuries to the brain, head and face
74
Who improved plastic surgery during WWI and how?
Harold Gilles
75
How did X-rays improve during WWI?
reduced in size, so that mobile X-ray units so could travel closer to the front lines, and then number of people qualified to work the machines and read the images correctly increased, to include nurses as well as surgeons and doctors.
Surgeons developed more effective methods of taking x-rays and extraction metal and completely avoided infection
Machine enabled doctors to diagnose fractures
By 1917 as awareness for dangers of radiation increased protective screens and gloves and aprons were widely used by 1917
76
Problems with X-rays?
They were dangerous, and overheated quickly, and they could not identifyy fragments of uniform or pieces of dirt embedded in the body, which could easily result in fatal infection. It was also not possible to achieve a clear image if the patient was nor still.
77
X-rays impact long term and short term?
Short term - Saved hundreds of thousands of lives during war
Long term - X-rays symbolised lasting change as it became standardised to use in hospitals in peacetime and in the post-war period
78
How did blood transfusions improve during WWI?
Before - person to person transfer and blood could not be stored
After - Sodium citrate could be added to the blood to delay clotting and refrigerating blood preserved its used for up to two days.
Portable transfusion kit invented.
By 1918 blood was being stored on larger scaled than it had been thought possible moods ready for peacetime application
79
Problems of transfusions in WW1 and why?
Improvement only benefited troops on a small scale because large quantities of blood could not be stored for a longer period
80
What were the major killers during WW1?
Tetanus and with the first use of gas gas gangrene
Existing antiseptic like carbolic acid ineffective agains gas gangrene
81
How did fighting infection improve during WW2?
Surgeons improved their ability to remove damaged or dead tissue from wounds, which reduced the chances of inflection.
Surgeons improved their ability to amputate limbs while preventing death from shock or post-operative infection.
Carrel - Dakin salt sterilising solution method prevented infection and was widely accepted by 1917
82
Number of amputees by end of ww1?
250,000
83
Problems of infection in WW2?
Risked re-infection when returning to trenches due to filthy conditions
Trench foot which lead to gangrene remained a danger
84
What was ww1 significance?
War proved the catalyst of social, political, technological and therefore medical change on a vastly greater scale
On the other hand - funding for research into non-war related illnesses dried up between 1914 one 1918 which impacted the health of the civilian population.
Also 14,000 doctors left work in Britain so access to good medical care was reduced for the civilian population during the conflict as winning war was general priority
85
Who created penicillin and when and what was it?
Alexander Fleming, first antibiotic ( a bacteria mild that could be used to kill other bacteria)) in 1928
86
Why was penicillin hard to produce in large scale?
Expensive as he could not obtain funding to continue his research
87
Who improved penicillin during WWII and why?
Howard Florey and Ernst Chain contributed with biochemist Norman Heatley to purify the mould and produce it in sufficiently larger quantities
American Pharmaceutical companies because they provided large-scale funding for penicillin.
This was due to ww1 so government large scale funding increased
88
Impact of penicillin short term and long term?
Short term - Progress in war time was rapid by 2943 penicillin was being used successfully in North Africa campaign to prevent amputations
By 1944 D-day landing there was enough penicillin to treat all the casualties in need of it on the five normandy beaches
Long term - since flemings discovery antibiotics have been estimated to save the lives of over 200 million people
89
Why is Penicillin a useful case study?
It shows that its development to the point where it could be used successfully to enable human beings to recover completely depended on the role of other individuals together with the catalyst effect of a world war, technology and large-scale funding. Without the interactions to these factors, penicillin would not have hadthe impact that it had.
90
Why was plastic surgery important during WWII?
It was needed for soldiers who suffered from burns and extreme injuries, that resulted in deformation.
91
Who was main plastic surgeon during world war 2 and what did the do?
Archibald McIndoe cousin to Harold Gilles, he treated badly burned young pilots.
92
What did he discover was harming the soldier rather than helping?
Tannic acid, he realised it actually harmed the patient.
93
What did McIndoe observe about the pilots?
Those who were rescued from the sea suffered less pain and had cleaner wounds.
94
What did MccIndoe, develop from his discovery of soldiers‘ conditions from the sea?
He developed and refined the concept of the saline bath.
95
What were features of the saline bath?
It had to be of constant salinity and temperature, and the soldier would be immersed in the salt water for one hour.
96
What did McIndoe do physically and mentally to help soldier during ww2?
Worked tirelessly to counter psychological damage of patients being disfigured
He organised concert and provided beer and cigarettes in the ward to keep morale high. He realised he had to change society‘s attitudes towards these men so not shunned and gawped at by society.
97
What was the disadvantage of McIndoe‘s methods?
The female nurses felt a constant pressure for sex from the patients, many young nurses complained that they had felt harassed.
98
What were McIndoe’s methods for plastic surgery?
When skin was to damaged to allow new skin to grow grafts were taken from undamaged skin from other parts of body and attached to damaged area to improve appearance
99
When was ww2?
Between 1939 and 1945
100
Why and How did blood transfusions improve during WWII?
The British learnt through the unsuccessful Norway campaign that a blood transfusion had to happen early. British Officers reflected on the experience of each campaign and applied them to the next, this meant that they saved more lives and medical care steadily improved.
Realised that for blood transfusion to be effective they had to be given as near to the front lines as possible even at dressing stations of field ambulances
101
Problems FTUs experienced during France campaign?
Shortage of blood quantities underestimated
Lack of proper training for everyone working within the FTUs
Lack of Blood Bank near front lines created unnecessary restriction on mobility of FTUs
Example of improvements in blood transfusions du to trial and erorr(case studies)
Blood supply depot at Bristol tried to cope with shortage produced 990 bottles of whole blood and 116 bottles of plasma
Field Trials of plasma-transfusions carried out during BEFs campaign two crucial lessons learned. 1 successful in reducing wound shock 2 there were no apparent side effects
Western dessert campaign - lesson learnt so all medical staff including nurses and orderlies given blood transfusion training and equipment was stored in all medical centres, not only specialists centres like FTUs
FTUs established in all theatres of war and volunteer donors provided them with plentiful supply of blood
Blood banks - first set up during peacetime at Ipswich in 1937 in 1939 blood transfusion service had established a basic panel of 5000 donors to collect blood in peacetime 1946 National blood service was established
102
Where was blood stored and transported during ww2?
MRUs Mobile refrigeration units
103
What was the danger from 1919 onwards for the role of women in medicine?
That the old prejudices and stereotypes would reassert themselves, so the gains made during wartime were lost.
104
What was women role in medicine by 1930?
Peacetime would bring complacency of old attitudes
By 1930 most female doctors were still only treating other women and children very few had secured positions in specialist medicine and still fewer were in positions of seniority or in teaching research. Societal expectations of marriage and a child shortened career paths
105
What was the importance of WW2 for changing role of women in medicine?
WW2 did not lead to a dramatic increase in the number of female doctors working overseas at or near the front lines. This was a result of greater efficiency. There were more opportunities for women to qualify and serve as nurses. Unlike women doctors, nurses served overseas.
Exit attitudes help explain governments reluctance to allow female doctor service
By 1939 only four women doctors had been appointed to junior positions
By 1941 full commissions had been awarded full commissions but in practice they were were kept away from front line and used to perform administrative duties
What was the role of women doctors viewed as?
Staying home and treating civilians many joined emergency medical service but even here women tended to be sent to smaller hospitals but emergency care was more likely to be needed in big cities as they were bombing targets.
106
What was exception to the rule for women during ww2?
Women working in Far East who were captured and placed in Japanese prisoner of war camps where incredible demands were made of them in treating their fellow inmates
107
What was different between women doctors and women nurses experiences during the ww2?
Unlike women doctors, nurses served overseas in both Europe and Far East in great numbers for example QAIMNS the Queen Alexandra’s imperial nursing service
Women doctors received greater opportunities during ww1 than ww2
108
What was estimated about the contribution of the military medical service in ww2?
1945 field Marshall Montgomery estimated the contribution of military medical services to victory as “beyond all calculation”
109
Overall progress of medicine due to WW2?
Surgical practices improves - complex brain and heart surgery
Dramatic advances were made in skin grafts and blood transfusion that built on earlier advances made during ww1 and pre ww2
British army learnt that medical staff should be landed at the same time as the troops and should ideally be as near to the front as possible
Surgeons regarded the presence of forward units in large numbers as a major indicator that medical arrangements for a campaign had been properly made.
Improved understanding of importance of ensuring that convalescence and rehabilitation facilities existed at hospitals.
110
Why were crucial lessons learnt with medicine in ww2?
Because victory depended on returning as many wounded men to the front as possible which amounted to lasting progress in medicine
111
What was the long term impact of changes in medicine during ww2?
Improved methods amounted to lasting progress in medicine because treatments devised were followed and re-applied in the civilian context
112
When was the Beveridge Report released?
1942
113
What is the context of the Beveridge Report of 1942?
Collective memory of the British public of Broken promises made to them about the social change that would happen after WW1
Greater mixing of the classes as a consequence of WW1, led to increased general awareness of extremes of poverty, as well as local authorities taking greater responsibility for hospital facilities.
Some people began to receive free medical care due to perceived importance to the war effort.
What did Beveridge acknowledge in 1941?
Unemployment insurance , he made a report which made recommendations on how existing measure might be improved.
114
What were the five giant evils that had to be addressed in the post - War period in his report in 1942?
Want, disease, ignorance, squalor and idleness
115
What were the solutions of the five evils?
To help defeat the evils Beveridge proposed
Unemployment benefit, pensions and sick pay, funded by taxes
116
What link did Beveridge stress and what did it lead to?
He stressed the link between illness, lack of proper health care and poverty
So he proposed a national health service free medical care at point of access
117
Who won the general election of 1945 and why?
Clemente Atlee of Labour Party
British public knew Churchill might have been an effective war leader but was less likely to build homes fit for heroes in peace time(empty promises)
118
Who was determined to turn Beveridge’s report into reality?
Aneurin Bevan, minister of health he announce creation of a healthcare state to protect people
119
When was the National Health Service created?
1948
120
What is the umbrella under the NHS?
Nhs became the umbrella of welfare state because it brought together and sheltered all aspects of medicine and care into a single organisation under government control and funded through taxation and national insurance contributions
121
How was the NHS organised?
three parts
hospital service : run by regional boards
doctors dentists opticians and pharmacists : employed on individual contracts, maternity clinics
vaccination programmes and school dental services : local authority health services.
122
What did doctors fear and what did Bevan do as a result?
Doctors feared loss of income from private patients and also feared not being allowed to charge their own fees so Bevan compromised to allow doctors to keep private GPs as well as working within the NHS as GPs
What were the limitations of the NHS?
Some services had to be paid for, cost was a problem that was identified early.
123
What were the limitations of the NHS?
Some services had to be paid for, cost was a problem that was identified early.
124
What was the impact of the NHS?
Life expectancy and infant mortality fell because many people who would never have gone to a doctor had access now and those who might have gone too late could now have access quickly when condition still treatable
Received medication was free at point of delivery
Newly born babies received health visits in homes
Ambulance service transported people to hospitals where life-saving surgery was performed
NHS responsible for medical research and for hospitals in which doctors and nurses could receive proper training and gain experience
125
What problem was identified with the NHS?
Cost
126
What does the NHS’s creation success dramatise?
The interaction of the major factors needed to cause historically significant change and a decisive break with harmful continuity
127
What did WWII act as?
A catalyst of social, political and technological change.
128
What was the role of the individual in NHS creation?
Role of individual - Figures like McIndoe and Beveridge can also be seen as very important but these men were shaped by the attitude of the time as well as shaping them
129
