Modern Britain

• Medival
• Renaissance
• Industrial
• Modern

• Mobile X-rays
• Bloodloss and Transfussions
• Plastic Surgery

Wilhelm Rontgen discovered X-rays in 1895.

X-rays were used from the start of the First World War to find broken bones, but the equipment included glass tubes that were unreliable and often stoped working.

They were often located in hospitals miles away from the battlefeilds.

The American scientist William Coolidge had invented a more reliable X-ray tube in 1913.

The 'Coolidge tube' became widely used by the end of the war and is even still used today.

In 1914 the Polish scientist Marie Curie developed mobile X-ray units (ambulances equipped with X-ray machines) which allowed doctors to transport X-ray equipment.

The war also increased the number of radiologists - people who knew hopw to operate X-ray equipment.

Curie and French scientist Antonie Beclere set up training schools to teach doctors how to use X-ray equipment.

The idea of blood transfusions was known from the 17th centuary, but they were rarely successsful because the blood of the recipient often clotted and becasue of blood groups. Blood also clotted if stored outside the body.

In 1900 Karl Landsteiner discovered blood groups. Certainblood groups couldn't be mixed togather as the blood would clot, blocking the vessels.

Landsteiner's discovery meant doctors could performe more successful blood transfussions as long as the donor's blood group was the same as the pateint's.

During World War One the seriousness of wounds from gunshots and explosive shells meant that many soilders died of blood loss. This made being able to store blood very important.

In 1914 doctors found that sodium citrate stopped blood from cloting so it could be stored.

In 1917 this discovery allowed the first ever blood depot to be se up at the Battle of Cambrai.

In 1946 the British National Blood Transfusion Service was established.

Doctors in France and Germany had been working on skin graft techniquessince before the First World War. Their work helped pave the way for Harold Gillies,who set up a plastic surgery unit for the British Army during the war.

Gillies was interested in reconstructing facil injuries so that patients could have a normal apperance.

Gillies developed the use of pedicle tubes and kept detailed records of his achiments.

Gillies' work was continued during the Second World War by his assistant Archibald Mclndoe.

• Fleming's discovery
• Purifying Penicillin
• Mass production

Alexander Fleming was searching for a cure to avoid people dying of septic wounds caused by staphylococcal bacteria.

He identified the antiseptic subtance in tears, lysozme in 1922- but this only worked on some germs.

One day in 1928 he came to clean up some old culture dishes on which had been growing staphylococci for his experiments. By chance a fungal spore had landed and grown on one of the dishes.

Flemming saw that the colonies of staphylococci around the mould had stopped growing. The fungus was identified as Penicillium notatum. It produced a substance that killed bacteria. This substance was given the name penicillin.

Fleming published his findings in articles between1929 and 1931. However nobody was willing to found futher research so he was unable to take his work further. The indsutrial production of penicillin still needede to be developed.

Since it is a natural product penicillin needs to be purified.

A breakthrough was made by Howard Florey's team in Oxford in 1938 and 1940.

Ernst Chain a memebr of the team devised the freeze-drying technique which was an important of the purification process.

At first Florey and Chain didn't have the resources to produce penicillium in large amounts. They made penicillin for their first clinical trial by growing Penicillium notatum in every container they could find in their lab.

Their patient began to recover only to die when the penicillin ran out.

Florey knew that penicillin could be vital in treating the wounds of soldiers fighting in World War Two however, British chemical firms were two busy making explosives to start mass production so he went to America.

American firms were also not keen to help untioll America joined the war in 1941. In December 1941 the US government began to give out grants to businesses that manufactured penicillin.

By 1943 British businesses began to also start mass-producing penicillin.

By 1944 the mass production was sufficient for the needs of the military medics by 1944

After the war the cost of penicillin fell, making it more accessible for the general use.

Fleming, Florey and Chain were awarded the Nobel Prize in 1945.

• Pharmaceutical Industry
• Problems faced by the Pharmaceutical industry
• Transplants
• Technology
• Aletnative treatments

In the late 1800s the chemical industries were booming. In the late 19th and 20th centires saw the discovery of new drugs including asprin,1899, insulin,1921, sulphonamides,1932 and penicillin.

The chemical companises were best placed to manufacture these new drugs and medicines on a large scale and make them available to lots of people. The success of their mass-produced drugs in the 1940's helped modern pharmaceutical industry take off.

Pharmaceutical companies have played an important role in researching and developing new medicines. They also mass produced these drugs to sell worldwide.These compaines have been important in curing new diseases and researching  new forms of treatments;

~Chemotherapy is the treatment of cancer using drugs. It began to be developed during World War 2 and pharmaceutical companies have been prodcuing cancer drugs since the 1960s.

~ In 1981 doctors identified a new illness AIDS which is caused by the HIV virus. In 1987 pharmaceutical companies began mas producing a drug called AZT, the first approved drug to treat HIV. They have since been involved in developing more effective treatments of HIV.

Drugs have to go through a series of clinical tests before they are given to patients. This is to make sure that they work properly and don't cause any damaging side-effects.

In the 1950s the drug thalidomide was realsed without thorough testing. It was orginaly used as a sleeping pill, but it soon became popular amoung pregnant women as a treatment folr morning sickness. Tragically, thalidomide affected the women's unborn babies causing thousands of children to be born with under-developed limbs and other issues.

The thalidomide tragedy forced pharmaceutical companies to test drugs more thoroughly. The government responded to the tradedy in 1963 by setting up a Committee on Safety of Drugs to make sure all new drugs were safe before given to patients.

Pharmaceutical companies have high costs for reserch and development of new medicines. Rare diseases sometimes go unreaserched because companies tend to focus on common diseases that will make them a lot of money.

Antibiotic resistance stops antibiotics from working properly making it more difficult to treat some diseases. This has increased the levels of disease and the time taken for pateints to recover. Around 25,000 people die in the EU each year due to antibiotic-resistant bacteria.

In 1905 the first successful transplant of the cornea of the eye was performed.

The first complete organ to be successfuly transplanted was the kidney. Livers, lungs, pancreases and bone marrow can now also be transplanted.

The first successful heart transplant was carried out by South African surgeon Christian Barnard inb 1967. The pateint however only survied for 18 days - he died of pneumonia.

The problem for transplants' is rejection.The immune system attacks the implant as if it was a disease.

~ The success of early transplant operations was limited because doctors lacked effective immunosuppressants - drugs that stop  the immune system attacking.

~ Since the 1970's researches have develped increasingly effective immunosuppressants making transplants safer and more likely to be successful.

Advances in science and techonoly had led to improvments in the treatmewnt of diseases like cancer. The discovery of radiation in 1896-1898 by Antoine Henri Becquerel, Marie Curie and Pierre Curie led to the creation radiation therapy.

The development of lasers since the 1950's led to their widespread use in medicine in the 19080s. Laser surgey is used to correct vision problems and lasers are also usede in cancer treatments and dentistry.

Advanced in video technology led to the development of keyhole surgery in the 1980s.

Keyhole surgery involves the use of a speacil type of camra called an endopscope.

Keyhole surgery leaves patients with smaller scars and allows them the recover more quickly with less chance of infection.

Mistrust of modern medicine and tehnology means some poeple use al;ternative therapies instead.

~ Acupuncture is the method of putting needles in a specific points of the pateints skin to relieve pain.

~ Homeopathy is treatment using extremly weak solutions of natural substances.

Unlike mainstream treatments aletnative therpies are not based on evidence gathered from scientific research. As a result there is little scientific evidence to suggest they work effectivly and some doctors believe they even do more harm than good.

However some doctors are now working with alternative therapists to see if using a mix of alternative and mainstream medicine might result in benefits to the patient.

Slums and overcrowded housing were all still common in the industral towns in the 1900. The poor worked long hours for low wages. Many people ccould barely afford to give their children three decient meals a day. Booth's and Rowntree's reports show how widespread poverty was.The lacks of access to good healthcare meant that most peoples health was poor. When the Boer War broke out in 1899 army officers found that around 40% of vounteers were physically unfit for militaryt servies - mostly due to poverty-related illnesses linked to poor diet and living conditions.

The government reailised that it need to improve basic health care in oder to have a efficient army

~ In 1906 free school meals were introduced - paid for by local counsil taxes.                                ~In 1907 Local Education Authorities started giving children at their schools free medical inspections.                                                                                                                                         ~ In 1908 old age pensions were introduced for the first time, they were for people over 70 and paid for by national taxes.                                                                                                                ~ In 1909 Labour excanges were introduced to help the unemployed people find work.                ~ In 1911 the National Insurance Act was passed. Introducing health insurance for workers, their employer and the government all contributed to a central fund that workers could use for sick pay

The first and second would wars broke down social distinctions and brought people togather whose lives had been very seprate before.

The raising mass armies made governemnt and miltary officals more aware of the health problems of the poor. Powerful people were more concerned at solving these problems when at war due to the need of strong healthy army to defend their country.

The evaccutaion of the children during the second world war increased awareness in richer rural commnuities of how disadvataged many people were in other parts of the country.

After the second World War people looked for improvements in  society. Such feelings led to the 1945 victory for the Labour Party which promised healthcare for everyone and full employment.

• The wars created pressure for change
• Housing and health improvments
• The Beveridge report

Towards the end of the 1st world war Prime Minsister David Lloyd George promised to tackle poor-qualilty housing by building 'homes fit for heros' to tackle poor-qualty housing. Som enew counsil houses were built in the 1920s and 1930s but  many of them were too expensive for the poorest families who still lived in slums.

During the 2nd world war destruction from bombing and a lack of construction  led to serve housing shortages making the situation worse.

After the war the Labour government built 800,000 new homes between 1945- 1951. In 1946 it passed the New Towns Act - this created completly new towns near major citites. Governemtns in the 1950s and 1960s demolished over 900,000 old, cramped slums - around 2 milolion inhabitants were rehoused.

In 1961 a report called 'Homes for Today and Tomorrow' gave specific standards for new housing, including adequate heating, a flushing toilet abd enough space inside and outside. This was the final step in tackling the issues of overcrowding, poor nutrition and poor waste disposal that had caused major publich health problems.

In 19842 during the second world war economist and social reformer William Beveridge published his famous report. The report became a bestseller- it was widley read and hugwly popular.

In his report he called for the state provison of social security 'from cradle to the grave'. Beveridge argued that all people should have the righrt to be free from want, disease, ignorance, squalor and idleness. He called these the five 'giants'

In his report Beveridge said that the government had a duty to care for all its citizens, not just the poor or unemployed. To achive this Beveridge suggestede the creation of welfare state - a system of grants and servies avalibale to all British citizens.

The 1945 Labour government was elected with the promise to implement Beverudge's proposals. One of their acts was to pass a new National INsurance Act of 1946 to support anyone who coudn't work whether as a result of sickness, pregnacy, enemployment or old age.

• Establishment
• Popoularity
• Challenges faced

The Labour government implemented Beveridge's last proposal - a National Health Service.

Aneurin Bevan was the Labour Minister for Health, who after a lot of negotiatyion, introduced the NHS. The government nationalised hospitals and put them under local authority control.Treatment was made free for all patients.

They are many arguments for the NHS;

• During WW2 the governemtn took contreol of all hospitals, creating the Emergancy Medical Serivce. Its success led many to support the creation of the NHS.

• The NHS would make medical care free so it was accessible to everyone.

• The NHS guaranteed that hospitals would recive governemnt founding, rather than having to rely on charities for money.

They are also many reasons against the NHS;

• Many Conservatives opposed the NHS as they believed the cost would be huge.

• Doctors saw themselves as independent professionals - they didn't want to be controlled by the governemnt. They also worried that they would lose a lot of income from privert patients.

• Many doctors threatended to go on strike to protest against the NHS. They govvernment won them over by offering them payment for each patient they see and letting them continue treating privet patients.

Although many Conservaties were opposed to the creation of the NHS they couldn't abolish it when they came backi in power in 1951 due to its popualrity.

The NHS increased the number of people with accesses to healthcare - similariy the number of doctors doubled between 1948 and 1973 to keep up with the demand.

Today the NHS provided a range of health serivces, most of which are free and accessiblke to everyone. They iclude accidant and emergency care, maternity care andf major surgery aswell as pharmacies, dentists, mental health serives, sexual health services andf general practitioners ,GPs,.

In the long term the NHS has contributed to a drastic improvment of life expentancy and people's health in general.

By increasing life expectancy it means that they are many more older people in Britain today then they were in 1948, who are more likely to suffer from long term illnesses likee diabetes and heart disease. They need regualr medical attention and require alot of the NHS time, money and resoures.

Many people's lifestyle choices are also putting strain on the NHS. Smoking, obesity and alcohol consumption can all harm people's health and may require expensive treatment - for example, smoking can cause lung cancer andf drinking to much alchol can cause liver disese.

Mnay modern treatments, equipment and medicines are very expenive and the NHS has had to face rising expectations of what it can and should offer.

As a result of all these factors the cost of the NHS is rising rapidly. In 2016 the budget was  £116billion overall. In order to stay within this budget the NHS sometimes has to make difficult choices about which treatments it can and cant provide.