Modern medicine

• Impact of WW1: Surgery (Harold Gillies) - A New Zealand doctor. During World War One, he joined the army as a surgeon with the British army. He initially worked on the front line. However, in 1917 he set up a ward at Queen Mary’s Hospital, Sidcup, in London, to treat patients with facial injuries.
• Impact of WW1: Surgery (Harold Gillies) - Pioneered new skin graft techniques. In one technique, he moved a patch of skin on the face, called a pedicle. He left the veins attached to it, so it still had a blood supply and could successfully be attached to a different part of the face.
• Impact of WW1: Surgery (Frances Derwent Wood) - A sculptor. He worked in hospitals in England treating injured soldiers. He designed and made lifelike facial masks for soldiers who had suffered severe facial injuries. This helped them to regain confidence, supported their mental health and aided their reintegration into normal life.
• Impact of WW1: Treatments (Blood transfusions) - Since Karl Landsteiner had discovered blood groups in 1901, blood transfusions had been possible. However, blood could not be stored. During World War One, sodium citrate was added to packages of blood. This stopped it from clotting straight away and meant blood could be stored for a short period of time.
• Impact of WW1: Treatments (X-Rays) -  Marie Curie and her husband Pierre's scientific research was crucial in the development of X-rays for use in surgery. The X-ray machine was invented in 1895 before the start of World War One. During World War One, mobile X-ray units were available.
• Impact of WW1: Treatments (X-Rays) - Marie Curie played a vital role in getting 200 X-ray units into field hospitals along with 20 mobile X-ray vehicles, which the French troops nicknamed petites Curies which translates to 'little Curies'. This meant surgeons could see what internal injuries a patient had, meaning surgery could be better planned and was safer.
• Impact of WW1: Treatments (Amputation and the use of prosthetic limbs) - The nature of injuries suffered in World War One meant thousands of soldiers had limbs amputated. New and more sophisticated artificial - prosthetic - limbs were designed. A company in London that made industrial and electric tools began to manufacture a new prosthetic leg made of metal. This was lighter and easier to manoeuvre.
• Impact of WW1: Prosthetic limbs - James Edward Hanger became an amputee during the American Civil War. His prosthetic limb was ill-fitting and painful. Using his engineering experience, he designed a new one that was able to bend at the knee and the ankle and was better fitting. The state government commissioned him to manufacture improved prosthetic limbs for other wounded soldiers.
• Impact of WW1: Prosthetic limbs - James Edward travelled to Europe to observe the effects of trench warfare - so he could design better prosthetics. As a result of this trip, Hanger’s newly established company received contracts with both England and France during and after World War One to supply artificial limbs to Allied soldiers.
• Liberal reforms: Charles Booth - After the 1875 Public Health Act and other reforms, there was a feeling public health problems had been dealt with. However, a social researcher and reformer, named Charles Booth, conducted a piece of research in 1889. This showed that 35 per cent of London’s population lived in ‘absolute poverty’.
• Liberal reforms: Seebohm Rowntree - A philanthropist and social reformer, conducted an investigation in York in 1900. He found that people needed to be earning 21 shillings a week, equivalent to £125 in 2021, to stay out of poverty. He came up with the term ‘poverty line’ for people earning less than this amount.
• Liberal reforms: 1867 Reform act - Gave the vote to more working-class men. In the 1900 general election, the Labour Party entered candidates for the first time and won two seats in Parliament. In 1906, they increased the number of seats they held to 29.
• Liberal reforms: 1867 Reform act - The Liberal Party won the election in 1906 but wanted to ensure the Labour Party didn’t gain more seats in the future. The Liberal Party saw their own reforms as a way of maintaining the support of working-class voters.
• Liberal reforms: Second Boer War - In 1899, at the start of the war, one in three of the men who volunteered to fight were unfit to be recruited for health reasons. The government needed to take action to improve the health of the people.
• Liberal reforms:

  • In 1906, free school meals were introduced to improve the health of children.
  • In 1907, schools began medical inspections of their pupils.
  • In 1908, the Old age pensions act was introduced. Eligible people, who were also over 70 years old with an annual income of less than 21 pounds per year, received a pension of five shillings per week. People who earned over 21 pounds per year or were married received a smaller amount. Anyone who earned over 31 pounds and 10 shillings per year received no pension.
• Liberal reforms:

  • in 1909, the Labour exchanges act was brought in. Labour exchanges were similar to job centres today. Their aim was to match up employers and employees
  • in 1911, the National insurance act came in. This set up a system where workers had a sum of money deducted from their wages to pay for health care and sick pay if needed
• Liberal reforms: Opposition - Some people argued that the Liberal reforms did not go far enough. The Labour Party said more should be done to help women, who were less likely to benefit from National Insurance. They also argued that old age pension payments should be higher.
• Liberal reforms: Opposition - Some Conservative Members of Parliament said that giving people too much from the state would make them dependent on being given aid and support. They also thought it might reduce people’s desire to work. Additionally, there were concerns about the cost to taxpayers.
• Impact of WW2: The Guinea pig club - Archibald McIndoe was born in New Zealand and was a cousin of Harold Gillies. During World War Two, he worked with soldiers who had suffered severe facial injuries, especially from burns. McIndoe treated the physical injuries. He also supported soldiers who had difficulties with their mental health as a result of severe disfigurement from physical injuries.
• Impact of WW2: The Guinea pig club - McIndoe’s patients formed a support network known as the Guinea Pig Club. The club organised social events. It also helped recovering soldiers adapt to civilian life and learn to live with their injuries. The club became well known and was visited by the war-time prime minister, Winston Churchill.
• Impact of WW2: Blood transfusions - Charles Drew was an American surgeon. He came up with new methods to store and transport blood. When World War Two began, Drew was put in charge of a campaign called Blood for Britain. This involved US civilians donating blood, which was transported to Britain using Drew’s techniques. It was then used to treat injured British civilians and soldiers in blood transfusions.
• Impact of WW2: Evacuation - During World War Two, evacuation led to 3 million children moving to the countryside, so they were safe from the bombing of towns and cities. Many people in rural areas were shocked at the levels of poverty they witnessed in some of the evacuated urban children. This led to support for social reform and a commitment to help families in need of assistance. In turn, this helped to pave the way to the foundation of the National Health Service (NHS) in 1948.
• Impact of WW2: Penicillin - During World War Two, penicillin was mass produced for the first time. Howard Florey and Ernst Chain’s success in mass producing the first antibiotic meant US soldiers injured at D-Day were all given penicillin to reduce the risk of infection.
• Setting up the NHS: The Beveridge report - In 1942, William Beveridge, a Liberal politician and social reformer, wrote a report called Social Insurance and Allied Services. It became known as the Beveridge Report. He recommended that the government should act to deal with what he called the ‘five giants’.
• Setting up the NHS: The Beveridge report (the five giants) - Idleness, caused by a lack of employment opportunities. Ignorance, caused by people lacking a good education. Disease - caused by unaffordable health care. Squalor - caused by poor-quality housing. Want - caused by poverty.
• Setting up the NHS: Aneurin Bevan - After World War Two, Winston Churchill lost the general election in 1945 to Clement Attlee and the Labour Party. Aneurin Bevan then became Minister of Health. He organised the founding of the NHS based on the principles of the Beveridge Report.
• Setting up the NHS: Opposition -

  • The General medical council, which represented doctors, was concerned that doctors would be employees of the government. They worried that doctors would lose their independence and receive less pay.
  • Some politicians argued that the cost of the NHS would be too great and taxpayers should not have to pay.
• The birth of the NHS: For the first time, everyone in the country could receive free health care, regardless of income. This included eye tests, hearing tests, prescriptions and hospital care.
• The birth of the NHS: To ensure the NHS could be fully staffed, nurses and domestic workers from the Caribbean and Ireland were employed and encouraged to come and work in hospitals in the UK. During the 1960s, NHS employees were also recruited from South Asia and Africa, as well as from the Caribbean.
• The birth of the NHS: Prescription charges - Bevan strongly believed that the NHS should provide free health care for all, regardless of people’s income. The initial budget for the health service was £437 million per year - equivalent to around £15 billion in 2021. This was a significant cost, particularly at a time when Britain was heavily in debt following World War Two.
• The birth of the NHS: Prescription charges - Pressure on the NHS budget meant tough decisions needed to be made. In 1951, Bevan resigned from the government when charges for prescriptions were introduced to pay for the cost of the Korean War.
• The NHS today: New medicines and treatments are constantly being developed. The NHS runs public health campaigns to try to encourage people to lead healthier lives. For example, it encourages people to:

  • stop smoking
  • eat healthily
  • practise safe sex
  • get vaccinated (eg the flu vaccines)
• The NHS today: The NHS faces ongoing challenges regarding the cost of new treatments. Decisions have to be made about which medications and services can be paid for by the NHS and which cannot.