How did medicine and healthcare develop in the twentieth century?
Magic bullets and antibiotics including penicillin, advances in surgery and technology, the founding of the NHS in 1948, and modern public health campaigns.
A focused answer to the modern section of AQA's Health and the people thematic study, covering magic bullets and the discovery and mass production of penicillin, advances in surgery and technology, the founding of the NHS in 1948, and modern public health campaigns.
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What this dot point is asking
This is the final period of the Health and the people thematic study. You need to explain twentieth-century medical advances: the magic bullets and antibiotics, especially penicillin, the progress in surgery and technology, the founding of the NHS in 1948, and modern public health campaigns. It is examined by significance and difference questions and the 16-mark factor essay.
Magic bullets and antibiotics
Surgery and technology
Surgery was transformed by new science and technology. Blood transfusions were made safe by the discovery of blood groups (1901) and ways to store blood, allowing surgeons to replace lost blood. X-rays (discovered 1895) let doctors see inside the body. Later came transplants (such as the first heart transplant in 1967), keyhole (minimally invasive) surgery, and high-tech scanning. These let surgeons treat conditions that were once untreatable.
The founding of the NHS
Modern public health
Government today plays a central role in health. It runs mass vaccination programmes (which have nearly eliminated diseases such as polio), screening, and health-education campaigns against smoking, drinking and poor diet, and it passes laws such as the ban on smoking in public places (2007). The focus has shifted from infectious disease to lifestyle diseases such as cancer, heart disease and diabetes, a key difference from earlier public health.
This shift, from sanitation against infection to campaigns and laws against lifestyle disease, is the basis of the common difference question comparing the role of government across the periods.
Try this
Q1. Who discovered penicillin, and who mass-produced it? [Knowledge recall]
- Cue. Fleming discovered it (1928); Florey and Chain mass-produced it in the 1940s.
Q2. Explain why the founding of the NHS in 1948 was so important. [Short explanation]
- Cue. It provided healthcare free at the point of use, funded by taxation, giving the poor access to doctors and hospitals for the first time.
Exam-style practice questions
Practice questions written in the style of AQA exam questions on this dot point, with worked answer explainers. The year tag is the paper they imitate, not the source.
AQA 20188 marksExplain the significance of the development of penicillin for the treatment of disease.Show worked answer →
The Paper 2 thematic study "significance" question (8 marks, AO1 and AO2). Reward explained significance at the time and over time.
Develop two or three points. Fleming's discovery of penicillin in 1928 identified the first antibiotic, but it was Florey and Chain's mass production in the 1940s that made it usable, saving countless lives from infection during and after the Second World War. Over time antibiotics transformed the treatment of bacterial disease, although their overuse has since led to resistance.
Top band. Explain both the immediate and long-term significance, and note the role of several people and of war, ending with a judgement.
AQA 20218 marksExplain two ways in which the role of government in public health was different in the twentieth century compared with the nineteenth century.Show worked answer →
The Paper 2 thematic study "difference" question (8 marks). Reward two clearly explained, supported differences.
Way one. Scope of provision: nineteenth-century government action focused on sanitation and clean water (the 1875 Act), while the twentieth century created the NHS (1948), providing free healthcare for all, a far wider role.
Way two. Focus of public health: nineteenth-century reform tackled infectious disease and filth, while modern campaigns target lifestyle diseases through education, vaccination programmes and laws such as the smoking ban.
Top band. Develop each difference with specific detail across the two periods.
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Sources & how we know this
- AQA GCSE History (8145) specification — AQA (2016)