Author: Rachel Harvey

Key Question 5. Developments in patient care c.500-present day

Medieval / (Up to 1500ish)	Early Modern / 1500-1800 ish!	Modern / 1800 to the present day
The Church and monasteries: played a role in patient care though dominated by praying for the soul rather than actual treatments. Hospitals provided hospitality not treatments. Made patients comfortable. If they were seriously ill, not admitted, as interfered with the business of praying and religious services / Infirmaries : Looked after the old and ‘infirm’. / Leper hospitals for those with leprosy / Almshouses: medieval equivalent of care homes for the old, but also helped widows and young / children.	Voluntary charities from mid 16th century as / Henry VIII closed monasteries resulting in a drastic / decrease in patient care. / Royal hospitals set up in London (St Bartholomew’s, St Thomas’s etc) from royal funds / Endowed voluntary hospitals outside London: local councils petitioned the King to ask for funds when the monasteries shut. / Industrial Revolution lead to some individuals getting very rich and some like Thomas Guy a rich printer set up Guy’s Hospital in London / In this period more hospital evolved into places where surgery took place, as well as looking after the poor sick, and dispense medicines.	Big increase in the number of hospitals in the 19th century; increasing city populations required big general hospitals to be set up. (1800: 3000 patients in hospital, 1851: 7600) / Specialist hospitals like maternity and ear, nose and throat set up, but conditions were poor. / Florence Nightingale and the professionalisation of nursing: Became famous improving hospital conditions in the Crimean War. Reduced death rates / On return to England, a public fund was set up and raised £50,000. FN set up an Nursing School in 1860 at St Thomas’s Hospital and wrote Notes on Nursing in 1859. in 1850 there were no trained nurses, by 1900: 68,000 / Hospitals expected to be clean, have fresh air, warmth, light, appropriate diets / Mary Seacole and Betsi Cadwaladr: both nurses in Crimean War who did hands-on work, using their own money. / Government attitudes changed in early 20th century: welfare and social reforms to reduce poverty (Liberal gov 1906-1914), National Insurance Act 1911 / Beveridge Report 1942: 5 Giants (Want, Squalor, Ignorance, Idleness, Disease) / Lead to the NHS 1948: First time the medicine of ordinary people changed: FREE FROM THE CRADLE TO THE GRAVE. / Increasing financial demands on the NHS since then: rebuilding of hospitals in the 1960s, increasing cost of caring for an ageing population, increasing need as medicine becomes more sophisticated.