1. Healthcare in China What is healthcare? Who provides healthcare in the UK? Why is healthcare important?

2. We are learning to… Summarise how the Chinese healthcare system works Explain the negative impact of changes to healthcare in China. Justify conclusions based on evidence

3. I can… Write a short summary describing the Chinese healthcare system. Provide a detailed explanation of why changes in healthcare have had a negative impact on Chinese people. Come to a valid conclusion and provide appropriate evidence to support it.

4. Despite what many people may think, healthcare is not free or easy to access in modern China - however this was not always the case. Under General Mao, healthcare was universal, free, and generally of a high quality. There were two different healthcare systems: The Urban Scheme The Rural ‘Barefoot Doctors’ Scheme

5. Under General Mao… The Urban Scheme Under Mao, all hospitals and clinics were owned and funded by the Chinese government. All urban poor could be treated in these hospitals for free. This was known as ‘cradle to grave’ care. The ‘Barefoot Doctors’ Scheme The Barefoot Doctors were rural people with basic medical training. They were paid by the government to go around rural areas giving health advice. They made sure people got treatment for illnesses and gave them advice on how to prevent diseases. 90% of rural people had access to free healthcare clinics, run by the barefoot doctors. Create a mindmap in your jotter with 4 arms: -The Urban Scheme under Mao -The Barefoot Doctors under Mao -The Urban Scheme now -The Barefoot Doctors now

6. Modern Chinese Healthcare The Urban Scheme Now, healthcare is provided through a ‘hybrid’ system. The system is a mixture of employer-based insurance scheme, supplemented by state social service supplements. This means that, unless someone has a high-paying job that provides insurance for him or her, they are essentially on a ‘pay-as-you-go’ system. 60% of urban citizens cannot afford health insurance, and so basic healthcare is not available to them. When President Deng came to power, he sought to modernise the healthcare system as part of ending the Iron Rice Bowl. The ‘Barefoot Doctors’ Scheme Since Deng came to power, and introduced the health insurance system, 90% of people in rural areas do not have insurance. The barefoot doctors no longer have their wages paid by the government, and have been forced to charge for their services, meaning that the rural poor, who cannot afford their services, have little to no healthcare. As a result, infant mortality rates are double those in the cities. Infant Mortality: Death of children under age 1

7. Task One a) Watch the Clip about the modern “Barefoot Doctor” and answer the questions. Questions have been posted on the Blog. China's Barefoot DoctorsChina's Barefoot DoctorsWatch video until 3.48/ Questions Part 1 China's Ailing Healthcare System b) Write a 5 SENTENCE SUMMARY of the Chinese Healthcare system. Use Who? What? When? Where? Why? To help you complete your summary.

8. Impact of the current system Although President Deng’s Modernisation programs led to an increased focus on science and technology, the medical professions and healthcare system have not benefitted in the same ways. Impact of Changes in Chinese Healthcare System Many Chinese hospitals don’t keep soap in their public bathrooms because it is too expensive With 1.6 physicians per 1000 population in 2012, China had much fewer doctors per person than the OECD average (3.2 physicians). Life expectancy at birth in China was 75.2 years in 2012 although it remains five years lower than the OECD average (80.2 years). The number of nurses per person in China is also much lower than the OECD average: 1.8 nurses per 1000 in China to 8.8 nurses per 1000 elsewhere. Medical care is not available to more than 100 million people in remote rural areas. There is still widespread under-nutrition, vitamin and mineral deficiencies in rural areas.

9. Impact of the current system? What other factors may be affecting the health of Chinese people? Try to come up with four other factors in your groups and explain why you have chosen it.

10. HIV/AIDS has become a real problem in modern-day China. A large increase in the number of drug-users and a lack of education about safe sexual practices led to a dramatic increase in the number of AIDS patients in the late 1990s. The number of deaths from HIV/AIDS has increased from 1.1 per 100,000 in 2000 to 2.8 per 100,000 in 2012. In the urban areas, there are many prevention programmes that educate people about how to stop the spread of AIDS but drug culture is still an issue. In the rural areas, there are almost no prevention programmes and many people pass on AIDS without realising it. In the rural province of Henan (pronounced ‘her-nan’), the government set up blood stations, and encouraged patients to sell their blood to make money. There were few hygiene standards in the clinics, and re- use of needles and equipment was extremely common. Thousands of people in the province were infected with AIDS after coming into contact with contaminated blood. Impact of the current system: HIV/AIDS

11. Set 1 – Knowledge Questions 1.When did HIV/AIDS become a major issue in China? 2.What areas of China are badly affected by HIV/AIDS? 3.What has happened to the number of people dying because of AIDS in China? 4.What part of China was especially effected by HIV/AIDS? 5.What happened in Henan to spread HIV/AIDS? TASK TWO: Question Sets Set 2 – HOTS Questions 6. With a population of 1.3 billion, why is the health of its people so important to the government of China? 7. Why would a lack of qualified doctors and nurses have a negative impact on a country? 8. The issue of money (or lack of money) is a problem in the Chinese healthcare system. What do you think the Chinese government could do to help its citizens gain affordable healthcare?

12. Making a Conclusion A conclusion is a judgement or summary evaluation that you make, based on evidence. In Modern Studies, we are often asked to come to conclusions based on the evidence we are presented with. For example, if I asked you to come to a conclusion about the size of the population of China what would you say?

13. It can be concluded that China has the largest population of any country on Earth. There are currently 1.3 billion Chinese citizens. if I asked you to come to a conclusion about the size of the population of China what would you say? How can we reach this conclusion – we know the population of China is 1.3 billion and we know it is the biggest in the world! WRITE ON, WIPE OFF TASK

14. Draw a conclusion on the state of the education system in China It can be concluded that the Chinese education system is very poor because many rural schools are of a poor quality. It can be concluded that the Chinese education system is failing urban migrant children as only 40% of urban migrant children are enrolled in school. OR Now move onto Task Three!

15. Draw a conclusion about the following, based on the evidence provided in Source 1 and Source 2. China’s progress in tackling the HIV/AIDS crisis Public HIV campaigns have been important in China’s response to the HIV epidemic. Targeting key affected populations, different events have been held around the country. The Youth Red Ribbon is one such project providing HIV education for young people and adolescents. A further example of these mass HIV campaigns can be seen in China’s “100 universities going into 1000 enterprises”. The campaign involved using university students who have been educated by HIV prevention programmes to go to different organisations and businesses and educate workers in HIV prevention. The programme provided over 300,000 workers with HIV and AIDS education. Source 1 Source 2 Treatment, care and support challenges still exist in China. In 2013 alone, 28,000 people died from AIDS-related causes. The number of people living with HIV receiving treatment has steadily increased across the country. However, progress in reducing mother to child transmission (MTCT) rates is still regarded as slow. There are still high levels of stigma and discrimination against people living with HIV/AIDS across the country.

16. A conclusion about ___________________ is that ___________________________________________________. One piece of evidence which supports this can be found in Source ___ which states that _______________________. Furthermore, evidence from source ___ backs up this conclusion as it shows that ________________________________. Give two pieces of evidence to support your conclusion. Use Full sentences!!! Conclusions Writing Frame

17. Try a Nat 5 Exam Style Conclusions Question, using THREE sources of information. Use the same Writing Frame as before and create conclusions for the following two bullet points. inequalities in education in China Inequalities in health in China The sources are available on the blog Conclusions Extension Task

18. Plenary Task On the post-it note provided, write down any TWO things which you now know about the Chinese healthcare system/issues in the Chinese healthcare system. Write down one thing you would still like to know about the Chinese healthcare system.

19. We are learning to… Summarise how the Chinese healthcare system works Explain why many Chinese people cannot afford healthcare. Justify conclusions based on evidence

20. Did I…

21. I can… Write a short summary describing the Chinese healthcare system. Provide a detailed explanation of why many Chinese people cannot afford healthcare. Come to a valid conclusion and provide appropriate evidence to support it.