The 16 Mark "How Far do you Agree" Question (Edexcel GCSE History): Revision Note

Exam code: 1HI0

Zoe Wade

Written by: Zoe Wade

Reviewed by: Bridgette Barrett

Updated on

Summary of Question 5 or 6

  • You will choose between Question 5 or Question 6

  • Answering either question requires you to:

    • Make a clear, sustained judgement about a historical statement

    • Use second-order concepts like cause, change, significance, or consequence

    • Compare the given reason with other valid reasons

    • Reach a well-structured conclusion

  • From the 2025 exams onwards, the question will cover either a complete period or at least 200 years

Amount of marks 

16 + 4 SPaG marks

The time that you should spend on the question 

5 minutes of planning

20 minutes of writing

  • An example of the type of question you may encounter can be seen below:

Exam paper section asking to answer either Question 5 about John Snow's work on cholera or Question 6 about government action improving hospitals. Each question is worth 20 marks.
An example of Question 5 and Question 6 in Paper 1
  • In previous years, this question has focused on the following topics in Medicine in Britain:

    Year of Exam 

    Question Topic 

    2018 (opens in a new tab)

    Question 5: Understanding the cause of disease

    Question 6: Advancements in surgery

    2019 (opens in a new tab)

    Question 5: Galen and his impact on the progress in medical care and treatment

    Question 6: The role of the government in the development of care and treatment

    2020 (opens in a new tab)

    Question 5: The work of Florence Nightingale and the development of care and treatment in hospitals

    Question 6: The improvements in dealing with infectious disease

    2021 (opens in a new tab)

    Question 5: The role of the church in the progress of care and treatment

    Question 6: The significance of the printing press

    2022 (opens in a new tab)

    Question 5: The role of the physician in providing care and treatment

    Question 6: The work of Pasteur in understanding the causes of illness

    2023 (opens in a new tab)

    Question 5: The work of Thomas Sydenham

    Question 6: People's attitudes towards medicine

    2024

    Question 5: Progress in medical knowledge, c1500–c1700

    Question 6: The role of individuals in prevention, c1700–present

Making judgements in history

  • The 16-mark question requires you to weigh all the evidence and make a decision

    • Students often find this part the hardest to do 

Common mistakes in judgement questions

  • Explaining that all of the reasons are the most important 

  • Avoiding a clear decision by using phrases like “kind of” or “maybe”

  • Giving no opinion

  • Changing your argument halfway through

    • In the example question, you state in the introduction that John Snow was a key turning point in the prevention of infectious disease

    • However, in the conclusion you state that it was not a key turning point

    • Doing this means that there is not a sustained judgement and you can not access Level 4 (13–16 marks) 

What makes a good judgement?

  • Clearly answer the question using second-order concepts

  • Acknowledge other sides of the argument

  • Have a consistent judgement from start to finish

  • Use your best evidence to back up your decision

    • There is no "right" or "wrong" answer in history

    • Consider other reasons

      • Even if you fully believe a reason is the most important, you still need to present evidence for other reasons

What makes a great conclusion in GCSE history?

  • Conclusions are usually where most of your judgement marks will be awarded

  • All great conclusions have these three elements:

    • Judgement – State your opinion using words from the question

    • Counter – Mention a reason from the other side

    • Support – Use your strongest evidence to explain why your side is more convincing

How to get SPaG marks

  • In Paper 1, students have access to an additional four marks for answering either Question 5 or 6

  • This is awarded for SPaG ( Spelling, Punctuation and Grammar)

SPaG mark

Reason for this mark

0

  • The student writes nothing

  • The student makes too many mistakes in spelling, grammar or content

1

  • The student has basic control over spelling and grammar

  • The student uses a limited range of specialist terms in their answer

2-3

  • The student spells and punctuates well

  • The student has good grammar

  • The student uses a good range of specialist terms

4

  • The student spells and punctuates well consistently

  • The student has excellent grammar

  • The student uses a wide range of specialist terms

Top tips for boosting SPaG marks

  • Spell historical terms correctly

  • Use paragraphs

  • Re-read your work for punctuation

  • Reading the answer in your head

    • Where you would take a breath, make sure there is a comma or full stop

How to answer a "How far do you agree?" question

  • In the exam, only answer either Question 5 or Question 6

    • You should put an "X" in the box next to the question you have chosen to answer

Form with instructions to mark a cross for chosen question 5 or 6. A crossed box shows selection, and a changed mind option with a line and new cross.
An example of how to show which option you will be answering in the Medicine in Britain exam
  • You will receive two stimulus points

    • These are areas of knowledge to discuss in your question

    • If you only discuss these two stimulus points, you are limited to a maximum of 11 marks

    • You can choose not to use any of the suggestions

      • You can still achieve full marks by not using the two stimulus points

    • You must discuss three areas of knowledge in your answer to access Level 4

  • To answer this question successfully, you should:

    • Read the answer carefully and multiple times

    • Annotate the question to find the key demands of the question

    • Plan your answer, including:

      • What your judgement is

      • The key knowledge you wish to use

A GCSE History revision planning poster for a 16-mark thematic question:

‘John Snow’s work on cholera was a turning point in the prevention of infectious diseases c1700–c1900.’
How far do you agree? Explain your answer

Planning using a spider diagram:

Peel 1 – Snow was not a turning point (green):

Before Snow’s work, most believed in miasma. During the Broad Street outbreak, removing the pump handle reduced cholera cases.

However, after publishing his findings in 1855, the government did not act.

Peel 2 – Vaccinations (purple):

Jenner created the smallpox vaccine in 1798, vaccinating 100,000 people by 1800.

Pasteur later developed vaccines for anthrax and rabies, inspired by Jenner.

Peel 3 – Public Health Act (orange):

The 1875 Act forced local authorities to provide clean water, dispose of waste, and appoint a public health officer.

Long-term prevention relied on government intervention, not individual discoveries like Snow’s.

Conclusion (blue):

Snow’s work disproved miasma and helped understand cholera, but had little immediate or widespread impact.

Vaccination and public health measures had a broader, long-lasting effect on preventing infectious diseases.
An illustration showing how to plan a 16-mark Medicine in Britain answer using a spider diagram
A GCSE History revision image titled “Planning a question using a table.”

It shows a table planning an answer to the 16-mark thematic question on:

‘John Snow’s work on cholera was a turning point in the prevention of infectious diseases c1700–c1900.’

There are 3 PEEL paragraphs in table rows:

Peel 1: Snow was not a turning point. Before his work, most believed in miasma. Although removing the Broad Street pump reduced cholera cases, the government took no action after his 1855 report—so there was no national change.

Peel 2: Vaccinations had a greater impact. Jenner’s smallpox vaccine (1798) saved many lives. Pasteur later developed vaccines for diseases like anthrax and rabies. Vaccinations were a more significant development in disease prevention.

Peel 3: The 1875 Public Health Act made the most lasting changes. It required local authorities to supply clean water, remove waste, and appoint public health officers. Government action—not individual discoveries—was key to long-term prevention.

The table shows a clear argument that other developments had more lasting impact than Snow’s work.
An illustration showing how to plan a 16-mark Medicine in Britain answer using a table

"How far do you agree?" question structure

  • Your answer should include:

    • A logical structure

    • A range of specific and relevant knowledge

    • An explanation of the second-order concept outlined in the question

    • A clear and sustained judgement throughout the answer

    • A conclusion

      • If you want to include an introduction you can, but it is not necessary 

  • Your answers could be written in PEEL paragraphs: 

    • P - Make a point about the question

      • This should include your judgement 

    • E - Use evidence that supports the point that you have made (K)

      • Evidence needs to be relevant and specific to the question

    • E - Explain why this evidence supports your point

      • Your explanation should be focused on the second-order concept outlined in the question (SOC)

    • L - Link your explanation back to the question to help sustain your argument and show your understanding of the question

  • The question is out of 20 marks:

    • 6 marks for a wide range of specific knowledge of the period and the topic stated in the question (K)

    • 10 marks for the analysis of the key second-order concepts of cause and consequence, similarities and differences and importance (SOC)

    • 4 marks are awarded for Spelling, Punctuation and Grammar (SPaG)

Worked example of a "How far do you agree?" question

Worked Example

  1. ‘John Snow’s work on cholera was a turning point in the prevention of infectious diseases c1700-c1900.’

How far do you agree? Explain your answer.

(16 + 4SPaG)

You may use the following in your answer.

  • Jenner’s vaccination

  • the Broad Street pump

You must also use information of your own.

Answer

I disagree that John Snow's work on cholera was a turning point in the prevention of infectious diseases c1700-c1900. I believe that vaccinations had a bigger impact on preventing infectious diseases (SOC).

Some historians may argue that John Snow's work on cholera was significant for progress in the prevention of disease. Before Snow’s work on the Broad Street cholera epidemic, there was no understanding of how diseases spread. Most people believed in miasma. When Snow removed the handle from the Broad Street pump in 1854, the cases of cholera decreased (K). This proved his theory that contaminated water, rather than miasma, spread disease. This had an impact on the prevention of infectious diseases as this disproved the widely held belief in miasma. In 1884, Koch proved that contaminated water contained cholera which allowed scientists to give better advice to the public on how to avoid catching epidemic diseases. Therefore, Snow had some impact on preventing infectious disease. However, after Snow presented his findings in 1855, the government did not act. The government and the public ignored Snow's findings, showing that it lacked importance. In addition, Snow's findings were only relevant to cause of cholera (SOC).

I believe the most important factor in preventing infectious diseases was the development of vaccinations. Jenner created a vaccine for smallpox and published his findings in 1798. It saved many lives worldwide. By 1800, 100,000 people had been vaccinated (K). However, Jenner's methods in vaccine development could not be replicated to other diseases. It was not until Pasteur's work in vaccines that significant progress in preventing infectious diseases occurred. Pasteur used his method to create vaccines for other diseases such as anthrax and rabies. This meant that, by the start of the 20th century, more dangerous and infectious diseases were vaccinated against (SOC). Therefore, the creation of vaccines was a more significant turning point than John Snow's work. This is because it had a bigger impact on a wider range of diseases than just cholera.

Another important event in the prevention of infectious diseases was the 1875 Public Health Act. This act made it compulsory for local authorities to provide clean water, dispose of waste properly to avoid polluting drinking water and hire a public officer of health to monitor where epidemics of disease occurred (K). This improved the prevention of infectious diseases because it shows the government taking responsibility for preventing diseases. This allowed tougher rules to improve public health to be passed, which improved the living standards of people across Britain. This reduced the number of epidemics and gave the public more knowledge about how to prevent them from catching diseases (SOC). Therefore, the Public Health Act made progress in the prevention of infectious diseases. However, vaccines were a better preventative method as it was a scientific way to prevent diseases rather than relying on the actions of the public and the local governments.

To conclude, I believe that Snow's work on cholera was not a turning point in the prevention of infectious diseases. Whilst Snow's work disproved miasma as a cause of cholera, it had less application for other infectious diseases in c1900. However, the development of vaccines by Jenner and Pasteur had a longer-term impact on infectious diseases (SOC).

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Zoe Wade

Author: Zoe Wade

Expertise: History Content Creator

Zoe has worked in education for 10 years as a teaching assistant and a teacher. This has given her an in-depth perspective on how to support all learners to achieve to the best of their ability. She has been the Lead of Key Stage 4 History, showing her expertise in the Edexcel GCSE syllabus and how best to revise. Ever since she was a child, Zoe has been passionate about history. She believes now, more than ever, the study of history is vital to explaining the ever-changing world around us. Zoe’s focus is to create accessible content that breaks down key historical concepts and themes to achieve GCSE success.

Bridgette Barrett

Reviewer: Bridgette Barrett

Expertise: Geography, History, Religious Studies & Environmental Studies Subject Lead

After graduating with a degree in Geography, Bridgette completed a PGCE over 30 years ago. She later gained an MA Learning, Technology and Education from the University of Nottingham focussing on online learning. At a time when the study of geography has never been more important, Bridgette is passionate about creating content which supports students in achieving their potential in geography and builds their confidence.