عنوان

The provision and uptake of health care in Poland, 1971-1980 :

Number

TLets633132

Title Proper

The provision and uptake of health care in Poland, 1971-1980 :

General Material Designation

[Thesis]

First Statement of Responsibility

Hodgson, Christine Russell

Title Proper by Another Author

an examination of socialist principles in practice

Name of Publisher, Distributor, etc.

University of Birmingham

Date of Publication, Distribution, etc.

1985

Dissertation or thesis details and type of degree

Ph.D.

Body granting the degree

University of Birmingham

Text preceding or following the note

1985

Text of Note

The aim of the thesis is to evaluate the performance of the Polishhealth service in the 1970s in terms of the socialist principles uponwhich it is officially based. The thesis is presented as follows:Chapter One describes the development of the health service from 1944to 1970 in the context of post-war political, social and economicchange. This historical outline follows the same pattern as the thesisas a whole, beginning with a brief summary of the pre-war historicalbackground and moving towards the explicitly stated principles of thenew government established in 194-4. This is followed by an account ofthe severe constraints of health needs and resources, a description ofthe overall organisational framework of the health service, and adiscussion of the provision and scope of the health care system.Chapter Two takes a more detailed look at the evolution of Socialistprinciples of health care in Poland and includes a discussion of theelements of Soviet ideology and policy which influenced theestablishment of communist rule in Poland. The basic set of health careprinciples adopted from the Soviet Union are set out and there-emergence of health policy in the 1970s is discussed. The chapterconcludes with some comments on policy developments in 1980 and thelight this sheds, in terms of health policy and the principles fromwhich it is derived,on the 1970s.Chapter Three considers the practical, physical constraints whichinfluenced and modified the principles and policies of the 1970s.Health needs are dealt with in terms of the overall health status ofthe population, including basic demographic data as well as certainspecific population and disease groups. Health resources are discussedin terms of personnel, material and financial resources, focusing ondevelopments during the decade, and the impact of constraints onattempts to implement new programmes.Chapter Four shows how modified principles were put into practice, interms of the administrative and organisational framework of the healthservice during the 1970s. The chapter focuses on the changes inlegislation and reforms within the health service, particularly thereorganisation which partly coincided with the major local governmentreform of 1973 and 1975.Chapter Five sets out some of the main features of the health serviceas it exists 1 . The emphasis is on major areas of health care - primarycare and hospital care, as well as on a specific population group(mother and child care). Patterns of provision and uptake of servicesare discussed, as are the impact of the reforms which resulted from newpolicy initiatives introduced at the beginning of the decade.Chapter Six takes the form of three case studies, examining particularaspects of the health service from a wider perspective. The first looksat the problems of health care in rural areas, particularly in thelight of the 1972 reform which brought private peasant farmers withinthe socialised health service. The second considers the industrialhealth service, which was the focus of considerable controversy in the1970s. Issues of cost-effectiveness, friction between industrial healthdoctors and enterprise managers, sickness absenteeism, and ideologicalcommittment to the health care of industrial workers are central to thediscussion. Finally, the third case study examines the role of theprivate and cooperative health services. These are a very small adjunctto the main state health service, but they are significant because theyprovide additional insight into the functioning of the health serviceas a whole. Attempts during the 1970s to curtail official privatepractice and shift the emphasis towards the cooperative sector reflectofficial concern over the issue.Chapter Seven contains an evaluation of the health service in the1970s, according to the criteria set at the beginning - ie to evaluatethe health service performance in terms of whether or not it lives upto the principles on which it is based. The chapter concludes with adiscussion ofthe success and failure of the reforms in the 1970s, andthe reasons why reform proved difficult to implement, and setting theissues of social policy during the 1970s in a wider context.

Hodgson, Christine Russell

University of Birmingham

Electronic name

p

[Thesis]

276903

a

Y