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Title: The provision and uptake of health care in Poland, 1971-1980 : an examination of socialist principles in practice
Author: Hodgson, Christine Russell
Awarding Body: University of Birmingham
Current Institution: University of Birmingham
Date of Award: 1985
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The aim of the thesis is to evaluate the performance of the Polish health service in the 1970s in terms of the socialist principles upon which it is officially based. The thesis is presented as follows: Chapter One describes the development of the health service from 1944 to 1970 in the context of post-war political, social and economic change. This historical outline follows the same pattern as the thesis as a whole, beginning with a brief summary of the pre-war historical background and moving towards the explicitly stated principles of the new government established in 194-4. This is followed by an account of the severe constraints of health needs and resources, a description of the overall organisational framework of the health service, and a discussion of the provision and scope of the health care system. Chapter Two takes a more detailed look at the evolution of Socialist principles of health care in Poland and includes a discussion of the elements of Soviet ideology and policy which influenced the establishment of communist rule in Poland. The basic set of health care principles adopted from the Soviet Union are set out and the re-emergence of health policy in the 1970s is discussed. The chapter concludes with some comments on policy developments in 1980 and the light this sheds, in terms of health policy and the principles from which it is derived,on the 1970s. Chapter Three considers the practical, physical constraints which influenced and modified the principles and policies of the 1970s. Health needs are dealt with in terms of the overall health status of the population, including basic demographic data as well as certain specific population and disease groups. Health resources are discussed in terms of personnel, material and financial resources, focusing on developments during the decade, and the impact of constraints on attempts to implement new programmes. Chapter Four shows how modified principles were put into practice, in terms of the administrative and organisational framework of the health service during the 1970s. The chapter focuses on the changes in legislation and reforms within the health service, particularly the reorganisation which partly coincided with the major local government reform of 1973 and 1975. Chapter Five sets out some of the main features of the health service as it exists 1 . The emphasis is on major areas of health care - primary care and hospital care, as well as on a specific population group (mother and child care). Patterns of provision and uptake of services are discussed, as are the impact of the reforms which resulted from new policy initiatives introduced at the beginning of the decade. Chapter Six takes the form of three case studies, examining particular aspects of the health service from a wider perspective. The first looks at the problems of health care in rural areas, particularly in the light of the 1972 reform which brought private peasant farmers within the socialised health service. The second considers the industrial health service, which was the focus of considerable controversy in the 1970s. Issues of cost-effectiveness, friction between industrial health doctors and enterprise managers, sickness absenteeism, and ideological committment to the health care of industrial workers are central to the discussion. Finally, the third case study examines the role of the private and cooperative health services. These are a very small adjunct to the main state health service, but they are significant because they provide additional insight into the functioning of the health service as a whole. Attempts during the 1970s to curtail official private practice and shift the emphasis towards the cooperative sector reflect official concern over the issue. Chapter Seven contains an evaluation of the health service in the 1970s, according to the criteria set at the beginning - ie to evaluate the health service performance in terms of whether or not it lives up to the principles on which it is based. The chapter concludes with a discussion ofthe success and failure of the reforms in the 1970s, and the reasons why reform proved difficult to implement, and setting the issues of social policy during the 1970s in a wider context.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available