MANAGEMENT IN PREVENTIVE MEDICINE

PUBLIC HEALTH INSTITUTIONS LIST

I. CURATIVE- PROPHYLACTIC INSTITUTIONS:

a) Hospitals - district, central, city, regional

specialized: tuberculosis, infectious, psychiatric

b) Dispensaries – antituberculous, skin-venereal, oncologic, psycho-neurologic, sport-medical, antithyroid

c)Ambulatory-polyclinic institutions - ambulatory, polyclinic, stomatologic polyclinic, physio-therapeutic polyclinic, feldsher-obstetrician post, feldsher health station

d) Institutions of the First Medical Aid and Blood Transfusion - first medical aid stations with ambulances, blood transfusion station

e) Mother and Child Health Institutions - maternity homes, baby orphan home, mother and child home, milk-bank, children's hospital/polyclinic

f) Sanatorium-Resort Institutions - sanatorium, prophylactorium, balneological treatment centre, mud treatment centre, resort polyclinic

II. SANITARY-PROPHYLACTIC INSTITUTIONS

a) Sanitary-antiepidemiologic establishments - sanitary-epidemiologic station, isolation-control post

b) Sanitary-educational institutions - sanitary education home

III. INSTITUTIONS OF FORENSIC MEDICAL EXAMINATION

Bureau of forensic medical examination

IV. PHARMACEUTIC INSTITUTIONS

chemist's (shop), chemist's stall, drugstore, warehouse, control-analytic laboratory

 

(MEDICO-SANITARY) WORK

Ministry of Public Health and Social Development, Regional Health Department, City Health Department, District Health Department (on the city level), District Doctor-in-Charge, Sanitary Doctor-in-Charge.

 

Texts and Dialogues

Medical Service in Russia

 

The Ministry of Public Health and Social Development of Russia is responsible for the medical service as well as for the manufacture of drugs and medical equipment and goods. Health education preventing the spread of the diseases is also of great importance. For this purpose different mass media (the press, cinema, radio, TV, etc.) are of great use. Advertising new remedies and items of hygiene has become common practice. A great number of various kinds of commercial diagnostic and consulting centers have appeared. But, still, every citizen can receive medical aid free of charge at the local institutions of public health.

In cities and towns the basic unit is the polyclinic. Polyclinics are large units each often employing as many as 200 doctors. They have their own laboratories, X-ray, physiotherapy, minor surgery and dental consulting rooms. Some of them even have radiotherapy units.

Polyclinics are of three main types - those for the adult population of a given area, those situated in factories and plants (for employees only), and those for children. Thus, within one family it is possible to have father, mother and child served by three separate polyclinics.

When the patient comes to the local polyclinic he most often sees his own district doctor, who seeks specialist's advice only where necessary. In other cases the patient himself with a little help from the reception staff selects the specialist who appears to be the most needed and respected by him. He may be a surgeon, a physician, an ophthalmologist, a dermatologist, or any other specialist he needs.

If a patient is unable to come to the polyclinic himself he is visited by his district doctor at home. Only minor illnesses are treated at home; all other patients are hospitalized.

Every district has its own hospital. All the hospitals are well staffed with both medical and ancillary personnel. Besides that, we have a wide network of specialized institutions for the prevention and cure of some particular diseases, and also sanatoriums (ia), rest-homes and so on. The treatment usually begins in the department for resident patients, then it is continued in a sanatorium or hospital, and, finally, the person is treated as an out-patient. Dispensaries always continue their treatment and follow up of the patient till complete recovery has been attained.

 

An Interview on Medical Service in Russia

(C - correspondent, M - Minister of Public Health and Social Development of Russia)

С: Good morning! May I come in?

M: Of course! Come in, please. Sit down. What can I do for you?

C: Let me introduce myself. I am a correspondent of a new Russian journal «Medicine in Our Life». I know that being the Minister you have the most comprehensive information about medical service in our country. So I'd like to ask you some questions about medicine in Russia.

M: Well, I'll answer your questions with pleasure.

C: All right, let's start then. First of all I'd like to know something about the structure and organization of medical service in our country. Who manages the medical service?

M: The management of medical service is carried out by the Ministry of Public Health and Social Development, Regional Health Departments, City Health Departments, District Health Departments. There are also District Doctors-in-Charge and a Sanitary Doctor-in-Charge in every region.

C: And I wonder, what main groups can you differentiate among the public health institutions?

M: We differentiate such groups as curative-prophylactic institutions, sanitary-prophylactic institutions, institutions of forensic medical examination and pharmaceutic institutions.

С: Please, would you be so kind as to tell me about curative-prophylactic institutions in detail?

M: Of course. Curative-prophylactic institutions include hospitals, dispensaries, ambulatory-polyclinic institutions, institutions of the first medical aid and blood transfusion, mother-and-child health institutions and sanatorium-resort institutions.

C: I see. And what about the sanatorium-resort institutions? As far as I know most of the sanatoriums and prophylactoriums are closed now or they are too expensive.

M: How perfectly right you are! It's really so. But there is nothing to be done with it. We haven't got enough money to organize the work of the sanatoriums for people who really need it. But this problem is being solved at the present moment.

C: Now I wonder if our system of medical service differs from the ones in other countries, for example, in the USA or Great Britain.

M: It's a very interesting question. Of course, our system differs from the ones in other countries. First of all, our people are screened yearly to detect the slightest disorders at the early stage of disease and thus to prevent its development.

C: I am sorry for interrupting you, but my view of it is that on the one hand it's a mere formality, but on the other hand it's really useful sometimes. And now I'd like to put a question about the pay for medical aid. What can you say about it?

M: Well, it's the second difference between our systems. As you know a great number of various kinds of commercial diagnostic and consulting centres have appeared. But, still every citizen can receive medical aid free of charge at the local institutions of public health.

C: I understand. But what about compulsory medical insurance? I am not clear on this point either! Why do we have to use such a system?

M: It's really a difficult question. You know there are new medical methods, modern medical equipment, which we have to buy for our hospitals and polyclinics. But all modern equipment is very expensive. In addition we have to pay money to our doctors. And our country hasn't got the opportunity to have medical service free of charge. I know it's difficult to substitute the existing free medical service for paid service. But I think we can try!

C: I am sorry, but I doubt that it will be a success.

M: Well, no one can say for certain. But we are doing our best. And I hope it might be effective.

C: As far as I see our medicine faces a lot of problems. And I think the next one is the problem of the quality of our specialists training. What can you say about it?

M: Well, what can I say... One of our tasks is the training of well-qualified family doctors who are experts in up-to-date methods of examination and techniques of treatment. And now we have many highly-qualified specialists able to manage patients, rendering them necessary medical aid.

C: I hope so too. Now I'd like to know your opinion about advertising new remedies and items of hygiene which has become common practice.

M: Well, it seems to me it’s rather useful, because our citizens can find out something new about new drugs. And now they can buy these drugs in each chemist's. In addition to this, a year ago we could see commercials devoted to vaccination on TV. I think, it helped our doctors in vaccinating children and adults for poliomyelitis, hepatitis and other dangerous diseases.

С: It's really so. I agree with you. You know, thanks to our talk it was very interesting for me to get answers to some of my questions. And finally, would you tell me about your plans for the future?

M:Well, I think, at first we have to solve the numerous problems we have just discussed and the problems connected with the implementation of the new national projects in Russia.

С: Just so. And as a conclusion, I'd like you to wish something to our readers.

M: Oh, it'll be my pleasure. I want to advise them to go in for sports, keep good health and follow the proverb: "An apple a day keeps the doctor away"!

C: Oh, thank you ever so much. You’ll be able to read this interview in our journal this month. Good luck to you. Good-bye.

M: Thanks. Good-bye.

 

The National Health Service in Great Britain

 

The National Health Service was established throughout the United Kingdom on the 5th of July 1948. Similar services operate in England and Wales, in Scotland and in Northern Ireland, but with administrative difference.

The introduction of the new types of health services did not mean a complete break with the past. On the contrary all that was good in the existing services was absorbed into a new scheme. The National Health Service made it possible that the benefits once available only to insured persons or those who could afford to pay for them, or as a form of charity, became available to everyone.

The Service consists of three main parts: the general practitioner (including dental) services, the hospital and specialist services, and the local health authority services (comprising a range of home and clinical services for prevention, treatment or care).

The public is free to use the service, or any independent part of it, as it pleases.

The patient is free to choose his doctor, and to apply to another if he wishes to do so. The doctor may accept private patients while taking part in the Service. About 97 per cent of the whole population of Great Britain is using the Service. The great majority of specialists and general practitioners are taking part in the Service.