From Big Medical Encyclopedia

GREAT BRITAIN, the United Kingdom of Great Britain and Northern Ireland — the state located on the British islands in a cut enters England, Wales, Northern Ireland (Ulster) and Scotland. The area is 244,1 thousand km 2 , the population of 56,1 million people (1975), population density apprx. 230 people on 1 km 2 . The capital — London (with suburbs of 7,3 million people; 1972). Ofits. language — English.

Great Britain. On the right above — a geographical location in Western Europe (it is specified by an arrow).

The climate — sea, differs in the increased humidity.

The political system — constitutional monarchy. The head of state — the king (queen). The legislature is carried out by the king and parliament, executive — the government headed by the prime minister.

Century — one of the most economically developed countries. V.'s industry yields 2/3 national revenues, the leading role belongs to the heavy industry; a traditional industry — textile. The fundamentals of agriculture are made by livestock production.

The national structure of the population is rather homogeneous: 4/5 inhabitants — British, the others — descendants of the Celtic nationalities — Scots, Irish, uelsets (or Welshmen), etc. The urban population makes apprx. 80%. Social composition of the population: apprx. 90% of the amateur population make faces of wage labor — workers and employees, 5% — farmers, 2 — 3% — an upper bourgeoisie and the land aristocracy (landlords); in hands of the last two groups the main richness of the country (more than 1/2 national income) are concentrated.

The population of all country and certain areas given about the natural movement are brought in tab. 1 and 2.

Table 1. The NATURAL MOVEMENT of the POPULATION of GREAT BRITAIN in 1913 — 1974 (on 1000 people)

Table 2. The NATURAL MOVEMENT of the POPULATION of the DIFFERENT REGIONS of GREAT BRITAIN in 1967 — 1974 (on 1000 people)

The most typical demographic phenomenon in V. became the postareny population.

In structure of the reasons of death in 1971 first place was won by diseases of the blood circulatory system and vascular diseases of c. N, page (52,1%), the second — malignant new growths (20,5%), the third — pneumonia (7,9%), the fourth — bronchitis, emphysema and bronchial asthma (5,5%), the fifth — accidents (3,1%), the sixth — flu (1,3%). Infectious diseases and tuberculosis mortality (no more than 1%) was sharply reduced. So, in 1950 in England and Wales of tuberculosis 15 969 people, in 1972 — 1198 people, died of acute poliomyelitis — respectively 734 and 0, of whooping cough — 399 and 2, of measles - — the 221 and 29 persons. Big specific weight in structure of mortality is occupied by nonspecific diseases of a respiratory organs (bronchitis, pneumonia).

In structure of incidence the leading places are taken by diseases of a respiratory organs, a nervous system and sense bodys; digestive organs; accidents and injuries, diseases of skin and hypodermic cellulose. From infectious diseases in 1974 in England and Wales more than 103 thousand cases of measles, more than 7,5 thousand — infectious hepatitis, apprx. 16 thousand — whooping cough, St. 10 thousand — scarlet fevers, 8,5 thousand — dysentery, apprx. 12 thousand — all forms of tuberculosis, 2108 — meningococcal diseases, 218 cases of typhus and paratyphus were registered. More, than in other countries, flu, pneumonia, bronchitis are widespread in V. The problem of venereal diseases is not solved: in 1970 in England and Wales 3267 cases of syphilis and 54 764 — gonorrhea were registered.

The organization of health care

the slogan about insurance of health at the expense of the state and businessmen, providing preferential and free medical aid was One of slogans, moving-forward V. workers in fight for the social rights. These requirements found reflection even in the chartistsky movement developed in the mid-thirties 19 century. Under its influence and thanks to efforts of progressive doctors and medical officers — Chedvika (E. Chadwick), J. Simon, Smith (E. Smith), J. Hunter and others which activity was estimated by K. Marx and F. Engels positively in V. was accepted a number of acts for health care. According to the law on public health care of 1848 the Head department of public health care exercising supervision of work of local authorities in the area a dignity was founded. affairs. The law of 1855 entered obligatory appointment san.vrachy in all districts of London; according to the law on public health care of 1872 the new structure of management of bodies of health care was created. During the different periods laws on health care, and also so-called factory laws, laws on medical aid poor (1842), were adopted about hospitalization poor (1867), acts for the organization a dignity. districts (1875), hospitalization of infectious patients, expansion of the rights of local authorities concerning implementation a dignity. rules (1925, 1936), laws on social insurance (1911), the nation-wide Ministry of Health in 1919 is created (in the subsequent Department of health care and social security). These and other measures which the government was forced to accept under the influence of fight of workers, requirements of progressive forces and because of a possibility of epidemics of infectious diseases preceded the law on public service of health care adopted in 1946 and which became effective in 1948. According to this law in V. nationalization of medical institutions with very high compensation of their cost to the former owners is carried out; medical aid appeared free. However there is no full free service in V. since the population partially pays for medical aid; for recipes — to 2 shillings for each recipe, the dental surgery help — to 10 pounds sterling for a course of treatment. Also selection and an extract of points and some types of prostheses is paid. Paid chambers and beds in hospitals with comfortable conditions where it is possible to get out of turn remain. Besides, there are high indirect payments of the population through the taxes raised on needs of social security, a part of means from the budget to-rogo goes to public service of health care. Despite the limited nature of the reform which is carried out within the bourgeois state, creation of public service of health care according to the Communist Party of V. — the progressive phenomenon, result of long-term fight of working class.

175 public health departments of municipalities functioning in V. perform preferential scheduled maintenance: performing vaccination, dignity. - a gleam, works, fluoration of water, providing with sisterly and obstetric service at home, the help to family (family) doctors; besides, they bear responsibility for rendering ambulance, will organize consultations on care of children, patients, housekeeping and so forth. In states of public health departments of municipalities, in addition to doctors and paramedical staff, there are also so-called social workers.

St. Foma's Hospital in London.

In public service of health care, despite its character, progressive in comparison with health services of some other the capitalist countries, there is no uniform system of the organization of medical aid that conducts to a rupture of the extra hospital and stationary help, prevention and to lay down. affairs, to division of bodies of health care according to various departments. Besides, the insufficient number out-patient and polyclinic and a dignity is noted. - protivoepid, institutions, the centers of health, etc. In this regard under the influence of progressive forces and requirements of labor unions, labor movement, an example of the organization of health care in the socialist countries the government officially recognized need to make the changes in public service of health care directed to improvement of management of health care and rendering medical aid. In 1974 the reorganization of public service of health care providing elimination of some organizational shortcomings was made.

Extra hospital help to the population is given generally by general practitioners (family doctors) whose number exceeds 24 thousand. In 1970 apprx. 80% of all general practitioners of England and Wales were united in groups on 2 — 3 and more people (so-called group practice). The population has an option of the doctor and is attributed to the doctor usually at the place of residence. It is the share of the general practitioner apprx. 2500 the population. Payment to doctors is made for each attributed. For receiving the dental surgery help it is possible to see any dentist which in 1971 was apprx. 15 thousand. Dentists receive a payment for each patient. By the same principle ophthalmologists (which number apprx. 900 people) and ophthalmologists-opticians (more than 6 thousand people) work

The law of 1948 for rendering extra hospital medical aid and scheduled maintenance provided to organize 600 centers of health. By their 1972 168 were created.

In 1970 in the country there were more than 13 thousand drugstores and apprx. 16 900 druggists, from them apprx. 16 thousand in England and Wales, apprx. 250 — in Scotland and 660 — in Sowing. Ireland.

The organization and control of activity of general practitioners, tooth, ophthalmologists, behind work pharm, services is carried out by 138 executive councils consisting of 30 members working on a voluntary basis. Councils include doctors, druggists and representatives of local authorities.

Service of women and children

In obstetric departments of hospitals and maternity homes of public service of health care of England and Wales in which in 1971 there were 24 thousand beds is delivered more than 85%. Obstetric aid in other cases appears general practitioners and midwifes of local bodies of health care at home — the centers of motherhood and an infancy (anti-and post-natal clinics). Employees of the centers of motherhood and infancy (midwifes, patronage sisters, social workers, etc.) visit pregnant women and mothers at home, will organize classes in a psychoprophylaxis of pains at childbirth, perform vaccination of children and give help in their education. At the centers there are departments (sectors) on planning of a family. The centers are visited by about 1/4 pregnant women and insignificant number of women after the delivery. Mothers with children aged from 1 year up to 5 years visit these institutions in 30 — 40%.

Maternity allowance is paid to the working women for 6 weeks to and 7 weeks after the delivery. Medical aid to children appears family doctors and if necessary specialists of hospitals. The most part of beds for sick children is in the general hospitals.

Hospital help to the population is given in the general and specialized hospitals (psychiatric, obstetric, geriatric, orthopedic, children's, infectious, for hron, patients, etc.). Total quantity of hospital beds in England, Wales and Scotland in 1971 made 514 353 (9,5 beds on one thousand people). Distribution of bed fund in hospitals of England, Wales and Scotland is presented in tab. 3.


Almost in all hospitals there are out-patient departments in which specialists doctors advise. In 1970 in England and Wales from 22 thousand total number of the doctors working in hospitals there were more than 9 thousand consultants.

Activity of hospitals 15 hospital managements or councils of Public service of health care (according to number of hospital areas and medical f-tov universities) and 360 hospital committees on a voluntary basis consisting of representatives of hospital administration, local authorities and the population direct. Management of clinics is performed of administrative councils (26 councils in London and 9 — in other areas).

The sanitary and anti-epidemic service is decentralized: work on a dignity. to education, partially on a dignity. to control, epidemiol, to observation in the centers, to fluoration of water, vaccination it is carried out by local bodies of health care (public health departments, medical officers, the centers of health care). In general control of improvement of the environment, epid. a state, in particular for a dignity. a condition of borders, ports, airfields, observance of rules of rather quarantine diseases it is carried out by department of health care — department of hl. medical administrator. The network bacterial also participates in control of infectious diseases, including diagnostic testings, preventive measures and scientific research. and vir usal, laboratories subordinated to management of services of laboratories of public health care.

The department (ministry) of health care and social security bears responsibility for observance international a dignity. norms, for work port a dignity. services, for quality of food stuffs, quality and harmlessness of drugs, etc.

Control of living conditions, a condition of water supply, the sewerage, the air environment carries out the ministry of local government. Control of health of school students (excepting the hospital help) is exercised by the Ministry of Education, a dignity. control of working conditions and prevention of occupational diseases — the Ministry of Labour, control of poisons and strong drugs — the Ministry of Agriculture, fisheries and the food industry. Armed forces and some other departments have the medical managements which provide medical aid and a dignity. - epid, control. For many years in V. the dignity is noted not only separation. - epid, services, but also sharp staff deficit a dignity. workers.

Resort business. In the territory of V. the resorts of Brighton (see), Bournemouth (see), Eastbourne, Bath, Buxton, etc. are located. Resort matter in V. did not gain development as the industry of the state health care. Operation of mineral sources (Bath, Cheltenkhem, etc.) is in hands of the commercial organizations though medical service according to the law is carried out by public service of health care.

Medical education

Training of doctors is carried out at medical schools. Medical schools represent medical f-you universities and independent institutions which are under authority of the Ministry of Education. After 5 — 6 years' training at school and a one-year internship doctors acquire the right of practice; on specialization 4 — 7 years in addition leave.

Training of doctors in England and Wales is carried out at 28 schools, in Scotland — at 4 schools and to Sowing. Ireland — at 1 school. Training paid. Annual release of doctors — apprx. 3 thousand persons. However owing to emigration (annually 400 — 500 people) security with doctors of the population almost does not increase.

In 1970 from total number of doctors (83,7 thousand) more than 65 thousand worked (apprx. 12 for 10 thousand people of the population).

Dentists are trained at dental surgery schools (17 schools in England and Wales, 4 — in Scotland, 1 — in Sowing. Ireland).

The paramedical staff is trained by schools and schools at hospitals, high fur boots and other institutions. In 1970 there were more than 180 thousand diplomaed nurses, apart from assistants to sisters, ml. nurses and other categories of paramedical staff.

A scientific medical research in V. is conducted more than in 100 research in-ta, on a medical f-takh, at schools, colleges, including in such known as the London school of hygiene and tropical medicine, in-t of pathology, in-t of cancer researches, in-t of preventive medicine. The principal governmental body coordinating research is Council of medical researches. The largest research institutions — National in-t of medical researches, organized in 1920 and dealing with problems of theoretical medicine are under its authority, and the Clinical research center opened in 1970 Council of medical researches subsidizes activity of various research laboratories of high fur boots and more than 70 research centers. Functions of academy of Sciences in V. (including the medical direction) are performed by Royal society.

Scientific activity of outstanding doctors of the past became world-famous: U. Garvey who opened blood circulation, the anatomist T. Villiziya, the clinical physician T. Sydenham, the physiologist and the surgeon Ch. Bella, the physiologist D. Broun, the doctor and the anatomist D. Gunter, the creator of surgical antiseptics surgeon D. Lister, E. Jenner who opened a way of specific prevention of natural smallpox, and many others.

The solution of a number of urgent problems of medicine of 20 century is promoted by researches of doctors and V. scientists — Nobel Prize laureates of A. Fleming who discovered penicillin, T. The shout, together with Watson which opened molecular structure nucleinic to - t and shown their value for hereditary transfer of signs and properties of an organism; Katts and Axelrod's researches (V. of Katz, J. Axelrod) in the field of physiology of nervous cells, E. W. Sutherland in the field of physiology of hormones and other scientists.

In V. it is published apprx. 200 magazines on problems of medicine and biology, including «British Medical Journal», «Lancet», «Practitioner», «British Journal of Clinical Practice».

Budget of health care. Expenses of the state budget on health care in 1971 — 1972 made 5% of the national income. 60% of all expenses go for the hospital help.

80% of budget funds are more white becomes covered at the expense of taxes, the others — at the expense of national fund of insurance, from the payments arriving from patients, payment of the population for recipes, points, paid beds and other types of medical aid.

Plays an active role in the international cooperation on health care and in WHO's activities century.

On February 17, 1975 in Moscow the Intergovernmental agreement on cooperation in the field of health care and medical science between V. and the USSR was signed.

Bibliography: Vengrova I. V. From history of social hygiene in England the 19th centuries, M., 1970, bibliogr.; Questions of planning of economy of health care in some foreign countries, under the editorship of D. N. Kalyuzhny, etc., page 65, Kiev, 1967; Dobrovolsky Yu. A. Health of world's population in the 20th century, M., 1968; Lys and c y Yu. P N. Social hygiene and organization of health care, page 412, M., 1973; Pustova I. V. State health system of England and its economic problems, Health care (Bucharest). No. 4, page 395, 1972; World Health Statistics Report, v. 28, No. 11, 1975, at. 29, No. 1, 1976.

BB. H. Lisitsyn.