UNION OF SOVIET SOCIALIST REPUBLICS (USSR, Soviet Union) — the socialist public multinational state first in the history expressing will and interests of workers, peasants and the intellectuals, the working all nations and nationalities of the country.
The USSR is created on the basis of the principle of socialist federalism as a result of free self-determination of the nations and voluntary association of equal Soviet Socialist Republics. The birth of USSR — result of a victory of the Great October socialist revolution made under the direction of the Communist Party led by V. I. Lenin and which opened a new era in the history of mankind — an era of transition from capitalism by socialism, an era of general revolutionary updating of the world. On December 30, 1922 the I All-Union congress of Councils approved documents in which the Lenin principles of national policy were realized — the Declaration and the Contract on formation of the Union of Soviet Socialist Republics. It was the act of unanimous declaration of will of workers of RSFSR, USSR, BSSR and the Transcaucasian Soviet Federal Socialist Republic (as a part of Azerbaijan, Armenia, Georgia).
Association of the people to USSR was efficient weapon of fixing and enhancement of gains of Great October, implementation of the Lenin plan of creation of socialism in the USSR, strengthenings of the international positions and the authority of the first-ever socialist state. 15 allied and 20 autonomous republics, 8 autonomous regions, 10 autonomous areas, 129 edges and areas, 3213 areas, 41 963 Village Councils are a part of the USSR for January 1, 1984.
- 1 GENERAL DATA
- 2 The POPULATION of the USSR, ITS NUMBER, STRUCTURE, the NATURAL MOVEMENT
- 3 PHILOSOPHY of PUBLIC HEALTH CARE of the USSR.
- 4 DEVELOPMENT of the SOVIET HEALTH CARE
- 5 DEVELOPMENT of the SOVIET HEALTH CARE FOR YEARS of the TENTH FIVE-YEARS PERIOD
- 6 The MAIN DIRECTIONS of DEVELOPMENT of HEALTH CARE In the 80th. In the light of DECISIONS of the XXVI CONGRESS of the CPSU
- 7 Tables
The USSR — the world's largest state, across the territory occupies nearly 1/6 part of the manned land — 22,4 million km 2 ; it is located in Europe (the European part of the Soviet Union) and in Asia (an Asian part of the Soviet Union). The USSR borders on 12 states by land: in the West — with Norway, Finland, Poland, Czechoslovakia, Hungary, Romania, in the South and the East — with Turkey, Iran, Afghanistan, People's Republic of China, the Mongolian People's Republic and Democratic People's Republic of Korea. Total length of frontier makes more than 60 thousand km. The territory of the USSR stretches from the West for the East more than for 9 thousand km, the expert of the South on the North — more than for 4,5 thousand km. It is washed by 12 seas belonging to basins of three oceans — Arctic, Atlantic and Silent. In the territory of the USSR there are 11 time zones.
The most part of the European territory of the Soviet Union is occupied by the East European (Russian) plain. The northern part of the Asian territory where the West Siberian Plain, Central Siberian Plateau, Verkhoyansk Mountains, Chersky Range and mountains of the Far East are located, raises in the direction from the West on the East, in the western part of Central Asia there is a Turansky plain. In the southwest and the South of the country, both in European, and in its Asian part, preferential large mountain systems, such as the Carpathians, the Caucasus, Pamir, Tien Shan are located.
The geographical location of the country defines the main lines of climate, to-ry differs in an extreme variety: from cold Arctic in the north to subtropical and desert in the South and from sea in the northwest to sharply continental in Siberia and the Pacific Ocean, monsoonal on the coast.
The considerable sizes of the territory of the USSR, feature of its relief and climate cause existence in borders of the country of various natural zones. The most part it is occupied by forest, forest-steppe, steppe zones, semi-deserts and deserts; in the north there are tundra and forest-tundra zones which are a part of the Arctic and subarctic belts; some southern areas are in a subtropical belt.
The political system in the USSR is based on socialist relations of production. The social basis of the USSR is made by the indestructible union of workers, peasants and the intellectuals. The basis of the economic USSR system is made by socialist property on means of production in the form of the state (public) and collective-farm and cooperative ownership. An official state language — Russian.
The Soviet state is the highest form of socialist democracy. «In the country there is an objective process of rapprochement of all classes and social groups — it is said in the resolution of the Central Committee of the CPSU „About the 80 anniversary of the Second congress of RSDRP14. — The party and the state promote strengthening of social uniformity, conduct a consecutive course towards further deleting of essential distinctions between the city and the village, workers of intellectual and physical work» («Truth» of April 5, 1983). Result of creative activity of the CPSU, working class, collective-farm peasantry, labor intellectuals, all people which combined in the USSR was creation of the developed socialism — a natural stage on the way to creation of communistic society. In the USSR there was a new historical community of people — the Soviet people.
All power in the USSR belongs to the people (Art. 2 of the Constitution of the USSR). Sovereignty of the people means its boundless domination in all spheres of life socialist about-va, management about-vom exclusively at a will of the people and in its interests.
About a rganizatsionno-floor of wasps - new sovereignty of the Soviet people deeply democratic political system socialist about-va, making the mechanism of democracy serves itichesky. It provides a crucial role of a people at large in implementation of the program of communistic construction. The political system of the USSR includes the Communist Party of the Soviet Union, the socialist state, labor unions and other public organizations of workers, labor collectives. At the same time, according to Art. 6 of the Constitution of the USSR, the Communist Party is the leading and directing force of the Soviet society, a kernel of its political system, the state and public organizations.
The prime target of the CPSU and Soviet state is creation classless communistic about-va, in Krom public communistic self-government will gain development. Main tasks of the CPSU and socialist public state: creation of material and technical resources of communism, improvement of the socialist public relations and their transformation in communistic, education of the person communistic about-va, increase in the material and cultural standard of living of workers, safety of the country, assistance to strengthening of the world and to development of the international cooperation.
Deep democratism and a creative role of the socialist public state are expressed in its internal and external functions. Hozyaystvennoorganizatorsky and cultural and educational activity, control of a measure of work and consumption according to the principles of socialism — from everyone on abilities, everyone — on work, social service of members about-va, protection of socialist law and order, interests about-va, socialist property, the rights and freedoms of citizens belong to the main internal functions. The state cares about health and education of citizens, improvement of conditions of their life and work, steadily carries out a course towards salary increase and the real income of the population. For fuller satisfaction of needs of the Soviet people public funds of consumption are created. The USSR works and constantly the state health systems (see), national education, social security (see), trade, public catering (see), consumer services and municipal services develop.
The main external functions of the Soviet state are fight for peace, for consolidation of safety of the people, for peaceful co-existence of the states with various social system, mutual assistance and brotherly cooperation with the countries of the socialist commonwealth, support of fight of the people for national release and social progress, protection of the socialist Fatherland. The USSR steadily pursues Lenin peace policy, supports consolidation of the international security and broad international cooperation. In implementation of this policy active part is taken by the Soviet medical public.
Important constitutional guarantee of democracy in the USSR, its social basis are the indestructible union of working class, peasantry and national intellectuals, brotherly friendship of all nations and nationalities inhabiting our country. «The state — says Art. 19 of the Constitution of the USSR — promotes strengthening of social uniformity of society — to deleting of class distinctions, essential distinctions between the city and the village, intellectual and physical work, to all-round development and rapprochement of all nations and nationalities of the USSR». This situation serves one of the most important guarantees of providing equal opportunities to all citizens for preservation and promotion of health, achievement of social uniformity of health of the population of the USSR.
The political basis of the USSR is made by Councils of People's Deputies — the main form of implementation by the people of the government. «All other public authorities are under control and accountable to Councils of People's Deputies» (Art. 2 of the Constitution of the USSR). The organization and activity of the Soviet state are under construction according to the principle of democratic centralism: selectivity of all public authorities from top to bottom, the accountability to their people, obligation of decisions of higher bodies for subordinate. Democratic centralism combines the uniform management with an initiative and creative activity on places, with responsibility of each public authority and the official for the charged business.
The supreme legislative body of the government of the USSR is the Supreme Council of the USSR elected on the basis of general equal and ballot and consisting of two equal chambers: Council of the Union and Soviet of Nationalities. The sessions of the Supreme Council of the USSR are convened two times a year. During the period between sessions the legislature in the USSR is carried out by the Presidium of the Supreme Council of the USSR elected at a joint meeting of both chambers. The supreme body of public administration, i.e. executive and administrative organ of the government in the USSR, is the government — Council of ministers of the USSR. The supreme bodies of the government and management are formed also in all federal and autonomous republics where the Supreme Councils of federal or autonomous republics are created, to-rye elect Presidiums of the Supreme Councils of federal or autonomous republics and form Councils of ministers — the governments of federal or autonomous republics. Local public authorities in edges, areas, autonomous regions, autonomous areas, the cities, areas, areas in the cities, settlements, rural settlements are Councils of People's Deputies which elect from among deputies the executive and administrative organs — executive committees. Management of the separate industries of public administration is performed of the ministries and the state committees.
Activity of numerous public organizations and associations of workers of the country belongs to public forms of democracy. «Labor unions. The All-Union Leninist Young Communist League, cooperative and other public organizations — it is said in Art. 7 of the Constitution of the USSR —... participate in management of the public and public affairs, in the solution of political, economic and welfare affairs».
The big place in political system Soviet about-va is allocated to the labor collectives playing an important role in increase in labor and public activity of citizens, in formation at workers of moral qualities of the moral code of the builder of communism. Labor collectives participate in discussion and the solution of the public and public affairs, in planning of production and social development, in preparation and placement of personnel, in the solution of questions of management of the enterprises and institutions of t of improvement of working conditions and life, use of the means intended for development of production, welfare actions and material encouragement.
Economy. The basis of the economic USSR system is made socialist property on means of production, planned character of development of economy, and also the high level of development of productive forces caused by them and a maturity of socialist relations of production. Domination in national economy of socialist property provided basic change of the purpose of production, edges is defined by the fundamental economic law of socialism — ensuring welfare and all-round development of all citizens by means of the fullest satisfaction of their constantly growing material and cultural requirements. Implementation of this purpose on the basis of all-round development of the personality, implementation in production of modern technology and achievements of scientific and technical progress, and also every possible increase in labor productivity — the main principle of economic activity of the CPSU and socialist to a gos of a darstvo.
For years of the Soviet power in the USSR outstanding successes in economy are achieved. Considerably the volume of industrial output increased. The share of the USSR in world industrial production rose from one percent in 1922 to twenty in 1983 the Soviet Union turned into the mighty industrial power with the high-mechanized agriculture, advanced science and culture. Powerful growth of the industry and on its fundamentals of all national economy provided transition of USSR to a new stage — to a stage of the developed socialism. In 1983 the USSR occupied one of the leading places in the world and the first in Europe on the output of the electric power, oil, gas, coal, cast iron, steel, iron ore, mineral fertilizers, products of mechanical engineering, etc.
Considerable changes for years of the Soviet power came in agriculture, a cut from the backward, based on manual skills production, turned into the large, technically equipped industry playing an important role in world economy. Now the radical restructurings in the agrarian sector of economy designed to provide reliably the population of the country with food and agricultural raw materials are carried out. The party set the task to provide uniform planning, the proportional and balanced development of all industries of agro-industrial complex, to considerably strengthen its material and technical resources, to achieve dynamic development and growth of efficiency of all industries of agriculture, increase in production and growth of quality of agricultural products. The being of agrarian policy of party for the 80th years is expressed in the Prodolstvenny USSR program accepted by a May (1982) Plenum of the Central Committee the CPSU for the period till 1990. The purpose of this program — to provide steady and uninterrupted supply of the population of the USSR with all types of food by substantial increase of productivity of agricultural production on the basis of its consecutive intensification. The program provided implementation of considerable social transformations in the village for the purpose of the further growth of welfare, improvement of living conditions and health protection of country people (see. Food programme).
Growth of welfare and culture of the people. Steady rise in the standard of living of the people is pattern, a main objective of development of socialism, edge, according to V. I. Lenin, consists in providing «... full welfare and free all-round development of all members of society» (V. I. Lenin, Pauly. SOBR. soch., 5th prod., t. 6, page 232). At all stages of creation of the USSR, socialist about-va development of economy, it was carried out for the benefit of growth of welfare and culture of owls. people. Growth of education level of citizens of our country is a bright example of it. So, if among the population of imperial Russia there were only 28,4% competent, then the USSR — the country of continuous literacy also wins first place in the world on number of the specialists with the higher and secondary education occupied in the national economy (tab. 1).
In the USSR considerable scientific and technical potential is created. In 1983 in the country there were more than 1,4 million scientists. The corresponding conditions are created also for development of medical science. The state character of the Soviet health care defined a possibility of planned development of research establishments, scientific research and implementation of results of these researches in practice. In 1918 the foundation was laid for formation of network of scientific institutions of health care. Creation in 1944 of the USSR Academy of Medical Sciences was essential for development of the Soviet medical science (see) and the organizations in 1971 of its Siberian branch transformed in 1979 to the Siberian department of the USSR Academy of Medical Sciences. By 1983 in the country about 400 medical scientific research institutes functioned.
In the conditions of the developed socialism there is possible fuller turn of economy to the solution of the diverse tasks connected with rise in welfare of the people.
The social program which is carried out by the CPSU mentions all parties of material and spiritual life of the Soviet people and is directed to fuller satisfaction of such essential requests of all segments of the population as increase in the material income, providing the population with consumer goods, development of education, culture and health care, improvement of working conditions and rest, growth of housing construction, improvement of a social security system, consumer services, environmental control, etc. Further expansion of scales of satisfaction of material and spiritual needs of the Soviet people is connected with creation of highly effective economy, with systematic implementation in production of achievements of scientific and technical progress, improvement of an economic mechanism, growth of labor productivity. At a meeting of the Commission of the Central Committee of the CPSU on preparation of new edition of the Program of the CPSU on April 25, 1984 it was noted that steady increase in welfare of the people was and remains the invariable program requirement of the CPSU. From here follows to a pervostafoam importance a task — creation of highly effective economy, a basis for more and more full satisfaction of material and spiritual needs of the Soviet people, growth of power of our state. In the new edition of the Program of the CPSU the course of party towards every possible implementation in production of the latest developments of science and technology, improvement of the forms of government, development of an initiative and labor activity of masses will be accurately designated what in a decisive measure all our progress depends on. Worthy reflection in the new edition Programs of the CPSU will be received also by the idea of merge of two revolutions — scientific and technical and social.
A source of increase in national well-being is the national income about-va, growth to-rogo allows to increase the volume of national consumption constantly. So, the sum of the used national income in the tenth five-years period increased in comparison with the ninth five-years period almost for 400 billion rubles and made 2045 billion. At the same time 4/5 national income were used on consumption, housing and welfare construction. Directly 1625 billion rubles were spent for increase in the standard of living of the population, or is 334 billion more, than in the ninth five-years period. For the same period the real income of workers considerably increased. Implementation of the resolution of the Central Committee of the CPSU, Council of ministers of the USSR and the All-Union Central Council of Trade Unions on increase in a minimum of the salary by the worker and employee adopted in December, 1976 with simultaneous increase in tariff rates and salaries to average paid categories of the workers occupied in unproductive spheres of the national economy allowed to increase the salary of 31 million people on average by 18%. Especially considerably the salary of workers of such mass professions as nurses, nurses, druggists, tutors of nurseries, librarians, club workers increased. The resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for further improvement of national health care» (1977) entered monthly extra charges to the salary to doctors of the local hospitals and out-patient clinics located in rural areas, to local therapists and pediatricians of city policlinics and separate categories of doctors of other healthcare institutions for continuous operation over 3 years in the specified institutions and on territorial sites. In general 13 billion rubles were spent for implementation of nation-wide actions for salary increase by the worker and the employee only in 1980. In total in comparison with 1940 in 1983 the average monthly salary of workers and employees counting on one working grew more than by 5 times (tab. 2).
Further growth of social production and increase in its efficiency allowed to increase for the first three years of the eleventh five-years period the average monthly monetary salary of workers and employees of the national economy honor for 8%. By the end of 1983 it made 182 rubles against 168,9 rubles in 1980.
The course of party towards rapprochement of the standard of living city and villagers, realized by the advancing growth rates of the real income of country people was consistently carried out. So, if the average salary of workers and employees in the national economy for years of the tenth five-years period grew almost by 16%, then the income of collective farmers from public economy — for 26%. Compensation of collective farmers only for 1982 increased in public economy for 4%.
Growth of the monetary income of workers is followed sokrashcheny durations of the working day and working week (tab. 3). In the USSR transition of the vast majority of workers to five-day working week with two days off is carried out. For workers of a number of professions with severe conditions of work working hours are shortened to 6 hours, and in workshops with especially severe conditions of work — to the 4th hour. Each worker is annually granted the paid leave.
The increasing role in increase in the standard of living of the Soviet people is played by public funds of consumption. From public funds of consumption to the population free education and professional development, free medical care, grants, pensions, grants are provided to pupils, the paid annual vacations, free and at preferential prices of the permit in sanatoria and rest houses, keeping of children in preschool institutions and some other payments and privileges, the sums to-rykh constantly grow (tab. 4). In 1983 more than 50% made monetary payments of the total amount of payments and privileges. Only for years of the tenth five-years period at the expense of public funds of consumption 527 billion rubles — 134 billion more, than in the ninth five-years period are paid to the population.
Payments and privileges from public funds of consumption concern directly each family, each citizen of the USSR. Considerable economy in the budget of many Soviet families is created by free education and social security. It is known that expenses of the state on one pupil per a year make: at comprehensive schools — St. 200 rub, in average special educational institutions — over 750 rub, in higher education institutions — St. 1100 rub. More than 600 rub, and in kindergarten — St. 500 rub are spent for keeping of one child in a children's day nursery in a year, at the same time 80% of these expenses are paid with the state. In day the state allocates over 10 rub for the maintenance of one patient. Totally costs of education (apart from capital investments) made 34,7 billion rubles in 1983. 40 billion rubles were spent for payment of pensions of St. 50 million people in 1983, over 13 billion rubles are given to citizens in the form of various grants.
Significant growth in payments and privileges from public funds of consumption (their volume in 1983 increased in comparison with 1975 by 44,4 billion rubles and made 134,5 billion) expanded an economic basis for the solution of important social tasks, for implementation of such fundamental constitutional rights of the Soviet people as the right for free education, health protection, social security, rest. Expenses on welfare actions and science grow (tab. 5) from year to year.
In 1983 in comparison with 1975 expenses from public funds of consumption for needs of education increased by 38%, by health care and physical a sack TURA — for 49%, by social security and social insurance — for 59%. At the expense of public funds of consumption in days of the tenth five-years period provision of pensions of workers of the separate industries of the national economy was improved, the minimum sizes of pensions to collective farmers are increased, material conditions of disabled people of the Great Patriotic War and disabled people since the childhood are improved, norms of expenses on food in a number of healthcare institutions etc. are increased. The sum of payments and privileges per capita increased in 1983 up to 495 rubles against 441 rubles in 1980 and 354 rubles in 1975.
Important economic and social value has the course towards the advancing development of production of consumer goods accepted by party. For years of the eleventh five-years period the volume of their production will increase by 27 — 29%. It creates conditions for fuller satisfaction of demand of the population for various goods and services, stimulates increase in volume of a retail goods turnover. At the same time the volume of a retail goods turnover and services will quicker increase, than the monetary income of the population that is of great importance for balance of solvent demand with commodity resources and paid services. The course towards the advancing development of production of consumer goods steadily is put into practice. In the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About additional measures for improvement of providing the population with consumer goods in 1983 — 1985» (1983) it is emphasized that «... increase in production and improvement of the range and quality of consumer goods is one of the major party and national objectives in system of the measures which are carried out on increase in living standards of the Soviet people...» [Collection of resolutions of the government of the Union of Soviet Socialist Republics (department the first), 13, M., 1983, page 230].
One of the major national objectives is performance by the CPSU of the program of improvement of living conditions of the Soviet people including further development of housing construction, increase in efficiency of operation and ensuring safety of housing stock, increase in its improvement planned by the XXVI congress. For the eleventh five-years period it is planned to construct 530 — 540 million sq.m of living space. Construction of houses in east regions of the country and in rural areas extends, transition of all mass housing construction to new progressive standard projects comes to the end. Distribution of new housing is carried out by the principle: the apartment — one family. In the USSR and on the future huge scales of housing construction at simultaneous improvement of quality of housing will remain. About it, in particular, original positions of the resolution of the Central Committee of the CPSU issued at the beginning of 1983 «To measures for ensuring implementation of construction plans of inhabited dokhm and social objects» testify, planned the real program, performance a cut it is designed to solve finally a housing problem in the country. Plans of party are successfully realized. Only in 1983 over two million apartments — more, than in any year from the previous five years are built. There are all bases to consider that the plan target of the eleventh five-years period on input of housing will be not only is executed, but also it is exceeded.
«The main directions of economic and social development of the USSR for 1981 — 1985 and for the period till 1990» provided further significant growth in public funds of consumption. By the end of the eleventh five-years period they will increase in comparison with 1980 by 23% that will promote improvement of living conditions of many Soviet people, medical care, social security and rest of workers, expansion of advantages and privileges to the families having children, and the working mothers, and also the solution of some other the important social tasks creating favorable opportunities for implementation of effective population policy and education of younger generation.
Tasks of party are successfully realized. For the first two years of the eleventh five-years period the annual gain of public funds of consumption made 4,7%. At the expense of these funds in the form of various payments and privileges the population of the country only in 1982 received 128,3 billion rubles, with their account the salary of workers and employees increased to 246 rubles a month against 232.7 rubles in 1980. In 1982 at the expense of all sources of financing more than 2 million new well-planned apartments with a total area of 108 million sq.m, including in rural areas — 32,2 million sq.m are built. It allowed to improve living conditions about 10 million people.
According to decisions of the XXVI congress of the CPSU and the resolution of the Central Committee of the CPSU and Council of ministers of the USSR adopted in their development «About measures for further improvement of social security of the population» (1981) the measures allowing to exercise more stoutly constitutional rights of the Soviet citizens on material security in old age in case of a disease, full or partial disability or loss of the supporter are carried out. For further improvement of social security in 1981 the minimum size of old-age pension by the worker and the employee is increased to 50 rubles, disability pensions are increased and at loss of the supporter. The minimum size of old-age pension to members of collective farm is increased to 40 rubles. Old-age pensions at incomplete length of service are granted to the women who gave birth to five and more children and brought up them to eight-year age. The sizes of earlier granted pensions to the workers and employees who came for deserved rest more than 10 years ago for approach of the sizes of their pensions by nowadays appointed increase; actions for further improvement of life of participants of the Great Patriotic War and families of the died soldiers are carried out.
Since 1981 additional events for improvement of material security of the families having children, and to improvement of the situation of the working women are held. Decisions of the XXVI congress and the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for strengthening of the state help to the families having children» (1981) privileges to the families having children and to newlyweds, first of all concerning domestic conditions are expanded, partially paid child care leaves before achievement of age of 1 year by it are entered; the rights to additional issue non-paid on care of the child before achievement of age of 1,5 years by it (and further up to 2 years) with saving the continuous seniority and length of service in the specialty are granted. Duration of the paid period on a nosotrophy the child increases up to 14 days. Measures for a wide spread occurance of practice works of women on the mode of part-time, the sliding schedule and at home are developed and carried out. The working women having 2 and more children aged up to 12 years are annually granted additional three-day leave. Measures for improvement of conditions and labor protection of the working women are systematically carried out.
A number of the privileges provided to workers in the eleventh five-years period is directed to increase in material security of families. So, the welfare lump sum of 50 rubles at the birth of the first child is paid to mothers working or pupils with a separation from production and 100 rubles — the second and third child with preservation of the operating sizes of grants at the birth of the fourth and the subsequent children (see. Social insurance). Since 1981 the sizes of a benefit for single mothers are increased. Further development of network and improvement of work of kindergartens (see Kindergarten), a day nursery (see Day nursery, a day nursery gardens), groups (schools) of the prolonged day, summer camps is provided (see)? especially in areas with high employment of women in social production. By the end of the eleventh five-years period the network of preschool institutions will extend not less than on 2,5 million places, number of places in groups (schools) of the prolonged day — to 13,5 — 14 mlp. Quality of food and service of children in preschool institutions, boarding schools (see), nursing homes improves at schools (see) and orphanages (see Orphanage). In particular, in preschool institutions of norm of expenses on food are increased on average by 10 — 15%.
As a result of implementation of the measures provided by resolutions of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for further improvement of social security of the population» and «About measures for strengthening of the state help to the families having children» financial position of St. 4,5 million families having children and apprx. 14 million pensioners improves. Overall appropriations for their implementation make apprx. 2,5 billion rubles a year.
Throughout all history of our country the party showed continued care of improvement of rest and a dignity. - hens. service of workers, development of physical culture and sport as important conditions of preservation of health and working ability of the population (see. Resorts , Rest , Physical culture and sport ). In the 80th these directions of the social program gain further development.
So, the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About further rise in mass character of physical culture and sport» (1981) effective measures for widespread introduction of physical culture in daily life of the Soviet people, to strengthening of material and technical resources of physical culture and sport, expansion of scientific research, especially on problems of sports and recreational work are planned. In the resolution it is specified that the main task of the sports movement, all system of physical training — in every possible way to promote strengthening of health of Soviet it is crowded, to increase in their working capacity and labor productivity, readiness for protection of the Homeland, gains of socialism, formation of high moral qualities, courage, force and endurance, to education of healthy and cheerful younger generation. Therefore for improvement of work on physical training of the population of the Central Committee the CPSU and Council of ministers of the USSR obliged the Central Committee of the Communist Parties of federal republics, regional committees, regional committees, district committees, city town committees and district committees of party according to decisions of the XXVI congress of the CPSU to strengthen the party leadership in the sports movement, to increase the responsibility of the Soviet, trade-union, Komsomol, sports and economic organizations for originally mass development of physical culture and sport.
It is offered to Ministry of Health of the USSR, ministries and departments of the USSR, councils of ministers of federal republics to improve medical control (see) behind the state of health of athletes and athletes; to take measures to expansion of network of medical and sports clinics (see), to providing them with the modern equipment, the equipment and medicamentous means; to provide in comprehensive plans of sanitary and recreational actions for the corresponding industries of the national economy more intensive implementation of sports and recreational work for strengthening of prevention of a number of diseases.
In January, 1982 the Central Committee of the CPSU, Council of ministers of the USSR and the All-Union Central Council of Trade Unions adopted the resolution «About Measures for Further Improvement of Sanatorium Treatment and Rest of Workers and Development of Network of Health Resorts of Labor Unions». Before party, Soviet and trade-union bodies, Central office for management of resorts of labor unions, the M3 of the USSR set the task with the assistance of the interested ministries and departments to carry out in 1982 — 1985 and during the period till 1990 the wide program directed to improvement a dignity. - hens. treatment and rest of workers, expansion of network dignity. - hens. institutions and institutions of rest. At the same time first of all expansion of specialized sanatoria is provided (see) for treatment of patients with cardiovascular diseases, diseases of the digestive system, a nervous system and kidneys, and also a dignity. - hens. institutions for parents with children and institutions for family rest of workers.
In the resolution it is indicated the need to improve vocational training of workers for a dignity. - hens. institutions and institutions of rest to raise requirements to level of service of vacationers, to improve work on selection, arrangement and ideological but - lytically to education of shots of health resorts of labor unions, and also to raise a role a dignity. - hens. institutions and institutions of rest in promotion of a healthy lifestyle and a dignity. - a gigabyte. knowledge for the purpose of eradication of unhealthy habits — smoking and an alcohol abuse. The resolution provided also construction and commissioning in the eleventh five-years period a dignity. - hens. institutions and institutions of rest on 60 thousand beds, houses for service personnel of health resorts and objects of municipal services. Capital investments of 968 million rubles are allocated for these purposes. For providing a considerable part of patients a dignity. - hens. as treatment in areas of their permanent residence it is recognized necessary to expand construction of sanatoria, boarding houses and other institutions in resorts of republican and local value, first of all in Siberia, in the Far East, in the Nonchernozem zone and the Central Chernozem region of RSFSR, in the republics of Central Asia and Kazakhstan. It is entrusted to Ministry of Health of the USSR and USSR Academy of Medical Sciences to develop and carry out in the eleventh five-years period the wide program of scientific research in the field of balneology and physical therapy, first of all on treatment of patients with cardiovascular, gastrointestinal, neurologic and gynecologic diseases; to improve coordination of researches of in-t of balneology, physical therapy and other research establishments dealing with problems of use natural to lay down. resources and physical therapy.
The offer of Central office on management of resorts of labor unions about increase in number of places in sanatoria for parents with children is accepted. In the resolution carrying out and some other the actions directed to improvement a dignity is planned. - hens. affairs and the organizations of rest in our country.
The strategic directions of social and economic policy And ideological and political activity of the party for the 80th years are formulated in solutions of May (1982), November (1982), June and December (1983), February, April and October (1984) of March and April (1985) Plenums of the Central Committee of the CPSU. They contain the deep scientific analysis of a state and perspectives of development of the national economy of the country, ways and methods of the embodiment to life of the grandiose political, economic and social transformations planned by party for the 80th years having the defining value for further improvement of living conditions and increase in level of health of the Soviet people are specifically defined.
Accepted May (1982) and October (1984) Plenums of the Central Committee of the CPSU the Food programme and the Long-term program of melioration, increase in efficiency of use of the reclaimed lands for steady building of food fund of the country — the most important components of economic strategy of party — planned new boundaries of rise of agricultural production for the eleventh and twelfth five-years periods. «The food programme — comrade M. S. Gorbachev wrote — sets as the main goal to provide steady supply of the population with all types of food. By the end of the 80th years it is planned to increase consumption of meat per capita more than by 20 percent, vegetables and melon cultures — on 30 — 39, fruits and berries — for 74 — 84 percent. Due to increase in consumption of animal protein, fats, vegetables and fruit the structure of food will be qualitatively improved.
Such reorganization of a diet demands high growth rates of production of the most valuable products.... Achievement of the planned boundaries is possible only on the basis of the balanced and dynamic development of the industries of agro-industrial complex. It has basic value. It is about strengthening of each link and all chain of this complex in general because weakness at least leads one of them to weakening of all system» (The communist, 1982, No. 10, page 11).
Considerable improvement of structure of food of the population, a cut will be reached as a result of implementation of agrarian policy of party, intended to play an important role in strengthening and preservation of health of the Soviet people, prevention of the most common forms of noninfectious pathology. Among the social transformations planned by the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for further improvement of housing, household and welfare living conditions of country people» (1982) one of the central places is occupied by measures for further development of rural health care, to-rye are designed to liquidate completely the distinctions taking place in the level of medical service of urban and country people, to radically improve health protection of villagers (see. Food programme). Problems of improvement of all types of medical care to country people, expansions of network and strengthening of personnel and material potential rural to lay down. - the prof. of institutions, expansions of scales of scheduled maintenance in the village along with other questions are more exhaustively stated also in the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About additional measures for improvement of public health care» (1982).
Not less importance for implementation of plans of economic and social development of the country in general and improvements of business of health protection of the Soviet people have solutions of November (1982). Plenum of the Central Committee of the CPSU. In decisions of the Plenum rod issues were touched, from to-rykh rates of economic and social development of the country, including and development of health care substantially depend. The party raised a question of the further growth of labor productivity, upgrading and overall performance, improvement of forms and methods of management, planning, an economic mechanism, acceleration of scientific and technical progress, increase in responsibility of workers and strengthening of labor discipline.
The largest political event in life of our country became June (1983) Plenum of the Central Committee of the CPSU. Materials of the Plenum, situation and the conclusions which are contained in its decisions with a new force convince that the main sense, the main content of activity of the party — care of the Soviet person, improvement of his life, its all-round development. Efforts of party and the people are concentrated on problems of systematic and comprehensive improvement of the developed socialism today, implementation to-rykh directly depends on the level of consciousness and activity of workers. In this regard formation of the new person becomes not only the major purpose, but also an indispensable condition of construction of communism. The plenum of the Central Committee of the CPSU highlighted that all ideological, educational and propaganda activities need to be lifted to the level of those big and complex problems which are solved by party in the course of improvement of the developed socialism resolutely. Transforming living conditions of people — it was specified in materials of the Plenum — it is necessary to do at the same time everything for their ideological and moral eminence. Without a lot of work on spiritual development of people, their socialist education with problems of improvement of mature socialism not to cope. It is well known including on the example of separate healthcare institutions what serious damage to business is caused by the defects taking place in ideological and educational work and the insufficient ideological and moral maturity of certain workers connected with it.
Decisions of a June Plenum set all creative power concluded in consciousness and ideological conviction of the Soviet people in motion. Implementation of the program of increase in level of ideological and voye-nutritious work planned by the Plenum will allow to strengthen even more the conscientious creative attitude to work of each Soviet citizen, will create conditions for improvement of the organization of work and by that will be a powerful factor of further progress of economy and culture, growth of welfare, improvement of living conditions and health protection of the people.
For toilers of service of health not only the ways and methods of reorganization of ideological and mass and political work developed on the Plenum have basic value. Materials of the Plenum contain the provisions which are directly concerning urgent problems of improvement of health protection of the Soviet people. In particular, it was specified the escalating importance of health care in the conditions of the developed socialist society, the main directions of further improvement of health protection — increase in qualitative level of medical care and every possible development of the preventive direction, including introduction of annual medical examination of all population are defined.
It is known that the defining value for prevention of diseases has a healthy lifestyle, the correct use of the vital benefits provided to the citizens developing socialist about-vom, rational life and food. The defining role in the solution of these of the major for implementation of the strategic direction of the present stage of preventive activity of the Soviet health care of tasks, undoubtedly, will be played by essentially new regulations on the maintenance of socialist civilization and culture of reasonable consumption which are put forward on the Plenum.
On December (1983) Plenum of the Central Committee of the CPSU a deep and comprehensive assessment of economic and social situation of the country was given, need of steady increase in level of the party and state management of all industries of the national economy was noted more actively to develop positive tendencies, to give them steady character.
Extraordinary February (1984) The plenum of the Central Committee of the CPSU brightly showed succession of domestic and foreign policy of party. In materials of the Plenum need of serious reorganization of a control system of economy and all economic mechanism on the basis of achievements of science, the equipment and the best practices, improvement of quality of state planning, increase in interest of collectives in development and performance of complicated plans and in fuller use of reserves of production, strengthening of responsibility for results of work, неуклонного^ carrying out in life of the socialist principle of distribution on work was highlighted compensation constantly stimulated growth of its productivity. The volume of the resources directed to satisfaction of social needs of the population on improvement of working conditions and life of the Soviet people, medical care, construction of housing, etc. depends on further increase in production efficiency, growth of labor productivity and decrease in product cost.
Ways of further strengthening of economic and defense power of the USSR, improvement of the developed socialism, the strategy of advance to communism are defined in solutions of April (1984) Plenum of the Central Committee of the CPSU. Documents of the Plenum contain the evidence-based strategy of advance to communism, the cut is guided party at the present stage. On the Plenum it was said that the strategy of party has nothing in common neither with sluggishness in actions, nor with jumping of historically necessary steps of development. On the way to communism of party and the people it is necessary to solve many the large and complex problems relating on the origin and character to the first phase of a communistic formation. In it, as a matter of fact, today the main content of big and hard work on improvement of the developed socialism also consists.
The measures for acceleration of progress of social production, completion of its transfer into an intensive way of development, improvement of an economic mechanism and increase in a role of labor collectives, growth of ideological, mass and political work which are carried out in the country are added with solutions of April (1984) Plenum of the Central Committee of the CPSU stated in them by the detailed program of improvement of activity of Councils of People's Deputies, development of public statehood and socialist democracy, the program of education of the new person corresponding on the ideological conviction and moral qualities to education level and labor skills, tasks to ohm nistiches to about about constructions.
Mobilization of workers on successful implementation of plans of 1985, the eleventh five-years period in general and to creation of strong base for the twelfth five-years period were devoted decisions of the Politburo of the Central Committee of the CPSU on November 15, 1984. The party and the people apprehended the decision of the Politburo of the Central Committee of the CPSU as the party document of a strategic importance, the instructions and conclusions which are contained in it completely approved and recognized necessary to be them the basis for activity of all party, public and economic organizations, public organizations and labor collectives.
The big and responsible tasks are set extraordinary March (1985) Plenum of the Central Committee of the CPSU. First-priority care of party and the people — it is successful to cope with the plan of the completing year of a five-years period, to make up for lag where it is allowed. The plenum put forward on the agenda such questions as an intensification of production, acceleration of social and economic development of our society, strengthening of labor, state and party discipline, persistent fight against everything that contradicts socialist norms of life. In the speech on the Plenum the Secretary general of the Central Committee of the CPSU comrade M. S. Gorbachev called communists, all Soviet people for the deep analysis and realistic assessment reached, for identification of the problems and obstacles hindering our advance to increase in organization in work, mobilization of all creative power and reserves successfully to complete the current five-years period and with high economic results to come to the regular XXVII congress of the CPSU.
Decisions of the XXVI congress and the subsequent Plenums of the Central Committee of the CPSU specify new ways of implementation of the tasks facing health care developed socialist about-va.
The POPULATION of the USSR, ITS NUMBER, STRUCTURE, the NATURAL MOVEMENT
Population of the USSR (by assessment for 1.07.84) average population density made 275,0 million people, more than 12 people on 1 sq.km. The central regions of the European part of the USSR, and also the Areas of Donbass, Right-bank Ukraine, Transcaucasia, the Moldavian, Lithuanian SSR and the Fergana Valley are most densely populated. Thanks to development of the industry and transport, development virgin and laylands the population of Siberia, the Far East and Kazakhstan considerably grew.
Total number of the population of the USSR constantly increases and by 1984 increased in comparison with the pre-revolutionary period more than by 1,7 times. Total number of women exceeds the total number of men a little that is connected generally with the dominance of women in the senior age groups caused mainly by effects of war. Gradual alignment of a ratio of yoles (tab. 6), and also absence in younger age groups of similar distinction, in particular, testifies to it.
The Soviet Union — the multinational state. Its population makes over 100 nations and nationalities differing on language, national and cultural traditions, features of life, but which are closely connected among themselves by a community of historical destinies and the uniform purpose creation of communism. The people inhabiting the USSR speak almost 130 languages. Languages of indigenous people are widespread in federal, autonomous republics, autonomous regions and districts. Language of international communication is Russian. The national structure of the population of the USSR (tab. 7) formed throughout several millennia in the course of long development and interaction of numerous tribes, the big and small people.
Significantly the ratio between the number of urban and country people changed (see tab. 6) that is connected with processes of an urbanization (see). Constantly the number of the cities, especially in connection with development of the Areas of Siberia and the Far East grows. The number of the largest cities increases. For January 1, 1984 in the USSR there were 22 cities numbering over 1 million people.
Processes of the natural movement of the population in the USSR are characterized in general by decrease in indicators of birth rate and mortality at preservation of favorable indicators of a natural increase (tab. 8). The high natural increase of the population at high levels of birth rate and mortality was characteristic of pre-revolutionary Russia. The achievements of the Soviet health care which led to falloff of child mortality, increase in life expectancy and by that to increase of a share of elderly people as a part of the population active involvement of women in the sphere of production were the main reasons for decrease in indicators of birth rate. A great influence on reduction of birth rate in 50 — the 60th exerted also effects of the Great Patriotic War. Since 1970, as a result of the introduction in prolific age of post-war generations, and also significant increase in national well-being, the population policy of the Soviet state directed to strengthening of young families, birth rate began to increase. The general mortality in the USSR in comparison with pre-revolutionary Russia decreased almost by 3 times. Some increase in level of the general mortality, since 60th years, is connected with «a postareniye of the population», i.e. increase as a part of the population of a share of elderly people. As a result of decrease in the general mortality the average duration of the forthcoming life in the USSR increased in comparison with the pre-revolutionary period more than twice.
Certain distinctions in structure of reproduction of the population of federal republics first of all are connected with fluctuations of level of birth rate (tab. 9).
Age structure of the population, specific weight of the women occupied in social production, a share of urban population, national traditions, life and family way of the separate people social psikhologiche-skiye, demographic, social and nek-ry other factors has significant effect on distinction of these indicators. In general processes of reproduction of the population in the USSR proceed more favorably, than in many developed foreign countries (tab. 10).
Incidence and causes of death of the population. Before revolution Russia won first place in Europe on prevalence among the population of infectious diseases, including especially dangerous. Not stopping epidemics of natural smallpox, cholera, plague, intestinal infections, sypny and returnable typhus, malaria and other diseases caused significant damage to health of the population and national economy. The sapropyra was especially widely widespread. At the end of 19 — the beginning of 20 centuries it was registered in Russia everywhere, striking the poorest segments of the population of the cities and villages. Prisons, dosshouse houses, inns, accumulations of workers on construction of the railroads, crafts, etc. were the constant centers of a sapropyra supporting spread of an infection in all country. The epidemic outbreaks of a typhus were noted in 1881, 1892—1893, 1908 — 1911. Cholera affected the population of Russia during all six pandemics of cholera, known in the history of medicine. From 1823 to 1910 in Russia it was registered 44 «cholera years». In 1892 — 1893, according to incomplete data, the St. 700 thousand patients with cholera, in 1907 — 1911 — 2,8 million was registered, at the same time the lethality in different years made from 30 to 43%. About 43 thousand people annually died of natural smallpox, and among survivors many remained blind people. From 1896 to 1913 268 thousand people had a malignant anthrax, from to-rykh about 25% died. In 1912 in Russia about 13 million infectious patients were registered. Even in rather favorable 1913 in the epidemic relation incidence inf. diseases in Russia remained very high: 7,3 patients with a sapropyra, 1,9 — a typhinia, 26,6 — a typhoid and paratyphus, 31,4 — dysentery, 31,1 — diphtheria, 216,6 — malaria, 4,4 — natural smallpox were the share of 10 thousand population.
In infectious pathology the important place was taken by the children's infections which were the main reason for high mortality of children till 1 year and also mortality of children of other age groups. So, according to S. A. Novoseljsky, during the period from 1891 to 1914 from scarlet fever, diphtheria, measles and whooping cough the St. 1,7 million children aged from 1 up to 15 years died. Before administration of diphtheritic serum the lethality from diphtheria reached 50 — 60%, but also after its introduction (1894) in Russia every seventh sick child perished from diphtheria.
Position of suburbs of the country was especially heavy. Double oppression — social and national, cruel operation and poverty affected the health and forces of the people of Far North, the Far East and Siberia, the Volga region and the Urals, the Caucasus and Central Asia, led to mass spread of the diseases claiming many thousands of the lives. Tuberculosis and syphilis were an original scourge of many people of Russia; in Central Asia, besides, the leushmaniosis, a parasitic worm and other tropical diseases were eurysynusic; in the Volga region and in the Urals trachoma raged. E.g., in 1902 in many counties of the Kazan province trachoma struck 70 — 80% of the population.
Extremely adverse sanitary condition of the country was the main reason for so high infectious incidence. For example, according to the All-Russian hygienic exhibition, in 1913 from 1063 cities only in 204 there was a water supply system delivering water to the houses located in the central quarters. At the same time 145 water supply systems had no filters. The sewerage was available only in 17 largest cities and that only in the central parts; the vast majority of the population used water, unsuitable on bacteriological indicators, for drink; many settlements were unsanitary. The adverse sanitary and epidemic situation was aggravated by extremely unsatisfactory zhilishchnobytovy conditions, poverty and low cultural level of most of workers. Efforts of progressive figures of medicine and zemstvo could not lead to positive takes: the sanitary bureaus created in the provincial and nek-ry district cities were forced because of a lack of means to be engaged in preferential statistical work; 257 doctors who were available in 1913 a dignity. - epid. a profile lived in the large cities and performed mainly sanitary and quarantine functions. The uniform sanitarnoprotivoepidemichesky organization did not exist, even the scanty sanitary legislation was not observed. The state practically did not finance sanitary and anti-epidemic work: according to G. E. Rein, in 1914 allocations for a dignity. actions made 1kh/4 kopek on one inhabitant a year.
World War I of 1914 — 1918 led to sharp deterioration in an economic situation of Russia, a further impoverishment of workers, shortage of food, growth of incidence of infectious diseases and mortality of the population. Conditions of civil war, intervention and economic blockade even more worsened already extremely difficult sanitary and epidemic situation. According to JI. A. Tarasevich, in 1918 — 1922 a sapropyra had apprx. 20 million people, from 1919 to 1923 a typhinia — apprx. 10 million persons. For 1918 — 1921 more than 200 thousand cases of cholera are registered. In 1919 the threat of development of epidemic of natural smallpox was created, incidence of malaria, intestinal and other infectious diseases considerably increased. In these conditions fight against infectious diseases was considered by party as one of key questions of domestic policy of the state. Speaking at the VII All-Russian congress of Councils on December 5, 1919, V. I. Lenin urged to throw all forces on fight against epidemics: «And the third scourge still approaches us — a louse, a sapropyra which mows our troops. And here, companions, it is impossible to imagine that horror which occurs in the places affected with a typhus when the population is exhausted, weakened there are no appliances — any life, any public disappears. Here we speak: „Companions, all attention to this question. Or louses will win against socialism, or socialism will win against louses! and» (V. I. Lenin, Half-N of SOBR. soch., 5th prod., t. 39, page 410).
During this period V. I. Lenin signed decrees of Council of People's Commissars about sanitary protection of dwellings (1919), about measures for improvement of water supply, the sewerage and sewage disposal (1921) and about sanitary bodies of the republic (1922), the circle of tasks to-rykh included control of implementation of measures for protection of reservoirs, air, the soil, dwellings, food stuffs, health protection of children, sanitary labor protection, the organization of anti-epidemic actions. Objectives dictated need of creation in the territory of the country of the profile research establishments developing scientific bases of hygienic rationing, the organization of service and implementation by it of the functions assigned to it. The decree of 1922 legalized legal bases a dignity. - epid. services and system of the state sanitary inspection (see), are defined in a legislative order of the right and a duty of health officers.
Approach to infections began in all directions: broad sanitary and anti-epidemic events were held, domestic conditions improved, the inhabited places equipped with modern conveniences, special care of growth of culture of the population was shown. All conscious workers actively helped bodies of health care. History did not know such scales of anti-epidemic work. The taken emergency measures in unprecedentedly short terms led to falloff of incidence of the population of infectious diseases, elimination of the majority of especially dangerous infections, to establishment of a safe sanitary and epidemic situation in the country. So, e.g., incidence of a sapropyra decreased by 1922 in comparison with 1919 — 1920 by 3 times, and by 1927 — more than by 100 times. This success was result of broad holding anti-epidemic actions and sanitary and educational work, household bypasses for the purpose of identification and isolation of patients, active participation of the population in fight against epidemic. After 1927 incidence of a sapropyra had sporadic character, nek-ry rise in incidence of a sapropyra in 1942 — 1945 was noted preferential in the territories freed after their temporary occupation by fascist army. Since 1948 in the USSR only cases of a disease of Brill which number constantly decreases are registered; in 1970 it decreased in comparison with 1950 by 8 times, and in 1981 only isolated cases of this disease were registered. Incidence of a typhinia in 1927 decreased in comparison with 1920 — 1922 more than by 100 times. Since 1938 the typhinia was almost liquidated.
Fight against natural smallpox went on the way of creation of necessary conditions for the organization of planned universal smallpox vaccination. 10 apre-relya 1919 I. Lenin signed the decree of Council of People's Commissars about obligatory smallpox vaccination. As a result of systematic actions for mass anti-smallpox immunization since 1924 incidence of natural smallpox considerably decreased, and by 1936 natural smallpox in the USSR was completely liquidated. Experience of fight against natural smallpox in the USSR formed the basis of measures, implementation to-rykh allowed to liquidate completely in 1977 smallpox on the globe (see Smallpox natural, Smallpox vaccination).
Fight against malaria was marked by dazzling successes. In pre-revolutionary Russia from 5 to 7 million cases of diseases of malaria annually were registered. Fight against it began from first years of the Soviet power. In 1920 the Central institute of protozoan diseases was organized. In 1921 the Central malarial commission at Narkomzdrava under the direction of which the wide network of antimalarial institutions was created was founded and the evidence-based program of elimination of malaria in the USSR was developed (elimination of the centers of an infection, identification of patients, holding lechebnoprofilaktichesky actions, fight against carriers of an invasion — mosquitoes and protection of the population from their stings). In 1934. The Council of People's Commissars adopted the special resolution on measures for strengthening of actions for fight against malaria. In 1949 the task of elimination of malaria as mass disease was set. Since 1963 only separate cases of malaria in border areas of Azerbaijan and the nek-ry republics of Central Asia are registered (see Malaria).
Considerable progress managed to achieve also in fight against other infectious diseases. So, in 1981 in comparison with 1913 incidence of a malignant anthrax decreased by 90 times, a typhoid and a pas-ratifami — more than by 40 times, whooping cough more than by 30 times.
All this led to change of nature of incidence in the USSR: in its structure the leading place was taken by noninfectious diseases, including chronic, is long flowing, causing among the working population considerable I rub-dopoteri and being the main reason of permanent disability. Not epidemic type of pathology which gained the main distribution in the USSR is characteristic of all economically developed countries.
The analysis of dynamics of incidence confirms increase in frequency of some noninfectious diseases. It belongs hl. obr. to diseases of a respiratory organs, cardiovascular and oncological diseases. Respectively also the share of these forms in the general structure of incidence grows. So, about 12 — 15% of total number of the diseases registered in the country fall to the share of diseases of a respiratory organs (excepting acute respiratory diseases). Especially powerful damage to the state of health and working ability of the population put cardiovascular diseases, to-rye, according to negotiability, make 7,5% in the general structure of incidence. At the same time it is necessary to consider that true prevalence of diseases of bodies of blood circulation is much higher what confirm, in particular, given specially conducted mass examinations of the population. Besides, as well as diseases of a respiratory organs, cardiovascular pathology tends to growth that in a certain measure is connected with increase in life expectancy of the population, and also about a nek-eye increase of level of this incidence in younger age groups of the population. Diseases of digestive organs, musculoskeletal system and connecting fabric, skin and hypodermic cellulose make respectively 5,9, 5,3 and 5,0% in the general structure of incidence. Incidence of malignant new growths is high: according to the available data, get sick with them annually apprx. 500 thousand people.
The structure of causes of death in the USSR is typical for economically developed countries. The leading place in it was taken by chronic, including noninfectious diseases and injuries. The infectious diseases holding earlier prevailing position in structure of mortality in all age groups of the population, and first of all children's make nowadays insignificant part.
In 1983 in structure of mortality of the population chronic diseases of the blood circulatory system made 53,5%, malignant new growths — 14,3%; the third place was taken by diseases of a respiratory organs. Cardiovascular diseases mortality for the last 20 years grew more than twice and though at the beginning of the 80th the tendency to its decrease was outlined, diseases of cardiovascular system continue to hold strongly a leading position among causes of death. Level and dynamics of mortality from diseases of the blood circulatory system are determined by two groups of diseases — the coronary heart disease and vascular damages of a brain which are more than in 80% of cases a cause of death from diseases of the blood circulatory system. It is characteristic also that coronary heart disease mortality rate has the expressed communication with age: it progressively increases in process of aging of the population. Though other cardiovascular diseases mortality has no so expressed communication with age, nevertheless over 80% of cases of death of diseases of bodies of blood circulation are the share of age groups 50 years are more senior. Vkhme-ste with that is marked out a nek-swarm increase in death rate from cardiovascular diseases and in average age groups, especially at men in recent years. It is connected first of all with the fact that the middle-aged persons having cardiovascular diseases very reluctantly refuse addictions and behavioural installations, adverse for health, existence to-rykh not only promotes developing of a disease, but also complicates its current, considerably increasing probability and accelerating approach of a lethal outcome. Oncological
diseases mortality in the USSR is lower, than in the majority of economically developed countries, its level in the 2nd half of the 70th years was stabilized. According to N. N. Blochin (1981), in the USSR there live over 2 million people who had various oncological diseases and completed the corresponding course of treatment, including over 660 thousand people live more than 10 years after the carried-out treatment. It testifies to efficiency of long-term and purposeful campaign against cancer in the USSR.
A little mortality and from diseases of a respiratory organs decreased in recent years. At the same time bronchopulmonary pathology continues to take the 3rd place in structure of causes of death.
PHILOSOPHY of PUBLIC HEALTH CARE of the USSR.
For years of the Soviet power in the USSR the harmonious system of protection of national health is created, edges includes actions not only medical, but also first of all social and economic character, directed to strengthening of health of each person and all population, to creation of premises for active creative longevity of all members of society. Creation of a socialist health system. at a cut the state undertakes care of public health care, clearly demonstrates advantages of a socialist system.
In pre-revolutionary Russia of the state system of health protection did not exist. Management of health care was separate. Medical help to the population was given by preferential private medical practitioners.
The fundamental principles of socialist system of health protection were developed by V. I. Lenin and found reflection already in the first party program (see Lenin and health care). From the first days of the Soviet power care of health protection of workers was proclaimed the most important problem of the socialist state. The main ways of development of the Soviet health care were defined in the Program of the Communist Party adopted by the VIII congress in 1919. In particular, in it it was noted: «In the field of protection of national health of RCP believes in a basis of the activity first of all carrying out the wide recreational and sanitary measures aiming at the prevention of development of diseases» (the CPSU in resolutions and decisions of congresses, conferences and plenums of the Central Committee, M., 1970, t. 2, page 59). Thereby the general line of the Soviet health care — its preventive direction was planned, a cut is a basis of activity of all medical institutions, the fundamental and defining principle of policy of the state in the field of public health care.
In process of emergence of new tasks of socialist construction, with development of economy and in connection with achievements of medical science and practice changed and forms and methods of work of bodies and healthcare institutions were improved, but at the same time invariable were philosophy of the Soviet health care — the state planned character of health care, free of charge and general availability of medical care, the preventive direction, unity of the theory and practice, broad participation of workers in activity of bodies and healthcare institutions (see Health care).
The main directions of development of health care and medical science, tasks facing them systematically find reflection in the most important resolutions of Party and Government, to-rye pay constant and huge attention to questions of improvement of public health care (see the Communist Party of the Soviet Union). Acceptance of Bases of the legislation of USSR and the federal republics about health care approved by the Supreme Council of the USSR in 1969 in was important for the Soviet health care to-rykh philosophy and forms of the organization of medical care to the population were established (see. Legislation on health care ).
Success achieved by the Soviet health care found reflection in the Constitution of the USSR (1977) and care of the socialist state of health protection of the people was visually shown. The transformation of the state of dictatorship of the proletariat to the public state noted by the Constitution means change of character and the maintenance of the Soviet health care which became national health care of the first-ever public socialist state.
The health care of the USSR is designed to satisfy needs of all population, irrespective of an economic condition and a class association of citizens, in all types of the qualified medical care. This situation formed a basis for declaration as the Constitution of the USSR of the right of all citizens for health protection, for receiving the free and available qualified disease-prevention and medical service, for material security in old age, in case of a disease, full or partial disability. Real political, economic, legal and other types of guarantees of full and unconditional implementation of these rights by holding social and economic and special medical events, on further strengthening of health of the people are legislatively fixed. «Citizens of the USSR — article 42 of the Constitution of the USSR states — have the right to health protection.
This right is provided with the free qualified medical care provided by State Healthcare Institutions; expansion of network of institutions for treatment and strengthening of health of citizens; development and improvement of the accident prevention and production sanitation; holding broad preventive actions; measures for improvement of the environment; special care about health of younger generation, including prohibition of the child labor which is not connected with training and labor education; expansion of the scientific research directed to the prevention and decrease in incidence on providing long active life of citizens».
More than in 20 other articles of the Fundamental Law of the USSR provisions are formulated, to-rye have a direct bearing on preservation and promotion of health of the population and development of health care that confirms huge care of socialist society about health of the people. So, article 15 announcing the prime target of social production at socialism the fullest satisfaction of the growing material and spiritual needs of people in this respect is essentially important. From the point of view of health protection of the people big sots. - a gigabyte. articles of the Constitution matter, in to-rykh the right of the Soviet citizens for work (article 40), education (article 45), rest (article 41), material security in old age, in case of a disease, full or partial disability (article 43), on the dwelling (article 44) is recorded. In article 24 it is specified systematic development in the USSR of the state health system, social security, public catering, and also mass physical culture and sport. For the prevention of diseases and preservation of human health the measures for protection and improvement of the surrounding environment (article 18, 42, 67) provided by the Constitution have essential value. In the relevant articles of the Constitution implementation of special safety arrangements and health of women, legal, material and moral support of motherhood and the childhood (article 35), manifestation by the Soviet state of care of a family, development of wide network of child care facilities (article 53), the right of citizens of the USSR for judicial protection against infringement of life and health (article 57) is guaranteed. In article 21 care of improvement of working conditions, of reduction, and further and full replacement of hard manual skills on the basis of complex mechanization and the industrial automation is proclaimed; in article 22 consecutive implementation of the program of transformation of agricultural work into a version industrial, expansion in rural areas of network of healthcare institutions, trade, public catering, transformation of villages and villages into well-planned settlements is proclaimed. For the solution of problems of health protection of the people and development of health care also the provisions of the Constitution guaranteeing the state care of development of education and sciences about improvement of working conditions of citizens, increase in level of their material income, growth of public funds of consumption have basic value.
The political guarantee of the rights to health protection of the people in the USSR follows from humane essence of socialism and all activity of the Communist Party which proclaimed the benefit and happiness of people the prime target of economic and social development. It is shown in steady increase in the leading, organizing and mobilizing role of party in life of society, including in the solution of problems of health protection of the people. The political guarantee of the rights to health protection is recorded in the Program of the CPSU, decisions of the XXVI congress, in legislative and directive acts concerning health care. The state economic guarantee of the rights of the Soviet citizens for the free qualified medical care is accrescence of economic capacity of the country that allows society to direct huge material and financial resources to protection and strengthening of health of citizens. Important place in economic guarantees of the right to health protection is taken by a guarantee for every possible strengthening and further development of the state social insurance, at the expense of the budget to-rogo payment of grants at temporary disability, pregnancy and childbirth is made, on a dignity. - hens. treatment of workers and employees to lay down. food. Considerable means under this budget are paid on the maintenance of preschool institutions, summer camps, on out-of-school service and other needs.
Thus, the Constitution recorded creation in the USSR of system of socialist health care as important building block socialist about-va and along with it fixed the highest legal guarantee of protection of public health of the USSR. However, being the Country constitution, the Constitution contains only the main, most basic provisions guaranteeing the general right to health protection. The others — reveal and concretized in various special legislative and directive acts of the state.
According to the current legislation the management and control of health care in the country is exercised of the supreme bodies of the government and state bodies of the USSR, federal and autonomous republics, and also local councils of People's Deputies. A lot of work is carried out by the constant commissions of the Supreme Councils of the USSR, federal and autonomous republics. Direct management of the organization of the medical and sanitary help to the population is performed by the Ministry of Health of the USSR, the Ministry of Health of federal and autonomous republics, regional, regional, city and regional public health departments (see Management of health care). For the organization of medical care to workers of the separate industries of the national economy (civil aviation, railway transport, etc.) as a part of the relevant ministries departmental services are created (see. Medical and sanitary service of departments ).
The main source of financing of health care of the USSR is the state budget, to-ry provides the maintenance of network of medical institutions and bodies of health care, and also carrying out in the country necessary to lay down. - the prof. and recreational actions. The big contribution to financing of health care is made by also state enterprises, cooperative, trade-union and other public organizations (see Economy zdravookhran en iya).
The consistent focus at all stages of development of the Soviet health care is provided on questions of preparation and improvement of medical shots. The network of the highest and average medical and pharm develops. educational institutions, in-t of improvement and f-tov professional development, medical education (see Institutes of improvement of doctors, Medical institutes, Health care workforce, Medical it is educated iye) is improved.
Treatment-and-prophylactic help (see) the population there is wide network out-patient and polyclinic, hospital also a dignity. - hens. institutions, institutions of emergency medical service, protection of motherhood and childhood. The major section to lay down. - the prof. of the help is the vneboljnichny help (see) the population, edges are provided by general availability of the qualified and specialized medical aid. Special attention at all stages of development of the Soviet health care was paid to questions of health protection and medical care of the working industrial enterprises, construction and transport that found the reflection in preferential medical - a dignity. providing these contingents of the population. The consistent focus is provided on questions of improvement of medical aid to country people which especially increased in connection with accepted May (1982) Plenum of the Central Committee of the CPSU Food programme. In the center of attention of the Soviet state, bodies and healthcare institutions there is a care of health protection of women and children, edges is provided with system of the governmental, public and medical activities (see Hospital, the Medical and sanitary part, Health protection of children and teenagers, Protection of motherhood and the childhood, Policlinic, Emergency medical service).
Integral part of the Soviet health care is the dignity. - epid. service, tasks a cut include implementation of precautionary and current sanitary inspection, the organization and holding the sanitary and anti-epidemic actions directed to prevention, decrease and elimination of infectious diseases. Activity dignity. - epid. services is guided by the Soviet sanitary legislation (see), the large powers conferred to it. Instructions of the chief state health officer are obligatory for performance by all state, public organizations, institutions and certain citizens. In the USSR putting into operation of the industrial enterprises without treatment facilities is forbidden. The USSR is the first-ever country which developed maximum allowable concentrations of pollutants of the environment. Construction of any object, as well as a design of the inhabited places, is carried out only at respect for sanitary standards and rules. Sanitary bodies will organize work on carrying out preventive inoculations to the population, hold anti-epidemic events in case of developing of infectious diseases or at threat of their emergence and distribution, sanitary and quarantine actions etc.
As a result of accurately held governmental and public activities, the qualified and harmonious work sanitary and anti-epidemic the sanitary condition of the country organizatsiiznachitelno improved. E.g., for years of the Soviet power the extent of a water supply system increased in tens of times, the sanitary condition of the cities, settlements of city type and the rural inhabited places considerably improved (see. With anitarno-epidemiological service, the Hospital attendant but-e pidy the iologichesky station). Important function of the Soviet health care is sanitary education (see), a cut the dignity plays a large role in increase. cultures of the population, level gigabyte. and medical knowledge and promotion of a socialist way of life (see). Component of health care is the medicinal help to the population. Development ^медицинской the industries is essential for improvement of health care (see) — the industry of the national economy which is engaged in development and production of pharmaceuticals, the medical equipment and products of medical appointment.
The Soviet health care for years of the existence achieved huge successes, to-rye brought it high authority on the international scene. An important condition of further improvement of health care, distribution around the world of the advanced achievements of the Soviet medical science and practice is the broad international cooperation of the USSR in health care which is carried out first of all within Council of Economic Mutual assistance and World Health Organization, and also bilateral and multilateral cooperation with various countries. Big help is given by the Soviet health care to young developing countries. Extremely important aspect of the international importance of the Soviet health care is its active participation in fight for preservation and consolidation of peace and easings of international tension. In the conditions of the impetuous race of nuclear weapons started by administration of the USA, the Soviet doctors use huge international authority of the Soviet health care and medical science for association of the progressive medical public of the whole world in fight for prevention of nuclear catastrophe. It, in particular, finds expression in their active participation in work of the international movement «Doctors of the World for Prevention of Nuclear War» which combined more than 60 thousand doctors from 45 countries by 1984 (see. Doctors of the world for prevention of nuclear war , t. 29).
In June, 1981 at Presidium of the USSR Academy of Medical Sciences the Soviet committee «Doctors for Prevention of Nuclear War» under the chairmanship of the academician E. I. Chazov was created. This committee headed the anti-war movement of doctors in our country and carries out a lot of work according to the general Soviet and international public concerning medical effects of nuclear war.
The III International congress of the movement «Doctors of the World for Prevention of Nuclear War» which took place in the Netherlands in June, 1983 suggested to add national and international oaths and codes about a professional ethical duty of the doctor with point obliging physicians to fight against nuclear catastrophe. According to this offer and moving towards wishes of the Soviet medical public, the Presidium of the Supreme Council of the USSR the Decree of November 15, 1983 decided to add the text of the oath of the doctor of the Soviet Union with the paragraph of the following contents: «understanding danger which is represented by nuclear weapon for mankind, to struggle constantly for peace, for prevention of nuclear war».
DEVELOPMENT of the SOVIET HEALTH CARE
In detail questions of formation, development and condition of the Soviet health care up to the 2nd half of the 70th are described in the articles Health care, The Communist Party of the Soviet Union (see), Lenin and health care (see), Meditsina (see), and also in articles devoted to separate fields of activity in the field of health protection, e.g., Hospital (see), Hospital construction (see), Children's hospital (see), Children's policlinic (see), the Treatment-and-prophylactic help (see), the Medical and sanitary part (see), Rest (see), Labor protection (see), Protection of motherhood and the childhood (see), Planning of health care (see), Policlinic (see), the Food programme (see), Prevention (see), Prevention primary (see), Sanitary and epidemiologic service (see), Emergency medical service (see) etc. Therefore results of development of health care in the tenth five-years period and the main activities of health care in the light of decisions of the XXVI congress of the CPSU are stated below.
DEVELOPMENT of the SOVIET HEALTH CARE FOR YEARS of the TENTH FIVE-YEARS PERIOD
in days of the tenth five-years period the Soviet health care developed according to the decisions of the XXV congress of the CPSU and tasks stated in the Resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for further improvement of national health care» (1977). Progress of medical science and improvement of health care along with the constant growth of national well-being led to further improvement of the state of health of the population. For years of the tenth five-years period incidence with temporary disability, professional incidence (by 26%), primary exit to disability was reduced (for 8,3%), decreased child and maternal mortality, birth rate increased. Under the direction of party and Soviet bodies, with broad participation of the public the actions which provided further strengthening of material and personnel potential of health care, increase in level of the medical and medicinal care to the population, improvement of scheduled maintenance were carried out. Escalating allocations for health care formed an economic basis for implementation of these actions, to-rye only under the state budget made in 5 years 66 billion rubles — 14 billion more, than in the ninth five-years period. About 7 billion rubles of capital investments were spent for strengthening of material and technical resources of health care.
Growth of network of medical institutions continued, and special attention was paid to construction of healthcare institutions in the republics with more low level of security of the population with medical aid. A row large multi-profile is constructed and specialized to lay down. - the prof. of institutions, carried out modernization and integration of the operating hospitals. 28 600 — 1000 hospitals and more beds, 118 maternity homes and obstetric cases, 127 children's hospitals are put into operation and others to lay down. - the prof. of institutions in the cities and rural areas. In only 1976 — 1980 more than on 324 thousand beds (tab. 11) was put into operation medical institutions.
Entered a system of policlinic on 650 thousand visits per shift. At construction of medical institutions means of the industrial enterprises, state farms and collective farms were widely used. In particular, in 1978 — 1980 at the expense of means of the enterprises and the organizations new hospitals on 36,7 thousand beds and policlinic on 103,1 thousand visits per shift were put into operation. An essential additional contribution to strengthening of material and technical resources of health care was use of means of All-Union communistic community work days for the total amount of 1,2 billion rubles. At the expense of these means it is constructed hospitals on 31,2 thousand beds, policlinics on 26 thousand visits per shift, and also All-Union scientific centers — oncological, cardiological and health protection of mother and the child.
As a result of the carried-out measures security of the population with the stationary help (tab. 12) increased. And, though the number of medical institutions in connection with their enlargement in the 70th was reduced (tab. 13), the bed fund of the country considerably increased and made by the end of the tenth five-years period 3324 thousand beds, and in 1983 — 3497,5 thousand beds. Security of the population with hospital beds in 1980 made 124,9, and in 1983 - 127,9 on 10 000 inhabitants that surpasses security with hospital beds of the population of the majority of foreign countries (tab. 14).
Special attention was paid to providing country people with the stationary help. So, security with beds of city dwellers grew for the 70th years by 7%, and villagers — for 27%. The volume of stationary medical care increased: only in 1980 hospitalization was received by 62,6 million patients, and the level of hospitalization of the population for years of the tenth five-years period increased from 22,9 to 23,7% without reduction of terms of hospitalization. Events for more effective use of bed fund, improvement of succession in work of stationary and extra medical institutions were held. Power of hospitals increased that allowed to create in many of them specialized departments, more effectively to use bed fund, shots of specialists, the machinery and equipment. In many hospitals departments of an aftercare and rehabilitation were created.
Significantly also the volume of the out-patient and polyclinic help to the population extended. For years of the tenth five-years period in the country it was put into operation apprx. 500 medical institutions giving out-patient and polyclinic help to the population, their number reached 36,1 thousand (tab. 15). The number of visits of out-patient and polyclinic institutions increased by 500 million in 1980 in comparison with 1975. At the same time the volume of the medical extra hospital assistance increased in rural areas more intensively. So, if the number of the medical visits falling on average on one city dweller increased for years of a five-years period almost by 11%, then in rural areas this indicator increased by 23%.
Special attention was paid to strengthening of local service. According to the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for further improvement of national health care» (1977) disaggregation of territorial medical sites with simultaneous increase in their number was carried out. Only for 1978 — 1980 the number of established posts of local therapists increased on 9,5 thousand units, and the average number of adult population of one therapeutic site decreased by 270 people. Scheduled and medical and diagnostic maintenance in policlinics extended: St. 36% of polyclinic visits (including clinics for women and children's policlinics) were made with the preventive purposes.
Construction of the new large multi-profile policlinics and enlargement operating continued that allowed to improve quality of specialized medical care, and also equipment of out-patient and polyclinic institutions by modern medical equipment.
For improvement of advisory work and development of specialized types of the extra hospital help a significant role the organization on the basis of the large policlinics joint with multi-field hospitals, with the assistance of medical higher education institutions and research in-t played a wedge, a profile of the consulting and diagnostic centers. Activity of such centers equipped with powerful laboratory and diagnostic base, staffed by highly qualified personnel of specialists including from the faculty and research associates of in-t, allows to improve considerably quality of diagnosis, to timely develop tactics of treatment of these or those patients, promotes professional development of doctors of out-patient and polyclinic institutions. The m3 of the USSR was approved experiment of the Ministry of Health of the Latvian SSR on creation of the scientific and educational and practical associations consisting of departments of medical higher education institutions, research establishments, hospitals and policlinics.
In process of development of forms and methods of medical rehabilitation departments of recovery treatment in policlinics began to be created. Results of synthesis of experience of these departments testify to efficiency of extra hospital recovery treatment both with medical, and from the economic point of view as it promotes more rational use of bed fund and reduction of terms of disability of patients.
In 1978 association of ambulance and emergency medical service is complete. In 1980 the number of stations of ambulance made 4,4 thousand, number of established medical posts in them — 42 thousand. Specialization of emergency medical service gained further development: the number of specialized crews at the end of 1980 made 2,5 thousand (of them apprx. 1,3 thousand — cardiological). In 1980 85 hospitals of ambulance with a general power over 50 thousand beds functioned. Every year the number of graduates of the medical institutes directed to work in institutions of ambulance increased. For years of the tenth five-years period security of the population with doctors of emergency medical service increased for 30%.
Further development was gained by health protection of mother and child. Considerably the material and technical resources of obstetric and gynecologic and pediatric stationary and out-patient and polyclinic institutions became stronger: the network of children's policlinics, clinics for women, maternity homes (tab. 16, 17), children's hospitals extended, the level of specialization of bed fund, quality and volume of the extra hospital help increased. A lot of work on disaggregation of pediatric sites is carried out; in a number of the republics (the Belarusian, Georgian, Latvian, Lithuanian, Estonian SSR) the number of the children falling on one pediatric site by the end of a five-years period was finished to 870.
Improvement of medical providing workers of the industry, construction and transport continued. The network of medical and sanitary parts developed, the number to-rykh made in 1980 apprx. 1,4 thousand. The general power of hospitals of medical and sanitary parts increased since 1977 by 21 thousand beds and made 255 thousand beds in 1981. The number of shop sites increased for 1976 — 1981 by 3,1 thousand, and from 18,1 thousand shop sites over 9,5 thousand were developed on the basis of territorial policlinics that demonstrates the increased attention of bodies of health care to medical - a dignity. to service of the working industrial enterprises which do not have the medical and sanitary parts. The network of sanatoria dispensaries developed (see), the number to-rykh for years of the tenth five-years period increased by 1,2 times, and number received in them preventive treatment — by 1,5 times. Considerable work on improvement of working conditions in the industry and construction was carried out. It was promoted in many respects by implementation of the joint plan of the All-Union Central Council of Trade Unions and M3 of the USSR, and also comprehensive plans of recreational actions of 26 ministries of the USSR. More than 11 billion rubles Besides, are spent for actions for labor protection for years of the tenth five-years period 8 billion rubles are spent for production of individual protection equipment, providing a number of categories of workers with milk and lechebnoprofilaktichesky food.
In medical and sanitary parts of the industrial enterprises departments of professional rehabilitation where, in addition to a complex of medical and recreational actions, in the conditions which are brought closer to a process of manufacture by means of specially designed equipment recovery of labor skills at persons with effects of injuries and a number of diseases was carried out began to be created. Wide positive experience of such work testifies to prospects of this form of service of the working industrial enterprises.
The m3 of the USSR and the All-Union Central Council of Trade Unions was also generalized and recommended for a wide spread occurance experience of medical and engineering crews in a number of the areas of RSFSR. Creation of medical and engineering crews, in structure to-rykh, in addition to doctors medical - a dignity. parts and dignity. - epid. stations, join representatives of administration, technical personnel, the trade-union organization, Society of the Red Cross and Red Crescent, promotes more operational solution of questions of labor protection and the accident prevention, development of recommendations about mechanization and the industrial automation, implementations of the scientific organization of work, prevention of diseases and production injuries, improvements of public catering at the enterprises, increases in effectiveness of routine medical examinations etc.
As a result of purposeful work on improvement of working conditions and medical service health of workers of the industry, construction and transport improved. In 1980 indicators of temporary disability on 100 workers decreased in comparison with 1975 by 8,7% in cases and for 6,8% in days, and decrease in these indicators took place in all nosological forms. Considerably primary exit to disability decreased. Operational injuries in 1981 were reduced in comparison with 1975 in general on the national economy by 29%.
Actions for development of rural health care, improvement of medical aid to country people, strengthening of material and technical resources and completion of shots rural were carried out to lay down. - the prof. of institutions. For completion of institutions of primary and regional link of rural health care during the tenth five-years period annually 15 thousand doctors from among graduated medical institutes went for work to rural areas of the country. Special attention was paid to providing rural institutions by pediatricians, the number to-rykh for 1976 — 1980 increased by 1,5 times. Annually in in-ta and on f-takh improvements of doctors, and also on the basis of regional (republican, regional) hospitals improved skills apprx. 10 thousand doctors working at rural medical sites. For strengthening of rural health care new regular standards of medical staff of institutions of a regional link were entered that allowed to enter in addition into states of these institutions 60 thousand doctors, 80 thousand averages and 43 thousand junior health workers.
At the end of the tenth five-years period medical care to villagers was provided by more than 10 thousand regional (regional., republican), the central, regional, and local hospitals, more than 15 thousand independent or being a part hospitals of out-patient and polyclinic institutions, about 90 thousand medical and obstetrical centers.
For the 70th years along with expansion of network to lay down. - the prof. of the institutions rendering specialized medical aid were developed by improvement of completeness by their shots more rational forms of the organization of medical aid to country people. Regional (regional, republican) hospitals, average power to-rykh for the 70th years increased almost by 1,5 times and reached 813 beds in 1981, became not only the coordination centers for providing the population of rural areas with specialized medical aid, for rendering the emergency and planned and advisory help, but also active participants in each of these processes. Only in 1980 departments of the emergency and planned and advisory help regional (regional, republican) hospitals serviced about 1,4 million patients that demonstrates approach of the specialized help to country people.
Special attention was paid to strengthening of material and technical resources of the leading link of rural health care — the central regional hospitals. For The 70th the power of the central regional hospitals with the center in the cities increased for 37%, with the center in the village — for 36%. St. 15% of the central regional hospitals in 1980 had the power of 400 and more beds. Development and integration of the central regional hospitals, equipment by their necessary technical means, the diagnostic equipment and the laboratory equipment allowed to concentrate main types of the specialized stationary and out-patient and polyclinic help in borders of the administrative region. At the same time in many central regional hospitals of the Latvian, Lithuanian, Ukrainian, Uzbek SSR, a number of the areas of RSFSR certain success in increase in culture and improvement of the organization of work is achieved. Approach of the specialized help to country people in many respects was promoted by the development of interdistrict specialized departments which began in days of the tenth five-years period (hl. obr. on the basis of the central regional hospitals). Integration of local hospitals or their reorganization in departments of the central regional hospitals, rural medical out-patient clinics or medical and obstetrical centers was at the same time carried out. Average power of local hospitals for 1965 — 1980 increased by 1,4 times.
Also out-patient and polyclinic help to country people was improved. During the tenth five-years period the number of medical out-patient clinics increased in rural areas for 38,7% and made in 1980 4956. The number of stations (departments) of emergency medical service increased. In 1980 957 rural stations and departments of emergency medical service gave help at departures of more than 5 million patients. Mobile types of medical assistance (out-patient clinics, clinical diagnostic laboratories, dental and fluorographic installations) were widely used. In the late seventies for medical, social and labor rehabilitation in rural areas began to create the stationary and out-patient and polyclinic centers which are specially intended for this purpose.
Considerable experience in the organization of preventive actions is accumulated. Forms and methods of scheduled maintenance were improved, the contingents of the rural toilers who are under dispensary observation and had routine medical examinations considerably increased. Visits of out-patient and polyclinic institutions with the preventive purpose in 1980 made 40% of total number of requests of villagers for medical aid. There was an experience of the organization at livestock farms of dispensaries for improvement of rural toilers, for the prevention of various diseases.
The consistent focus was provided on development of the medical equipment, production a cut for years of the tenth five-years period increased more than by 1,5 times. Intensively the instrument making with use of coherent light sources (the laser equipment) developed. Production of the diagnostic automatic machines and the equipment for information processing supplied videoterminalakhm is arranged. The serial release of polyanalyzers, one - and multichannel electrocardiographs, electronic and membrane measuring instruments of arterial pressure, the spirometric equipment, the equipment for a blood analysis, the various ultrasonic and X-ray diagnostic equipment is mastered. Implementation of the project on the organization of service of transfer of electrocardiograms for wire and radio channels of communication in system of emergency medical service began. Remote diagnostic aids in the Saratov and Volgograd regions were successfully used. Lithuanian SSR, large districts of Moscow region. Development and release of cardiopulmonary bypasses and an artificial kidney continued. Use of the cryogenic equipment was widely adopted. The Soviet Union became the large producer of the ultrasonic equipment used in the diagnostic purposes and also for surgical and conservative treatment. Serially began to make complexes of the equipment for hyperbaric oxygenation.
Measures for fuller satisfaction of need of the population and medical institutions in medicines, to approach of the medicinal help to the population, improvement of forms and methods of work of pharmaceutical institutions were carried out. The network of drugstores increased almost by 10% and reached 26,6 thousand. Resources of pharmaceuticals and other products of medical appointment increased. New effective medical drugs were implemented into practice.
Considerable work on preparation and providing health care with qualified personnel is carried out. The number of doctors countrywide reached more than 1 million people by 1981 that exceeds one third of all doctors of the world; security of the population with doctors made 38.5 on 10 Ltd companies of inhabitants. The USSR — the country with the highest security with doctors in the world (tab. 18, 19). At the same time the advancing rates security with doctors of country people increased. So, for the 70th years the number of doctors of all specialties on 10 thousand urban population increased by 29%, and by 10 thousand country people — for 51%. Significantly also the number of paramedical staff which in 1981 made 2879.6, and in 1983 — 3035,4 thousand people increased, and security of the population with average medics reached respectively 107,3 and 111,0 on 10 000 population (tab. 20). Special attention was paid to increase in security with medical shots of the Areas of Siberia, the Far East and Far North, the Nonchernozem zone RSFSR. Enrollment of students on pediatric, dental and pharmaceutical faculties increased. Would be again organized pediatric and 12 dental f-tov, the network of institutions on training of pharmacists and druggists increased. Inclusion in medical schools increased by 22,1 thousand and reached 163,3 thousand people in 1980. The system of professional development of paramedical staff began to be created.
On the basis of successive development of scientific research the Soviet scientists-physicians made the significant contribution to the theory of medicine and practice of health care. Success in development of complex problems of clinical and preventive medicine is achieved. In practice new highly effective methods and prophylactics, diagnoses and treatments of patients with cardiovascular, oncological, viral, pulmonary, endocrine and other diseases were implemented. All-Union cardiological scientific center of the USSR Academy of Medical Sciences developed the program of prevention of arterial hypertension at industrial workers. As a result of long-term epidemiological researches scientific bases of prevention of some types of acute disorders of cerebral circulation were developed and social and economic effects of a stroke are defined; at the first stage it was succeeded to achieve decrease in frequency of this disease by 2,3 times. The encouraging results in to theoretical development of biochemical prevention of carcinogenesis were received. New data on value of genetic predisposition to development of chronic diseases of a liver and a stomach are revealed. Certain success in development of prevention of caries is achieved. The complex of means for prevention of pyodermas and allergic professional dermatosis is offered. The important place in scientific work was taken by the researches connected with specifics of working conditions and life in areas where the economy intensively developed. In this respect the big role was played by the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About further development of medical science in the Areas of Siberia and the Far East» (1979). Many works were conferred Lenin awards and the State award USSR.
Further development of the preventive direction of the Soviet health care found the reflection in strengthening of theoretical and organizational bases of such new scientific disciplines as preventive cardiology and preventive psychiatry.
For the solution of preventive tasks it was paid to improvement of forms and methods of medical examination (see), to expansion of its volume much attention. In 1980 under dispensary observation in out-patient and polyclinic institutions of the USSR M3 system about 45 million patients consisted, the general coverage of patients with dispensary observation in comparison with 1975 increased by 10,4 million people, or for 30%. In 1981 under dispensary observation there were more than 5 million patients with cardiovascular diseases, more than 2 million patients with malignant new growths, 1,5 million patients with a peptic ulcer of a stomach and a duodenum, as much patients with a diabetes mellitus, more than 1 million patients with chronic gastritis and a duodenitis.
Especially a lot of work on upgrading of medical examination and increase in coverage of the population by it is carried out in the Latvian SSR where for years of the tenth five-years period the share dispanseriziruyemy in the total number of the population increased from 57,2% up to 62,1%. The number of the patients of a therapeutic profile consisting under dispensary observation annually increased for 4 — 5%. E.g., the average number of the patients consisting on dispensary observation on one therapeutic site in policlinics of Riga for years of the tenth five-years period increased with 170 to 217. Patients with rheumatism, diabetes mellitus, nephrite, peptic ulcer of a stomach and duodenum are almost completely captured by dispensary observation had a myocardial infarction. Significantly the coverage dispensary observation of patients with pathology of bilious ways, bronchial asthma, coronary heart disease increased. Considerable specific weight among captured by dispensary observation belonged also to the persons who had acute diseases (pneumonia, myocarditis, pyelonephritis, etc.). Short-term medical examination of this contingent of patients is carried out for the purpose of early identification and treatment of possible effects and complications of the postponed diseases.
In KNTs USSR Academy of Medical Sciences together with the Kaunas institute of physiology and pathology of cardiovascular system with active participation of institutions of practical health care in the tenth five-years period implementation of the program of multifactorial prevention of coronary heart disease began. In the course of its implementation the considerable number of persons with arterial hypertension and initial stages of an ischemic disease was revealed and put on dispensary observation. Positive experience of medical examination of villagers is accumulated by bodies of health care of the Estonian SSR.
Progress in development of prevention of diseases, in carrying out medical examination of the population was reached also in other federal republics that along with creation of powerful material and technical resources of health care allowed to put the new, even more complex challenges directed to further improvement of protection and strengthening of health of the Soviet people before medical science and practice.
A lot of work was carried out to the fields of implementation of scientific bases of management of health care. Development is carried out and the industry multi-level automated system for planning and management of institutions and services of the industry — About ACS «Health care» is opened up.
One of important means of increase in efficiency and quality of work of bodies and healthcare institutions was implementation in work to lay down. - the prof. of institutions of various forms of the scientific organization of work (see). The wide experience on use of rational forms and methods of work of medical staff (a teamwork, creation of offices of pre-medical reception, the rational organization of a workplace, new forms of dispensary work, centralization of by-works, etc.) is accumulated.
The period preceding the XXVI congress of the CPSU is noted by also considerable progress in sanitary and anti-epidemic activity. Accurate work of the uniform sanitary and anti-epidemic organization created in the USSR performing functions of sanitary inspection and sanitarnoprotivoepidemichesky obsl an uzhi-vaniye consisting of a large number of the special facilities staffed by qualified personnel and equipped with the modern equipment affected its results. The huge role belongs in this activity to the sanitary and epidemiologic stations (SES) operating in all urban and rural areas of the country, in all federal republics (tab. 21).
As a part of SES the number of specialized divisions and laboratories (tab. 22) grows from year to year.
Forces and means sanitary about - tivoepidemicheskoy services in general steadily increase (tab. 23).
Activity of sanitary and anti-epidemic service is guided by the Soviet sanitary legislation (see) conferring it large powers in control of actions for environmental control (waters, air, the soil) from pollution, in supervision of the industry, construction, public catering, water supply, improvement and a design of the inhabited places etc.
In the tenth five-years period the standards (G1DK) developed by research institutes and approved by M3 of the USSR approximately for 800 pollutants of water, 400 pollutants of free air, 20 pollutants of the soil, apart from numerous official documents on rationing of a microclimate of residential and public buildings, jobs etc. already worked. On occupational health 170 normative documents regulating work in the conditions of influence of harmful production factors, more than 250 standards of safety of work were used a significant amount of the normative documents defining hygienic requirements to production and implementation of food stuffs, clothes and footwear, school furniture, wall materials and coverings, children's toys etc. These requirements were included into norms, obligatory for execution, and the rule.
Considerable expansion of the rights and duties dignity. - epid. services in the field of state a dignity. supervision defined the Resolution of Council of ministers of the USSR (1973) which approved the Provision on the state sanitary inspection to the USSR, and also other actions of party and Soviet state for environmental control (see). So, the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About additional measures for strengthening of nature protection and improvement of use of natural resources» (1978) provided strengthening of responsibility of the ministries, departments, the enterprise for pollution of the soil by industrial wastes and toxic chemicals, water sources trade and household drain waters, free air industrial emissions and exhaust gases of motor transport, for unconditional performance a dignity. - a gigabyte. norms and rules, and also implementation of measures for prevention of harmful pollutions and dumpings of the contaminated drain waters, for timely construction of treatment facilities, increase in their quality, development and development of production of new types of the equipment and devices for gas purification and a pyleulavlivaniye. It is offered to increase release of cars, the equipment, control izmeri-telnykh the devices and the automation equipment allowing to improve business of nature protection. Development of the town-planning standards providing the maximum improvement of the environment in the industrial and administrative centers is provided. The reliable legislative basis for broad carrying out effective measures for environmental control in our country is created by the Constitution of the USSR, Bases of the water, land and forest legislation, Bases of the legislation of USSR and federal republics about health care, about a subsoil, laws on protection and use of fauna, protection of free air, and also the legislative and directive acts directed to strengthening of nonconsumptive activity on certain regions and water objects of the country.
In the tenth five-years period nonconsumptive events were held in wide scales, 9,3 billion rubles of capital investments were spent for their implementation. As a result of improvement of technological processes and construction of treatment facilities emission of harmful substances in the air basin of the cities and industrial centers in 1982 was reduced in comparison with 1975 by 22,5%; pollution of the atmosphere dust, sulfur dioxide gas, hydrogen sulfide was stabilized or decreased more than to 70% of the cities. In a number of the cities incineration and waste recycling plants are put into operation. Dumping of nedoochishchenny waters at increase in insistence to extent of their cleaning decreased by 20%, was stabilized or improved a dignity. condition of the seas and number of the large rivers. The network of the centralized water supply extended, the Crimea the vast majority city is provided and rural you zhit manywhether. Water supply of the population at the expense of the water sources guaranteed in the sanitary relation increased.
Creation of nation-wide service of observation and control of the level of environmental pollution became an important measure for improvement of nonconsumptive activity. At the end of the tenth five-years period this service covered the St. 450 cities and apprx. 1,9 thousand water objects, all closed and suburban seas, and also soils of areas where means of chemicalixation rural and forestry are applied.
The MAIN DIRECTIONS of DEVELOPMENT of HEALTH CARE In the 80th. In the light of DECISIONS of the XXVI CONGRESS of the CPSU
Relying on advantages of the developed socialism and the increasing economic opportunities of our country, the XXVI congress of the CPSU planned the grandiose program of further growth of welfare, improvement of living conditions and health protection of the Soviet people. In «The main directions of economic and social development of the USSR accepted by a congress for 1981 — 1985 and for the period till 1990» it is noted that the Communist Party will consistently continue implementation of the economic strategy, the prime target a cut — steady rise in the material and cultural standard of living of the people, creation of the best conditions for all-round development of the personality.
Development of a uniform economic complex, increase in its efficiency, transition of the national economy to preferential intensive way of development create in the 80th years new material premises for implementation of the main objectives of social policy of party. The XXVI congress of the CPSU referred implementation of system of measures for increase in life expectancy and labor activity to number of the major purposes of economic and social development of the country, strengthening of health of the population. This installation is confirmed and developed in decisions of the subsequent plenums of the Central Committee of the CPSU. In such wide social plan orienting to positive net results, the task is formulated for the first time. It reflects those new conditions and opportunities, to-rye open before about-vom the developed socialism in ensuring active influence on formation, preservation and strengthening of public health.
Along with the general tasks of providing a high level of national health the party defined also the main directions of development of a health system for the 80th:
— increase in level and quality of medical providing population, further expansion of network of healthcare institutions, improvement of their structure and rational placement, improvement of providing with pharmaceuticals, tools, products of the medical equipment, transport and means of communication;
— acceleration and widespread introduction in practice of scientific and technical achievements, use of progressive forms and methods of the organization of work of medical staff;
— strengthening of work on the prevention of diseases, increase in efficiency and increase in scales of medical examination, first of all due to expansion of coverage it children, women, the working leading industries of the national economy;
— increase in production of the medical industry approximately by 1,4 times, creation and development of new highly effective pharmaceuticals, especially for treatment of cardiovascular and oncological diseases, diseases of endocrine system and development of production of semi-synthobiotics, expansion of production of the modern medical equipment.
Thus, decisions of the XXVI congress of the CPSU set the task — to considerably improve activity of bodies and healthcare institutions both in the field of preventive, and in the area to lay down. works. According to these decisions in August, 1982 the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About additional measures for improvement of public health care» is accepted. This document contains the program of further development of the preventive direction of socialist system of health protection, the system of measures for acceleration of implementation of achievements of science and technology in activity of healthcare institutions is stated, to strengthening of their material and technical resources, improvement of all types of medical aid to urban and country people, improvement of protection of motherhood and the childhood, education at citizens of a conscientious attitude to preservation and strengthening of the health (the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About additional measures for improvement of public health care» is detailed it is stated in the article Prevention primary (see).
According to headed party for strengthening of an intensive way of development of the national economy questions of more effective use and rational distribution of the main resources of health care — network of institutions, medical shots, material means, budgetary appropriations, widespread introduction of the new progressive methods of work corresponding to the modern level of development of health care and new tasks facing it, improvement of planning, organizing activity, increase in level of the management of bodies and healthcare institutions are of particular importance. For streamlining of planning of development of network of akhmbulatorno-polyclinic institutions by the Ministry of Health of the USSR in 1982 special methodical instructions are developed and distributed to the ministries and departments of the USSR, bodies of health care. They are directed to establishment of uniform policy in development of network of institutions of the extra hospital help, on definition of first priority of construction and reconstruction of out-patient and polyclinic institutions according to the actual needs of the population and perspectives of development of certain territories. The work aimed at timely implementation of construction plans and commissioning of healthcare institutions is at the same time carried out. The Central Committee of the CPSU and Council of ministers of the USSR charged to party and Soviet bodies of the republics, edges and areas, the ministries and departments to carry out additional measures for the solution of this question. Federal republics, the ministries and departments of the USSR on development of network of out-patient and polyclinic institutions. tasks in the State plan of economic and social development of the USSR since are provided 1982 According to the order of the Ministry of Health of the USSR bodies of health care of autonomous republics, edges, areas, large cities of the country monthly consider the course of construction of facilities of medical prescription and inform party and Soviet bodies, the Ministries of Health of federal republics on the course of performance of the established tasks. It is entrusted to Ministries of Health of federal republics to consider systematically results of implementation of construction plans of health care facilities and to report quarterly on results and the taken measures on the government of the republic and the Ministry of Health of the USSR.
Also measures for elimination of irregularity of distribution and increase in efficiency of use of bed fund are carried out. Actions for improvement of planning of development of the network of stationary institutions taking into account the nature of resettlement on perspective expected a demographic situation and structure of pathology of the population, and also a condition of material and technical resources of the available hospitals are implemented. In a first-priority order construction and reconstruction of hospitals in those regions of the country is carried out, where the material and technical resources of health care insufficiently fully provide needs of the population in stationary, including specialized, to the help; implementation of the development plan for network of stationary institutions due to consolidation of beds is not allowed. An important problem of economy of health care is increase in efficiency of use of hospital beds. Researches showed that the cost of the contents of the empty bed is only 25% less than the cost of a busy bed, and reduction of terms of stay of patients in a hospital for 1 day will allow to hospitalize in addition 3,5 million patients that more than on 179 thousand beds is equivalent to input of new hospitals.
For increase in efficiency of use of bed fund measures for strengthening of succession works of stationary and extra medical institutions, to expansion of volume of pre-hospital inspection of patients, improvement of system of intrahospital consultations and broader involvement of doctors of hospitals to advisory work in policlinics are carried out, to improvement of hardware to lay down. - the prof. of institutions (equipment by the medical and diagnostic equipment, etc.), to improvement of a duty of medical and diagnostic services of hospitals, creation of systems of the differentiated stationary service (group of patients on weight of a state, volume and intensity of treatment and leaving). Since 1982. The m3 of the USSR makes in a number of large hospitals an experiment on an intensification of their activity and increase in turnover of hospital beds. Depending on extent of increase in turnover of bed fund material stimulation of medical staff at the rate to 20% of the salary is provided.
In improvement of management the big place is allocated to implementation of automated control systems to lay down. - the prof. institutions, to improvement of selection, arrangement and preparation of the managerial personnel of health care. In 1981 studying of work of the ministries, bodies and healthcare institutions with a reserve of the managerial personnel is carried out. Need of federal republics for preparation of a reserve of the managerial personnel is defined. In 1983 at the Central institute of improvement of doctors there began work specially organized courses on preparation of the managerial personnel. For further improvement of management of bodies and healthcare institutions on the basis of the Central institute of improvement of doctors in 1984 the cycle of improvement of heads of bodies and healthcare institutions for modern methods of management and processings on the COMPUTER of medical and economic information will be organized. Events for improvement of preparation of the managerial personnel on places, to strengthening of departments of social hygiene and the organization of health care of medical higher education institutions and GIDUV, expansion and increase in effectiveness of scientific research in this major area of medical knowledge are at the same time held. Much attention in the eleventh five-years period is paid to questions of ideological work and moral education of the managerial personnel of health care. In the deontological plan for them the heavy responsibility connected, first, with the persistent embodiment in life of the principles of socialist health care, and, secondly, with creation of an optimum deontological situation lies in to lay down. - the prof. institutions. Moral, professional and cultural level of organizers of health care in many respects defines the nature of their activity and the general moralnopsikhologichesky climate in the healthcare institutions headed by them. Strengthening of a role of medical collective in modern health care, emergence of new moral and ethical problems in the collective made this task especially urgent. In this regard in the eleventh five-years period especially resolute fight against everything is conducted that contradicts the high principles of moral of the health worker, in a cut the leading role belongs to organizers of health care (see Ethics in medicine).
Further increase in efficiency and quality of work of medical personnel is connected with development and deployment of a complex of actions for the scientific organization of work in work of treatment and prevention facilities (see. Scientific organization of work).
Forms of participation of the public in public health care continue to be improved. Bodies and healthcare institutions receive the huge help from the commissions of health care of Councils of the People's Deputies who are comprehensively considering key problems of improvement of the industry, exercising efficient control of work of all links of health care. The big contribution to the solution of specific objectives is rendered by public councils at medical institutions, in to-rykh collective farmers, workers, heads of the enterprises, representatives of labor unions and other public organizations actively work. These forms of creative, efficient public relations in odinnad-date to a five-years period become in every possible way stronger and used not only for the solution of specific questions of improvement of medical service, but also for educational work with shots of health care, first of all by leading.
Strengthening of communication of heads of bodies and healthcare institutions with the serviced population is helped by the new form of work which is given rise in the current five-years period — reports of chief physicians before the population. Only in 1981 60 thousand such reports were heard. They were very useful. The population raises new questions, states critical remarks, helps to see what did not get to the sphere of attention of the head. This form of work in the eleventh five-years period in every possible way extends.
Mighty means of increase in labor activity and improvement of quality of work is the socialist competition which was widely adopted in staff of healthcare institutions. More than 5,5 million people participate in all its forms, from them 2,8 million people the rank «Drummer of Communistic Work» is given, more than 2 thousand staff of healthcare institutions and the medical industry are collectives of communistic work. In the eleventh five-years period new forms of a competition extend: conclusion of contracts between one-profile institutions and structural divisions, and also contracts on creative cooperation of research institutes and medical higher education institutions with institutions of practical health care. The best collectives became schools of the best practices, to-ry is implemented in other institutions taking into account their features.
Further development of forms of a socialist competition among groups of health workers is connected with the embodiment in life of solutions of June (1983), December (1983), February April and October (1984) Plenums of the Central Committee of the CPSU, to-rye open new opportunities for fight of labor collectives of healthcare institutions for upgrading and cultures of medical aid, rational use of bed fund, the hmeditsinsky equipment, operating time, implementation of new progressive methods of work.
The central link of multidimensional work on increase in intensity of health care, to improvement of all forms of preventive and to lay down. activity improvement of preparation, arrangement and use of shots, increase in their ideological and political level, improvement of labor and moral education is. «Today upgrading of medical care is put in the forefront — the member of the Politburo of the Central Committee of the CPSU, the Chairman of the board of Ministers of the USSR comrade N. A. Tikhonov said — and it is defined by use in medical practice of scientific and technical achievements, modern diagnostic methods and treatments, effective medicines. And, of course, the level of medical care in huge degree depends on professional knowledge, experience, keenness and warm-heartedness of the doctor, nurse, nurse to everyone who needs the help. It is necessary that bodies of health care, staff of medical institutions paid unrelenting attention to professional development and education of high moral qualities without which the noble profession of the physician is inconceivable» (Materials of the XXVI congress of the CPSU. M, 1981, page 106).
The maximum of attention is paid to work with shots in the specified directions in the eleventh five-years period. In modern conditions the most effective forms and methods of this work are defined by solutions of June (1983), February, April and October (1984) Plenums of the Central Committee of the CPSU.
Measures for further upgrading of training of specialists, their readiness for independent work, for improvement of selection in the highest and average medical educational institutions of professionally oriented youth are carried out. The essential role in this work belongs to preparing rooms of medical higher education institutions, the number to-rykh is in recent years expanded. One of the important directions in increase in vocational guidance of entrants is creation of conditions for inclusion in medical higher education institutions of persons of an average and junior medical staff, in the relation to-rykh since 1982 privileges for reception are established. From this contingent of entrants in 1981 — 1982 years 17 thousand people are enlisted in medical higher education institutions. In pursuance of tasks of the resolution of the Central Committee of the CPSU and Council of Ministthe ditch of the USSR «About measures for further improvement of national health care» (1977) systematically increases enrollment of students by pediatric and pharmaceutical faculties of medical higher education institutions. In 1982 on these faculties respectively 13,9 thousand and 7,3 thousand people were enlisted.
In 1982 for medical and pediatric faculties new curricula and programs are approved. Their purpose — to increase the level of ideological and moral education of students, to bring closer teaching to problems of practical health care, to strengthen communication of theoretical and clinical preparation, to increase the volume of knowledge of scheduled maintenance, to create conditions for wider use in the course of training of the results of scientific research, and also the most progressive forms and methods of practical work which were repaid in practice. For increase in responsibility of departments for training of students on the IV—VI courses creation of uniform departments on the main disciplines is carried out: therapies, surgeries, pediatrics. Practical training of students is strengthened: since February 1, 1983 for listeners of preparing rooms and students of the I—III courses during training obligatory practice as junior medical staff on patient care is entered. New curricula provided that 25% of school hours students will be directly engaged and work in policlinics and at stations of emergency medical service.
Problems of radical improvement of work of primary links of health care served as the reason of implementation of a number of measures for increase in efficiency of primary specialization in an internship. In particular, since 1982 preparation on specialties is entered: the local therapist, the local pediatrician, the emergency doctor, the emergency doctor — the pediatrician.
The unrelenting attention is paid to improvement of system of professional development of doctors and pharmacists. For 1978 — 1982 three institutes and twelve f-tov improvements of doctors are organized that the number of the doctors who are annually passing cycles of professional development from 99 to 129 thousand people allowed to increase; in 1982 cycles of improvement passed 28,6 thousand doctors of primary links of health care. Measures for further expansion of postdegree training of doctors rural medical establishment, local therapists and pediatricians, shop doctors are carried out. Their obligatory periodic recertification entered since 1982 intended for confirmation of earlier appropriated categories is intended to play an important role in increase in vocational training of doctors.
The increasing requirement on average medical staff set the important tasks of accumulation of rates of training of specialists of this category. Already in the eleventh five-years period inclusion in average medical educational institutions increases by 24 thousand people and by 1985 will be brought to 187 thousand. Implementation of this task will allow to create more proper correlation between doctors and average medics, to improve patient care in hospitals. In 1982 inclusion in medical schools grew to 176 thousand people; it is 26 thousand more, than in 1977. The resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for further improvement of national health care» (1977) provided the organization of system of professional development of average health workers. For this purpose in the country 21 schools are already open for professional improvement of workers with an average medical and pharm. education.
Special attention is paid to questions of proportional distribution of medical shots on various regions of the country according to their requirements. Level of inclusion in nek-ry medical higher education institutions is reconsidered: the advancing rates carry out preparation of medical shots in those federal republics and the areas of RSFSR, to-rye have more low supply of medical shots. So, for example, at increase in inclusion in medical higher education institutions countrywide by 7% it increased in the Kyrgyz, Tajik and Turkmen medical institutes for 33%. The number of the young specialists who are annually directed to work in institutions of primary link of health care is increased; in 1978 they made 30% of the number of release, in 1982 — 52%. 16,5 thousand doctors instead of 15 thousand going in the previous years go for work to rural areas of the country since 1983 annually.
The important place in system of measures for increase in intensity of health care is taken also by implementation of new forms of work to lay down. - the prof. of institutions, the rational combination of specialization and integration of medical aid, etc.
the General direction of all activity of health care was and remains prevention.
In the last decade of one of priorities of medical science there was a studying of origins of the most widespread noninfectious diseases and development of effective methods of their prevention and treatment. And the nosological profile of the noninfectious diseases which are subject to studying gradually extended. This change in a scientific perspective matched the general orientation of research activity to the advancing development of fundamental search works, in particular in the field of biological sciences, and also in the field of sociology that had important effects for medicine and health care. In particular, there was obvious an important role of formation at the population of an active position concerning a healthy lifestyle, failure from addictions, irrational forms of behavior not only for the prevention of individual diseases, but also for providing a high level of health in general, increases in life expectancy and creative activity. It defined need of radical review of system of hygienic education and sanitary education, correction of an educational system of younger generation, acceptance of urgent measures for fight against irrational behavioural installations at the population, proceeding from interest of socialist society in health of each citizen and the integral communication of health with a socialist way of life.
As a result of complex studying of problems of cardiology, oncology, endocrinology, pulmonology factors, influence to-rykh on an organism authentically were revealed increases probability of emergence and development of noninfectious diseases — so-called risk factors. Development of ideas of risk factors and detection of specific risk factors of emergence and development of individual noninfectious diseases opened new perspectives for increase in efficiency of preventive activity. There were premises for development and implementation of the measures eliminating or at least directly influencing the risk factors having an undoubted causal relationship with emergence and development of noninfectious diseases.
It created necessary conditions in order that in the 80th to concentrate attention of bodies and healthcare institutions on prevention of the diseases causing the greatest damage to health and a manpower of the country — diseases of bodies of blood circulation, malignant new growths, chronic diseases of a respiratory organs and some other forms of noninfectious pathology, and also acute respiratory viral infections and a viral hepatitis.
Fight against incidence of noninfectious diseases assumes implementation of measures of primary prevention, expansion of scale and upgrading of medical examination, improvement of secondary prevention, in particular early detection and timely treatment of various forms of noninfectious pathology, and also broad development of recovery treatment (see Rehabilitation). Implementation of these tasks possesses a strategic importance in development of the Soviet health care. In particular, implementation of the comprehensive program on strengthening of prevention of diseases and strengthening of health of the population is planned. The purpose of the program — not only to define the main directions of the scientific research necessary for implementation of a problem of further increase in level of public health in the country, not only to carry out specific measures for elimination of the reasons and conditions generating emergence and development of the most common forms of pathology but also to develop uniform policy of preventive activity, within a cut all variety of the held events will turn into the uniform purposeful and balanced social process. Starting point is primary prevention including effective population policy, protection and improvement of the environment, providing optimal conditions of work on modern production, formation of a healthy lifestyle, etc. here (see Prevention primary).
Further improvement of working conditions and life of the working women, implementation of a number of the actions directed to improvement of environmental control and to the solution of a complex of the problems having essential value for harmonious development of younger generation is for this purpose provided, in particular.
It is planned to improve the organization and to increase efficiency state. sanitary inspection (see) behind performance dignity. - a gigabyte. and sanitary and anti-epidemic norms and rules on production, in trade, public catering, on objects of municipal services and in child care facilities. The importance belongs to improvement a gigabyte. rationing taking into account the combined complex and combined action of various environmental factors on health of the population; criteria integral a gigabyte are developed. impact assessments of state of environment on human health. Together with the ministries and departments effective actions for protection and improvement of the surrounding environment, creation of optimal conditions in the course of training and rest of children and teenagers, to improvement of fiziologogigiyenichesky bases of the legislation on a regulation of working conditions of women are developed.
Along with it the complex actions directed to further decrease infectious, including virus and parasitic, to incidence, first of all to prevention of children's infections, viral hepatitis, acute intestinal diseases and to implementation in large industrial regions of the comprehensive program on fight against flu are systematically carried out.
In the held preventive events it is easy to see their main appointment — to influence positively the factors which are directly influencing the level and the nature of incidence of the population on formation, preservation and strengthening of public health. The specific result of this activity consists in prevention of diseases by elimination of the reasons generating them, as makes the content of primary prevention.
One of the central places in preventive activity belongs to medical examination of the population, edges is considered in modern conditions as the most important form of work on prevention of noninfectious diseases. The main device of implementation of medical examination are out-patient and polyclinic institutions: territorial and shop local service, primary links of specialized and departmental services, and for rural areas, besides, establishment of a regional link of health care. Their main efforts are concentrated on further increase in efficiency and expansion of scales of medical examination, strengthening and improvement of activity of primary links of health care for implementation of primary prevention and activation of secondary prevention of noninfectious diseases.
The increasing value gets dispensary observation for healthy people, and in process of expansion of borders of medical examination the contingents of healthy faces will constantly increase and occupy the increasing specific weight in total number of dispanseriziruyemy. In the 80th years it is necessary to complete, thus, transition from medical examination of the separate contingents to annual medical examination of all population. «It — the member of the Politburo of the Central Committee of the CPSU, the First Deputy Chairman of the board of Ministers of the USSR said that century G. A. Aliyev — exclusively serious social and political action. Its implementation will lead in the long term to creation of qualitatively new system of the organization of health care: the state will gradually undertake care about health of each citizen in its highest form — the active observation beginning until the birth and continuing throughout all life» («The medical newspaper» of December 19, 1984). Development of the program of annual medical examination of all population is defined by the order of the Minister of Health of the USSR «About preparation and introduction of annual medical examination of all population» (1983). Consecutive expansion of coverage by it children, women, the working leading industries of the national economy with gradation to medical examination of all population is provided.
The plan of researches for the eleventh and twelfth five-years periods joins the questions connected with implementation of annual medical examination of all population and directed to development and deployment of methods of early diagnosis and treatment of the revealed diseases of their use in institutions of primary link of health care; on production of necessary medical equipment; modification and additions in programs of preparation in the highest and average educational medical institutions, at institutes and faculties of improvement of doctors; development of the automated systems and their use at annual medical examination of the population etc. For development of actions and the organizational and methodical leadership in annual medical examination of all population the permanent commission of M3 of the USSR is formed.
Further development of the preventive direction of the Soviet health care, especially primary prevention, is substantially connected with the attitude of people towards the health and health of people around, with performance of norms and rules of a socialist way of life (see). It requires new statement and problem solving in the field of promotion of a healthy lifestyle and a gigabyte. education of the population. According to tasks of Party and Government the Ministry of Health of the USSR developed and approved a comprehensive plan of the main actions on a gigabyte. to training and education of the population for 1983 — 1985, a comprehensive plan of actions for promotion of a balanced diet taking into account the specified physiological standards of needs of the person for the main feedstuffs. The system of professional development of specialists of service of sanitary education is defined (see). Measures for increase in responsibility of heads of bodies and healthcare institutions for planning, an orientation and quality of sanitary and educational work, for activation of activity of houses of sanitary education, strengthening of their material and technical resources, implementation in practice of medical institutions of new effective forms and methods of sanitary education, to studying, generalization and promoting of the best practices of their work are carried out. In pursuance of resolutions of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for strengthening of fight against smoking» (1980) and «About additional measures for improvement of public health care» (1982) events for strengthening of antialcoholic promotion and fight against smoking in staff of the enterprises and organizations, in public places and at the place of residence of the population are held. Educational and educational work is combined with delivery of health care with the purpose to facilitate disaccustoming from alcohol and smoking to the persons which expressed the sincere aspiration to get rid of these addictions.
For coordination of activity of various ministries, departments and public organizations in prevention of diseases and strengthening of health of the population, development and implementation of the relevant activities, generalization and distribution of the accumulated experience at the Ministry of Health of the USSR Interdepartmental council for prevention of diseases and strengthening of health of the population is organized.
For implementation of problems of prevention, and also for improvement of medical work measures for expansion and strengthening of material and technical resources of health care are carried out. For the first two years of the eleventh five-years period at the expense of new buildings the bed fund of hospitals is increased by 126 thousand beds, out-patient and polyclinic institutions — by 267 thousand visits per shift. The number of doctors increased to 1071,2 thousand people, average medical personnel — almost to 3,0 million people. By the end of a five-years period it is planned to finish toechny fund of medical institutions to 3,6 million beds to put in addition into operation ambulatornopoliklinichesky institutions on 435.1 thousand visits per shift, to bring the number of doctors more than to 1.1 million people, and paramedical staff — to 3,1 million people.
The special role in connection with strengthening of scheduled maintenance and a problem of transition to annual medical examination of all population belongs to a polyclinic link, local service of the Soviet health care. In the eleventh five-years period rates of disaggregation of territorial sites considerably amplified. Only for 1981 the number of established posts of local therapists increased more than by 2,9 thousand units. In 1983 — 1984 the annual average gain of number of local therapists will make nearly 9,1 thousand units. For work as district doctors a large number of graduates of medical higher education institutions goes. For expansion of volume to lay down. - the prof. of work and a possibility to the population to see a doctor in time, convenient for it, streamlining of a duty of out-patient and polyclinic institutions is carried out. Much attention is paid to improvement of material equipment of out-patient and polyclinic institutions. Policlinics are equipped with modern laboratory engineering, the portable medical equipment and means of express diagnosis for inspection of patients at home.
One of ways of improvement of the extra hospital help is creation of the consulting and diagnostic centers and policlinics intended for providing opportunities to out-patient and polyclinic institutions of a certain territory to carry out highly skilled consultations concerning diagnosis, prevention and treatment. They will be organized on the basis of specialized departments of the large policlinics joint with multi-field hospitals, medical higher education institutions and research institutes of a clinical profile. These institutions have large biochemical and cytologic laboratories, X-ray diagnostic, endoscopic and functional and diagnostic departments, departments (offices) of cardiology, urology, endocrinology, pulmonology, etc., are equipped with the modern medical equipment, highly qualified specialists take part in their work. Being expression of the present stage of the integration of medical care designed to combine organizationally all forces and means of health care which are available in this territory in a uniform complex for improvement of medical and preventive providing the population, the consulting and diagnostic centers and policlinics allow more widely and more effectively, than in any large policlinic, to use the advisory help of specialists of various profile, and also modern methods and prophylactics, diagnoses and treatments and by that to increase quality and overall performance of other out-patient and polyclinic institutions. Creation of consulting and diagnostic policlinics and the centers, thus, increases availability to the population of the highly skilled diagnostic and treatment-and-prophylactic help. The advisory help appears these institutions rather quickly. So, within three days more than 80% of the addressed patients, including 40% — in day of the address receive the advisory help. In the current five-years period the network extends and the material and technical resources of these institutions become stronger. For 1983 — 1987 it will be put into operation of 317 consulting and diagnostic centers, policlinics (departments).
The principle of the most rational combination of integration and specialization of medical care is in the eighties put in a basis of expansion of network and increase in power of stationary institutions, at the same time is taken into account that extent of specialization shall be various at the different levels of health care. Such approach provides more rational use of highly qualified personnel of specialists doctors and the expensive equipment, equipment, and, eventually, serves increase in efficiency of the specialized help.
On the basis of large hospitals the network of the specialized centers of various level extends, in particular, considerable development was gained by creation of the regional centers of the highly specialized help and interdistrict specialized departments: on cardiovascular surgery, pulmonology, gastroenterology, endocrinology, nephrology, treatment of burns, microsurgery, renal transplantation, a chronic hemodialysis. The organization in each regional center and the large cities of suras to logical and slukhoprotezny offices and departments (centers) for treatment of patients with shortcomings of hearing comes to the end. In the majority regional, regional, republican and many municipal hospitals the qualified help with 27 — 30 specialties is carried out. The positive moment is development and the approval of regional standards of the out-patient and polyclinic and stationary help that allows to plan more rationally network of medical and polyclinic institutions. As a result of improvement of specialized medical aid there was an opportunity to provide on places with necessary treatment of the patients who are earlier sent for treatment to Moscow, Leningrad and other large cities. In the eleventh five-years period various services of specialized medical aid gain further development. First of all step-by-step implementation of the State program of fight against cardiovascular diseases is provided. According to it the number of divisions of cardiological service increases. To the middle of 1983 the cardiological service of the country already had at the order 12 research in-t with 3 branches, 22 clinics, 778 departments in hospitals, 3154 offices in policlinics, 800 specialized crews at stations of ambulance. Only in two years of the current five-years period the free sanatorium therapy was received by 154 thousand patients who had a myocardial infarction. By 1985 the number of cardiological clinics will increase to 73, cardiological offices — to 3,6 thousand, specialized cardiological crews — to 1578, the bed fund of cardiological departments and sanatoria will increase.
In pursuance of decisions of the XXVI congress of the CPSU and the resolution of Council of ministers of the USSR «About measures for further improvement of the oncological help to the population» (1976) construction of large oncological clinics with boarding houses and hospitals on 460 beds, enlargement of operating continues; measures for improvement of early diagnosis, medical examination and active identification of patients with predopukho the left states are carried out; the network of the centralized laboratories for cytologic researches, endoscopic offices and the mammography centers extends (see. Oncological service).
Improvement of the ophthalmologic help is carried out on the basis of performance of tasks of the resolution of Council of ministers of the USSR «About measures for further improvement of the ophthalmologic help to the population» (1978): the network of ophthalmologic advisory policlinics (departments) and dispensary departments as a part of city policlinics is expanded, the organization of laboratories of contact correction of sight and offices for selection of contact lenses, laboratories of individual eye prosthetics comes to the end; development of recent trends in surgery and microsurgery of an eye is continued; actions for prevention and treatment of glaucoma, short-sightedness, eye traumatism, vascular and other diseases of eyes are developed and are carried out. Power of stationary eye departments exceeded 50 thousand beds (see Ophthalmology).
Development of the specialized help includes expansion and improvement of services of anesthesiology, resuscitation, an aftercare and recovery treatment. The extreme importance was gained by the organization of chambers and intensive care units and an intensive care, the organization in the regional centers and the large cities of departments of an aftercare and recovery treatment, hospitals of recovery treatment. The number and power of intensive care units and an intensive care considerably will increase in the eleventh five-years period, much attention is paid to development of extra hospital recovery treatment. In 1981 the provision and regular standards of departments of recovery treatment were approved, their organization as a part of large city policlinics is provided. To the middle of 1983 358 departments of recovery treatment in large policlinics, are organized by hl. obr. in RSFSR, the Ukrainian, Belarusian, Latvian, Lithuanian, Estonian SSR, from them only in 1982 — 162 departments. The rates of work on creation of departments of recovery treatment in large policlinics are constantly increased. For control of their organization the special reporting is entered. Within 1983 — 1987 years 1175 departments of extra hospital recovery treatment will be organized. At large policlinics special cases for placement of departments of prevention in them and recovery treatment are under construction. On the basis of powerful departments of recovery treatment of large policlinics the regional, interdistrict and city centers of extra hospital rehabilitation can be organized over time. Considering the high social and economic importance of the recovery treatment promoting preservation of a manpower of the country and for acceleration of development of this type of the help the Ministry of Health of the USSR approved regular standards and issued the orders regulating work on recovery treatment of patients with effects of injuries, neurologic, cardiovascular and orthopedic diseases after neurosurgical interventions both on the sick-list, and on polyclinic stages. Along with it both in research, and in practical institutions studying of the contingents of the patients who are subject to recovery treatment, need of the population for this type of the help and development of the most rational forms of its rendering continues. Projects of hospitals and policlinics taking into account the organization of new divisions of recovery treatment are revised.
Decisions of the XXVI congress of the CPSU, resolutions of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for strengthening of the state help to the families having children» (1981) «About additional measures for improvement of public health care» (1982) provided new effective measures for development and improvement of system of health protection of women and children, decrease in incidence of women and maternal mortality, strengthening of scheduled maintenance with children, to strengthening of their health, decrease in children's incidence and mortality. Great social and economic value has implementation of the effective population policy planned by the XXVI congress providing important measures for consolidation of a family and creation of optimal conditions for a combination of motherhood to labor and public work of women, to reduction of their employment on production and in life.
The solution of the main objectives of the eleventh five-years period in the field of development and improvement of system of health protection of women and children is provided with expansion of network and strengthening of material and technical resources of extra medical and stationary obstetric and gynecologic and pediatric medical institutions, completion by their shots, implementation in practice of new more effective forms and methods of medical and diagnostic and scheduled maintenance. All this work is carried out according to the Comprehensive plan of actions for further upgrading and efficiency of medical aid to women and children of the first year of life, decrease in child mortality in the country for 1981 — 1985 years. In all federal republics on the basis of studying of level and the reasons of child mortality are developed and the long-term republican comprehensive plans directed to the solution of the same tasks taking into account local specifics are implemented. For decrease in perinatal and neonatal incidence and mortality measures for improvement of quality of medical aid in clinics for women and obstetric and gynecologic hospitals are carried out, scientific development of questions of perinatology and a neonatology is actively carried out, results of scientific achievements widely are implemented into practice.
One of the leading directions in activity of clinics for women is the differentiated system of dispensary observation for pregnant women of «risk group». The network of medicogenetic consultations gained development, the all-Union centers for medicogenetic consultation on base Ying-that medical genetics of the USSR Academy of Medical Sciences, on prenatal diagnosis in the All-Union center of health protection of mother and child, etc. are created. The material and technical resources of the stationary obstetric and gynecologic help become stronger, the number of obstetric and gynecologic beds increases. So, security with them in 1982 made about 8,5 on 10 thousand inhabitants. Such quantity of beds in combination with rational dislocation of obstetrical institutions provides wide availability of obstetric care. Power of delivery and gynecology departments in the central regional hospitals increases, interdistrict departments of an obstetric and gynecologic profile are developed. Gynecology and obstetric departments with power not less than 40 — 60 beds are developed in many regional hospitals. Equipment of obstetrical institutions improves (see Clinic for women, the Maternity home).
Further development was gained also by the pediatric help. The number of children's policlinics increases, in their 1981 there were more than 14 thousand. Special attention is paid to questions of rational dislocation of child care facilities. Work on disaggregation of territorial pediatric sites is complete in general. In 1982 it was the share of one local pediatrician on average over the country of 780 children. Indicators of scheduled maintenance of children's policlinics improve: over 50% of visits are carried out with the preventive purpose; prenatal patronage and patronage of mothers makes more than 95%; more than 85% of newborns are visited by the doctor in the first three days after an extract from a maternity home; the coverage sisterly puerperal patronage increased almost up to 97%. In 1983 under dispensary observation there were already St. 80% of the children's population of the country. In children's policlinics offices of the healthy child are organized.
Development of the stationary help to children is carried out on the basis of a rational combination of construction of large multi-field children's hospitals to the organization of children's departments in hospitals for adults. Measures for creation of step-by-step system of recovery treatment of children in policlinics and hospitals, including in departments are taken for newborns, a neurologic and surgical profile; in nurseries departments of an aftercare of children would will be organized, recovery treatment of children in specialized preschool and school institutions, summer camps of sanatorium type, sanatoria and sanatoria dispensaries for parents with children extends.
For improvement of medical care to children of rural areas the main attention is aimed at the further development and strengthening of material and technical resources of children's regional, regional, republican hospitals and central regional hospitals — the main institutions providing to rural children specialized medical care. Average power of nurseries regional (regional, republican) BC increased up to 321 beds.
The network of preschool child care facilities extends: only in 1982 preschool institutions on 540 thousand places, including in rural areas on 180 thousand places are put into operation; in constant child care facilities there were 15 million children. Since 1982 regular standards of doctors and average medical personnel for service of preschool institutions are increased. It allows to enter into states of children's policlinics in addition more than 4 thousand positions of doctors and over 10 thousand average medics especially for work with the children visiting preschool child care facilities (see Health protection of children and teenagers, Protection of motherhood and the childhood).
According to the Main directions of economic and social development of the USSR for 1981 — 1985 and for the period till 1990, developed by the XXVI congress of the CPSU, measures for ensuring further development of system of national education, creation of premises for gradation on training of children from 6-year age in a podgotovitel are carried outny classes of comprehensive schools; also additional actions for the organization of medical service of children are developed and are carried out. In particular, obligatory profound medical examinations of children 3-and 5-year age for the timely prevention and treatment of chronic diseases and their maximum improvement by the time of receipt are carried out to school; obligatory medical examination of the children coming to preparatory classes with definition of their functional readiness for receipt in school is entered; medical overseeing is established by the state of health of the 6-year-old children studying in preparatory classes of comprehensive schools and preparatory groups of preschool institutions.
In the eleventh five-years period work io to improvement of health protection and medical care of the working industrial enterprises, construction and transport is continued. According to the joint plan of the All-Union Central Council of Trade Unions and Ministry of Health of the USSR for further improvement of medical care and health protection of workers and members of their families for 1981 — 1985 the network and material and technical resources of medical and sanitary parts and sanatoria dispensaries extends, the wide range of actions for labor protection (see) and the accident prevention is carried out (see). New methods of treatment are implemented, scales of medical examination extend. As a result of the carried-out measures significant improvement of indicators of health of working various industries of the national economy is reached. Professional incidence in 1982 in number of cases decreased in comparison with 1977 by 31,8%. Primary exit of workers and employees to disability per 100 thousand working in 1981 was reduced in comparison with 1977 by 5,3%. Temporary disability in 1982 in comparison with 1981 decreased for 47,2 days on 100 working that is equivalent to daily additional appearance at work of 200 thousand workers. For further improvement of medical and sanitary providing workers of the industry, construction and transport, decrease in level of temporary disability and for more effective prevention of disability strengthening and improvement of a shop uchastkovost with an attachment of workers and employees of the enterprises which do not have medical and sanitary parts to territorial policlinics are recognized as the most perspective such measures, as the organization in medical and sanitary parts of departments of recovery treatment; this work will be complete in the current five-years period.
In the eleventh five-years period also work on further upgrading of treatment-and-prophylactic work in sanatoria dispensaries (see), to expansion in them the specialized help and recovery treatment, to the accelerated implementation in practice of their work of the most effective methods and prophylactics is continued. It is promoted by implementation of recommendations of the Commissions on health care and social security of Council of the Union and the Soviet of Nationalities of the Supreme Council of the USSR «About work of sanatoria dispensaries on protection and strengthening of health of the working industrial enterprises» (1980). The network and power of sanatoria dispensaries even more will increase in the current five-years period; only in 1982 recreational and antirecurrent treatment was received in them by about 3,2 million people.
The most important problem of the Soviet health care in the eleventh five-years period is improvement of medical service of country people. This problem acquires special relevance in connection with agrarian policy of party (see. Food programme, Rural medical site, Central regional hospital).
According to the tasks set for health care it is necessary to improve considerably providing to lay down. - the prof. of institutions by the medical equipment. In pursuance of decisions of the XXVI congress of the CPSU and the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About additional measures for improvement of public health care» the target comprehensive programs of development and production of medical equipment covering more than 30 directions of health care and medical science, such as cardiology, oncology, gynecology, surgery, pulmonology, stomatology, pediatrics, etc. are developed. The preferential attention is paid to development and improvement of the equipment for polyclinic institutions, prophylactics and early diagnosis of diseases, including the equipment and the equipment for the mass inspections providing increase in capacity of policlinics and the maximum reduction of expenses of time of patients. The important place is taken by the equipment in prevention of diseases of children of early age, teenagers, diseases of women, especially during the periods of pregnancy and motherhood, the equipment for rehabilitation, including in a dignity. - hens. networks. Distinctiveness of development of the medical equipment is creation of diagnostic automatic machines with wide use of microprocessors and micro COMPUTER, the deshifruyushchy automatic machines which are memorable means of display, terminals. Works on development of means of remote diagnosis with use of radio - or telephone communication in ambulance and in system of a domiciliary care, digital methods of transfer and data recording, digital registration of images are continued. Further development is gained by the laser and cryogenic equipment. The state committee of the USSR on science and technology and the Ministry of Health of the USSR developed the program of creation of the special equipment for the laboratory service (chemical reactants and silt sets for the microanalysis) increasing its productivity and profitability. A lot of things become regarding development of the hospital equipment, for providing treatment and prevention facilities with X-ray and fluorographic equipments, the respiratory equipment, dental installations and chairs, the perfect lighting equipment, single-channel (among them portable) and multichannel electrocardiographs, devices for an anesthesia, various types of monitor systems for continuous and long overseeing by the state of health of patients, including in the conditions of the motive and labor mode, usual for them, tools for microsurgery. For the purpose of the correct and most rational determination of level of implementation of this or that technical tool, especially expensive, the Ministry of Health of the USSR made the list of hardware for various types of out-patient and polyclinic institutions. Widespread introduction of technical means will help to solve a problem of medical examination of all population.
According to decisions of the XXVI congress of the CPSU the leading directions of scientific research in the field of medicine in the current five-years period are: knowledge of the mechanism of physiological, biochemical, genetic and immunological processes of life activity of the person, improvement of methods of prevention, diagnosis and treatment of the most widespread diseases, development of new pharmaceuticals, drugs and medical equipment. Qualitatively new accepted in the national economy — program and target planning is extended to medical researches. In pursuance of the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About further development of medical science in the Areas of Siberia and the Far East» (1979) in these areas, and also on Far North were widely developed social and hygienic and me the wild and biological researches directed to creation of optimal conditions of work and life of the local and arriving population, decrease in incidence among inhabitants of these regions, increase in level of their health on fixing and increase in a manpower in these regions.
The important place belongs to also target programs oriented to joint researches by forces of medical scientific research institutes and scientific organizations of other profile (different departments). They provide search of new pharmaceuticals, development of medical devices and devices, surgical and microsurgical methods of treatment, use of laser radiation and other scientific and technical achievements in medicine. And the Ministries of Health of the USSR are carried out by institutes of Academy of medical sciences complex researches with institutions of Academy of Sciences of the USSR and with scientific institutions of a number of the ministries and departments on the problems which are of interest to the solution of urgent problems of medicine. Step-by-step implementation of the specified programs and implementation of their results in provide to the practician the successful solution of a number of tasks of fight against the most serious and widespread illness already today, have significant effect on increase in level of public health.
For scientific justification of ways of development of health care development of the forecast of change of the state of health of the population, demographic processes, needs of the population for different types of medical care, combination of efforts of scientific all specialties for development of scientific bases of prevention of the most widespread noninfectious diseases is of particular importance. The active work in this direction which is carried out under the direction of Academy of Sciences of the USSR by the lead scientific medical institutions of the country is an important component of the comprehensive program of scientific and technical progress of the USSR for the period till 2005.
The Soviet medical science has the powerful scientific and technical and personnel capacity, the developed network of research establishments which number, including medical schools, exceeds 400. The most important problem of the current five-years period is increase in efficiency of scientific research, further improvement of their planning and coordination, bystreyshy implementation of scientific achievements in practice of health care. In this respect the work on streamlining of network of research institutes, including on enlargement and merging of low-power institutes, improvement of their structure and definition of the main activities which is carried out by the USSR Academy of Medical Sciences, the academic councils of the Ministry of Health of the USSR and the Ministries of Health of federal republics is important.
Thus, the 80th years shall be the period of the embodiment in life of the extensive program of development of the Soviet health care dictated by all process of socialist society and provided with continuous care of party of the benefit, happiness and health of the Soviet people. «Our country — the Secretary general of the Central Committee of the CPSU comrade M. S. Gorbachev at a meeting in the Central Committee of the CPSU told on April 8, 1985 — endures the responsible period, preparation for the regular XXVII congress of the CPSU is developed everywhere. This time of big affairs and important decisions, the deep analysis and realistic assessment reached, identification and elimination of the obstacles hindering advance. This time shall be filled with intense work and a courageous thought, open a scope to an initiative and creativity of people. Now it is required to increase organization in work, to mobilize all forces and reserves to provide steady and dynamic social and economic development, to accelerate rates of our advance forward.... From that, how successfully we will solve these problems, social and economic development of the country, strengthening of its defense capability, improvement of life of the Soviet people depends» («Truth» of April 12, 1985).
See also articles about health care — Out-patient clinic , Hospital , Hospital construction , Extra hospital help , Medical site , Medical examination , Legislation on health care , Health care , Communist Party of the Soviet Union , Lenin and health care , Treatment-and-prophylactic help , Health protection of children and teenagers , Protection of motherhood and childhood , Policlinic , Food programme , Prevention , Prevention primary , Rural medical site , Emergency medical service , Specialized medical care , Medical and obstetrical center ; about management of health care — Ministry of Health . Planning of health care ; about a dignity. - epid. to service — Sanitary legislation , Sanitary and epidemiologic service , Sanitary inspection , Economy of health care ; about hygiene of the environment — Environmental control , Cleaning of the inhabited places , Sanitary protection of free air , Sanitary protection of reservoirs , Sanitary patrolling ; about medical science — USSR Academy of Medical Sciences , Research institutes , about preparation of medical shots — Institutes of improvement of doctors , Medical institutes , Health care workforce , Medical schools , Medical education , Pharmaceutical education , separate articles — Resorts , Meditsina , Medical industry , Labor protection , Sanitary education , Social security and articles about federal republics (e.g., Russian Soviet Federative Socialist Republic , Tajik Soviet Socialist Republic ).
Table 1. GROWTH of EDUCATION LEVEL of the POPULATION of the USSR And FEDERAL REPUBLICS (in 1939 — 1984)
Table 2. GROWTH of the AVERAGE MONTHLY SALARY of WORKERS AND EMPLOYEES of the USSR FOR 1940 — 1983 (on average on one working, in rubles)
The table 3 DURATION of WORKING WEEK (in hours) ADULT WORKERS of the INDUSTRY of the USSR IN COMPARISON WITH PRE-REVOLUTIONARY RUSSIA
the Table 4
PAYMENTS AND PRIVILEGES RECEIVED by the POPULATION FROM PUBLIC FUNDS of CONSUMPTION In 1 94 0 — 19 83
(in billion rubles).
The table 5 GROWTH of EXPENSES ON WELFARE ACTIONS AND SCIENCE OF the STATE BUDGET AND OTHERS ISTOChNIKOV1 IN 1940 — 1983 (in billion rubles).
Table 6 DYNAMICS of NUMBER AND STRUCTURE of the POPULATION of the USSR ON the FLOOR AND the RESIDENCE (1 940 — 1 984). In comparison with PRE-REVOLUTIONARY RUSSIA (1913)
NATIONAL STRUCTURE of the POPULATION of the USSR (according to a population census of 1 979 g).
Table 8 VITAL RATES of the USSR (1940 — 1983)
IN COMPARISON WITH PRE-REVOLUTIONARY RUSSIA (on 100 0 people of the population)
the Table 9
VITAL RATES of the USSR And FEDERAL REPUBLICS In 1983 (on 1000 people of the population)
the Table 10
VITAL RATES In the USSR And SOME CAPITALIST COUNTRIES In 1983
(on 1 0 00 people of the population)
the Table 11 NUMBER of the ENTERED HOSPITAL BEDS (in 1971 — 1980).
The table 12 NUMBER of HOSPITAL BEDS AND SECURITY with THEM of the POPULATION of the USSR And FEDERAL REPUBLICS (in 1940 — 1983).
The table 13 NUMBER of MEDICAL INSTITUTIONS In the USSR II ON FEDERAL REPUBLICS (in 1940 — 1983).
The table 14 NUMBER of HOSPITAL BEDS AND SECURITY with THEM of the POPULATION of the DIFFERENT COUNTRIES Table 15 NUMBER of MEDICAL INSTITUTIONS, OKAZYVAVSHIH AMBULATORNOPOLIKLINICHESKUYU HELP (in 1940 — 1983) *
The table 16 NUMBER of CLINICS FOR WOMEN, CHILDREN'S POLICLINICS AND OUT-PATIENT CLINICS (the independent and being a part other institutions)
In 1 940 — 1983.
Table 17 NUMBER of MEDICAL AND OBSTETRIC BEDS FOR PREGNANT WOMEN AND WOMEN IN LABOR In 1940 — 1983 of (in thousands)
the Table 18 NUMBER of DOCTORS of ALL SPECIALTIES AND SECURITY with THEM of the POPULATION of the USSR of the II FEDERAL REPUBLICS (in 1940 — 1983)
The table 19 NUMBER of DOCTORS of ALL SPECIALTIES AND SECURITY with THEM of the POPULATION IN the DIFFERENT COUNTRIES 1 Including doctors of the Chinese medicine —
303 thousand 2 Only in the public medical institutions.
Table 20 NUMBER of AVERAGE HEALTH WORKERS AND SECURITY with THEM of the POPULATION of the USSR And FEDERAL REPUBLICS In 1940 — 1983 of.
The table 21
NUMBER of SANITARY AND EPIDEMIOLOGIC STATIONS In the USSR And FEDERAL REPUBLICS In 1940 — 1982 *
Table 2 2 GROWTH of NUMBER of SPECIALIZED DIVISIONS IN SANITARY AND EPIDEMIOLOGIC STATIONS of SYSTEM of the MINISTRY OF HEALTH of the USSR
the Table 23 NUMBER of SANITARY and ANTI-EPIDEMIC INSTITUTIONS AND PERSONNEL IN THEM (in 191 3 — 1982)
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