p In the Soviet Union health protection is regarded as one of the most fundamental functions of the state on a par with guaranteeing the citizens the right to work, rest and education. In the USSR public health is based on an extensive system of social, economic and medical measures carried out by state and public organisations. This chapter will deal with the most important principles of socialist health protection.

p The Programme of the Communist Party of the Soviet Union adopted by the 22nd Congress reads: "The socialist state is the only state which undertakes to protect and continuously improve the health of the whole population. This is provided for by a system of socio-economic and medical measures.”  [46•* 

p These lines are not a mere political declaration, for every word in them is confirmed by the practical activities of all public health services and institutions of the USSR. But the readers who are familiar with public health in other countries, especially Great Britain, may argue that these countries, too, have, for a comparatively long time, also had a state or governmental public health service, for which reason one may not justifiably speak of state health protection in the Soviet Union as a unique phenomenon. However, such reasoning is disproved upon closer acquaintance with Soviet reality.

p When we speak of the state character of public health in the USSR we imply not only the activities of public 47 health bodies and institutions, not only those of the medical services, but emphasise that all links of the socialist state system, including the public health services, take part in caring for and improving the health of all the people. Herein lies the profound significance of the above-quoted words from the Programme of the Communist Party of the Soviet Union.

p The state character of public health in the USSR is an expression of socialist democracy which, unlike bourgeois democracy, not only declares the rights of the people, but also guarantees their realisation. It is the socialist state that fulfils the function of implementing the fundamental democratic, social rights of the Soviet people. It was the socialist state that assumed immediately after the Great October Socialist Revolution, the responsibility of caring for and improving the health of the people, and built up the most extensive system of public health with free, generally available and highly-skilled medical aid.

p As was already stated above, immediately after the armed uprising in October 1917 the Revolutionary Government of the Soviet Republic issued several decrees (laws) aimed at organising public health services.

p These decrees laid the foundation for Soviet, socialist health protection. In the summer of 1918, when the first congress of medical and sanitary boards was convened, the basic organisational principles of the new system of Soviet public health were already clearly defined, namely, free, generally available and planned medical aid, a single system of state public health and extensive participation of the people in sanitation and health protection. This was discussed at the congress by N. A. Semashko and Z. P. Soloviov, the leaders of the first state central public health body—the People’s Commissariat of Health. The principles of organisation of the public health service formulated in those years still retain their significance, the most important of them being, as was already noted, its state character.

p State health protection, considered as one of the functions of the socialist state, as its duty to ensure each Soviet citizen’s right to health, also means that the health of each citizen is regarded not only as his personal affair, but as public property as well. In this sense the state care for the health of the people, i.e., the state character of public health, is opposed to the principles of the private capitalist system 48 which proclaims medical business to be a most important principle in relations between physician and patient and the main principle of the public health policy as it is pursued in capitalist countries. It is well known, for example, that the leaders of the American Medical Association, one of the largest corporated organisations in the USA, have repeatedly declared that the basic principle of public health in their country is the responsibility ol the individual for his own health and that of his dependents.

What, in concrete terms, does the state character of health protection in the USSR mean? What functions and duties of the state and its public health system are included in this conception?