p The concept of the state character of public health also includes the idea of a unified public health system.

p The unity of public health in the USSR means that the country has a single system of medical services subordinated to a single central body—the USSR Ministry of Health. All public health institutions—from the smallest medical agencies supervised by surgeons’ assistants and midwives, and district hospitals in rural districts, to the largest city hospitals and research institutes—are under the jurisdiction of the USSR Ministry of Health which controls the activities of all these services and plans all measures connected with health protection in the country. In the USSR there are also so-called departmental public health services, i.e., medical institutions administratively subordinated to other ministries, such as, for example, the Ministry of Transport, the Ministry of 52 Waterways, the Ministry of Civil Aviation, and other central bodies. However, all medical institutions, regardless of their departmental subordination, have to be guided by the instructions of the USSR Ministry of Health with respect to the discharge of their direct medical functions. The Ministry of Health is thus the single co-ordinating and controlling centre.

p Every republic has its own ministry of health which oversees all health protection work in the republic. In regional and territorial centres public health problems are dealt with by public health boards which are departments of the corresponding executive committees of Soviets. While subordinated to the local Soviets, the public health institutions in the districts and regions are also guided in their activities by the instructions of the ministries of public health. It follows that in the activities and management of the public health bodies and institutions the principle of centralisation is combined with that of decentralisation and these two principles not only do not contradict each other, but, on the contrary, presuppose the unity of the public health system in the USSR as its distinctive feature. This viewpoint is correct also because the unity of Soviet public health must be conceived in a much broader sense than that of mere administration and management, because it means a unity of purpose, practical methods and general doctrines by which all medical personnel is guided in its multifarious health protection activities.

p Thus public health in the USSR is managed along two lines—the line of public health bodies and institutions under the jurisdiction of the USSR Ministry of Health and the line of state power of which the USSR Supreme Soviet is the highest legislative body and the USSR Council of Ministers is the highest executive body. As has already been noted, the Ministry of Health discharges its administrative functions through the system of health ministries of the Union Republics and their subordinate regional, territorial and city boards of health, district departments of health of large cities and head doctors of central district hospitals in the countryside. The public health bodies are, in their turn, controlled by corresponding bodies of state power. Local public health bodies and their subordinate institutions are, as a rule, run on local budgets, i.e., receive their allocations from the state budget. The ministries of health (of the USSR 53 and the Union and Autonomous Republics) are accountable to the corresponding councils of ministers.

p The state character of health protection in the USSR is also expressed in the planned development of all its services. The planned development of public health means that it is subject to the laws of planned development of the entire system of the USSR national economy. Planned development also makes it possible to avoid disproportions between health protection and the other branches ol the national economy.

p Like all the other branches of the single national economy of the USSR, health protection is being developed on the basis of state plans. There are current plans (for one year) and long-term plans determining further development of health protection as regards most important indices, such as improvement of the people’s health, expansion and improvement of medical institutions, training of medical personnel, production of medical goods, etc. The five-year plans for the development of the national economy and consequently, five-year plans for the development of public health have become a tradition. All the boards of health—from the district, i.e., small, rural hospital to the USSR Ministry of Health—take part in drawing up both the current and longterm plans. The general trend of the plan for the development of the national economy in the nearest future is elaborated by the State Planning Commission of the USSR. After approval by a session of the USSR Supreme Soviet the plan becomes law. For example, the law for all medical people of the Soviet Union, as well as for the organisations and institutions having anything to do with public health, during the past five years was the 1966-1970 Plan for the Development of Public Health.

p The 24th Congress of the CPSU summed up the fulfilment of the Eighth Five-Year Plan of Economic Development for 1966-1970 and adopted Directives for the next five years (1971-1975). Between 1966 and 1970 more than 440.000 beds were added to the country’s hospital fund. Today there are 10 beds per every 1,000 of the population. The number of doctors of all specialities grew to almost 700.000. During this period the production of the medical and pharmaceutical industries was greatly raised, and the number of hospitals, polyclinics, sanatoriums, holiday-homes, health-resort boarding houses and sports facilities greatly increased.

p Particular importance is attached to the further development of specialised medical aid in order to improve the quality of medical service. In accordance with this, large hospitals with various well-equipped departments are being built, specialised offices in polyclinics are being organised, dispensaries set up, physiotherapeutic services expanded, and other measures envisaged. The plan also determines the most important, urgent and practically necessary long-term trends of medical research, and provides the required means, research institutions and specialists.

Such are some of the concrete expressions of the state character of health protection in the USSR, which are inseparably connected with its other features, above all with prophylactic work.