Collectivization Period Of The Rural Health System

During the Collectivism Period,the medical care and public health system in rural areas aims to meet the basic medical and health care service needs of commune members.The system is led by Party branch at the grassroots level,supported by collective economy,with commune medical team and production brigade team as organizational units,equipped with unlicensed doctors,with prevention and treatment of diseases as principle task,supervised by Association of Poor and Lower-middle peasants.It is characteristic of distinctive socialist collectivism.During the Collectivism Period,that is,from 1956 to 1965,the medical care and public health system went through three stages:firstly,agricultural cooperation period,when there coexisted collectivist policlinics,agricultural health care centers and private medical practitioners;secondly,the period of the Great Leap Forward and the movement to establish people's communes,when there is only medical institution of people's commune;thirdly,the Adjustment Period,when the medical institution was delegated to lower levels,production brigade medical care centers coexisted with private medical practitioners.In accordance with the three stages, during this period of ten years,the medical service of rural medical staff transferred from decentralized and random private behavior to institutionalized public behavior of collectivist medical institution.The transfer facilitates supervision and management of medical work and therefore help promote the widespread development of health and anti-epidemic work.However,after the Great Leap Forward,forms of ownership kept changing:great leap forward,centralization, adjustment,delegation to lower levels,streamlining,all of which left health care career in rural areas in chaos to a certain degree.Frequent changes of medical organizations at grassroots level rendered the Association of Medical Staff titular. The professional training and improvement of rural medical staff was at a standstill, the overall technical level was still comparatively low,some old prestigious doctors of Chinese traditional medicine had no worthy successors to carry the torch. Moreover,more than half of the production brigades had neither doctors nor medication,which failed to suit the new situation in rural areas and the medical needs of peasants. In 1956,Mao Zedong gave orders "the focus of medical work should be on rural areas".In autumn of the year,a large number of urban medical staff formed rural medical care work-team,went deep into the countryside and helped train semi-peasant-semi-doctors,effectively better the predicament of lack of doctors and medication in rural areas.Following it,production brigade clinics were broadly established,thus the initial formation of three-tier medical care network in rural areas.At the end of 1968,the cooperative medical system was fully affirmed by Mao Zedong.Supported by the top leader,the form of cooperative medical system during the "Culture Revolution" period was widespread,relying on production brigade in its organization form at first,then evolving into joint organization of people's commune and production brigade,or organized by people's commune.Its capital roughly comprised of fund-raising of production brigade,production team and individual farmers,and solve the problem of lack of capital and medication by employing folk doctors,making use of folk medication,plucking,planting,making and using Chinese traditional medicine.The common practice of cooperative medical system moderately satisfied the medical care needs of peasants.The rural medical care system had achieved a lot in aspects of development of team of unlicensed doctors,medical aid,preventive inoculation,instruction of patriotic public health campaign,maternity and child health care and family planning.Not only the health of peasants was institutionally guaranteed but also the wide recognition was gained from the international world.The achievement was attributed primarily to great importance top leaders attached to it,national policy tendency,self-support character of collective economy and the mechanism of "politicization" advocated by "Culture Revolution" Movement.Although some problems arose in the implementation of cooperative medical system such as malpractice and jobbery of cadres at the grassroots level and unlicensed doctors, the defects can't obscure the virtues:from the standpoint of life expectancy and infant mortality rate,the former has risen from 35 in 1949 to 68 in 1982 and the latter has dropped from 200%to20-30%,which speaks for itself that rural medical system during the collectivist period has gained remarkable achievements.In early 1980s,the rural economic system reform made the reform of rural medical system necessary by impacting on cooperative medical system and team of unlicensed doctors.But as to the issue of cooperative medical system and unlicensed doctors,the newly-issued policies were seriously out of joint with reality and couldn't be implemented.To adapt to the reality of rural medical care career,all kinds of policies had to be adjusted.As a result,influenced by tide of market-oriented reform,medical care career was involved in it.Ever since,market dominated medical care resource allocation instead of the government.The rural medical care system in collectivist period and its transformation indicates that policy makers have to attach importance to public opinions,listen to the public,protect their rights,formulate systems suiting public needs and let the public truly feel the care of government and social welfare system.In this way,can the positive image of ruling party and government be enhanced,the cohesiveness of the nation and the people be strengthened.From the perspective of scientific development and humanistic care,the people-oriented system reform option can truly guarantee health of peasants and enhance social harmony on levels of practice.