An integrated approach to health services and manpower development: the experience of Poland

After World War II, a new socio-economic policy stimulated development of industry and the socio-economic reconstruction of Poland. One of the main objectives of the new social policy was to develop the national health service so that it was available to the whole population. The most important decisions made for the health services and health manpower development in Poland were the following: 1945 -- Ministry of Health appointed as superior body responsible for organization and administration of national health services; 1951 -- Medical and Pharmaceutical Faculties become Medical Academies under the administration of the Minister of Health. Medical schools for nurses, midwives, sanitary instructors, and allied health personnel placed under supervision of the Ministry of Health; 1954 -- Sanitary epidemiological services organized and State Sanitary Inspection Act passed; 1956 -- Industrial health service organized; 1960 -- Minister of Health and Social Welfare appointed and charged with the administration of social welfare as well as rehabilitation and employment of invalids; 1971 -- Medical care and medical aid made available free of charge for the entire population, including the rural population previously not covered by health insurance system. In the years 1946--1960, a tendency towards vertical centralization prevailed in the organization and administration of the health services. Subsequently, decentralization has dominated, with a tendency to integrate health services with the social services, especially at the provincial and county levels and, more recently, in the form of the Integrated Health Service Institutions at the local level.