[Aspects of vertical management and "preference" in basic health care]

The author deals with causes of inequalities of health care in different regions. He thinks that it is due to the professional and economic management of the health services. Local decision of the Communist Party and the national committees was frequently at variance with the competence of the state health administration and thus gave preference to some types of health institutions, while others were neglected. To ensure an even development it is important to introduce more consequential vertical management. The author mentions controversies between resolutions of the Communist Party and state organs and reality in conjunction with deceiving the public by maintaining that health care is developing and improving. Actually the health services deteriorated and only narrow specialized branches developed further. The authority of general practitioners declined and so did the satisfaction of patients whose health deteriorated and whose life expectancy declined. At present the objective is to eliminate existing disproportions and restore to the general practitioner his original mission and to enable him to become a family doctor. Subsequently the author deals with the use of the doctor's working hours, inadequate function of the ambulatory services because of technical shortcomings, training of doctors and the reduced ratio of paramedical personnel per doctor.