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KMID : 0358119760020020115
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Journal of the Korean Public Health Association
1976 Volume.2 No. 2 p.115 ~ p.117
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SEEKING BETTER METHODS OF DELIVERY OF HEALTH SERVICES IN KOREA
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McBain, Alan E.
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Abstract
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We are taking part today in the latest of a series of meetings here in Korea on the subject of new approaches to organization and delivery of health services to the public, a subject which is probably being discussed at much the same time now in many developing and developed countries.
The reason is the growing world understanding that traditional and mostly western-based methods of providing simple health services to the majority of a population are now clearly determined to be wasteful in personnel, ineffectual, unsatisfactory, and unnecessarily expensive. We of the international agencies must share some of the blame for helping for so many years to perpetuate this unacceptable type of system in so many places, but it is encouraging that we are all now studying better methods of doing a better job, less expensively, and with more satisfaction.
We believe now that health development is part of general social and economic development, and cannot be separated from them. We believe that an increase in the prosperity of a country, particularly in its gross national product, gives no guarantee that social welfare and health services will automatically be improved, particularly for the most sensitive group of the population-the young children; we believe that community participation in any health system, either in rural or urban areas, is an essential guarantee of success. Health Services, like water supplies, cannot be just a gift from a Government; they are the subject of general community interest, contribution and participation.
We believe that there are gross imbalances in the level of health services received by various sectors of the community. There are the "elite" groups-mostly in the cities who can afford expensive, sophisticated and usually effective health care; there are the poorer groups in the cities and villages who receive no care at all, or else elementary, ineffective and some times even dangerous attention.
We believe that the planning of health services and social development is as vital as the planning of economic and industrial development, and should receive the same amount of care and expert attention from both technical and economic planners, at the same time as the main development plan is decided.
We believe that much of the wastage in delivery of health and social services around the world arises from an unnecessary and avoidable lack of coordination between Government departments and social organizations, for whom "coordination" and "cooperation" should be the main watch words if they are seriously interested in the public welfare the time, on average, spent by the doctor on each patient-because he was obliged by law to see everybody, even some one who came for a repeat prescription of a few aspirin tablets! His real medical work was minimal; his administrative work in the center and in supervision of the sub-centers was maximal-he was more of an accountant than a physician.
Perhaps a last figure that should be mentioned is that appearing in a local newspaper here in November, when it was reported that 67 out of 198 health centers had no directors Similar figures were given for sub-centers, and an enormous figure was given of staff who were temporary rather than regular employees. The same newspaper reported on the great disproportion between doctors in the cities and those in the rural areas. These figures can be repeated in almost any developing country you can mention, and it is largely for this reason that so many nations and organizations are now available for health, the most effective and widespread work for the majority of the people who need health care, this including the most important elements of preventive health care and of family planning.
I congratulate you on organizing this symposium, and I hope that the results of the discussions this afternoon as of other recent similar discussions will be summarized and presented to the distinguished planners in this country now considering the next I Five-Year Plan.
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KEYWORD
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