试析19世纪50-70年代英国公共卫生管理改革

发布时间：2018-05-29 11:28

本文选题：英国 + 公共卫生管理　；参考：《四川师范大学》2017年硕士论文

【摘要】：19世纪,面对工业化带来的公共卫生环境恶化和传染病疫情大爆发的问题,英国政府加大公共卫生管理建设的步伐。19世纪30-40年代查德威克公共卫生管理改革试图增强中央的公共卫生管理权限,强化中央对地方的监督,从而提高政府公共卫生管理效率,但是“中央化”的公共卫生管理与英国自治传统相矛盾,在实践中受到地方政府抵制,公共卫生管理体系建设较为缓慢。同时,查德威克坚持以“瘴气论”作为指导思想,不重视医生意见,把环境清理作为公共卫生管理的主要方向。在实践中,他主要依靠工程师进行市政建设,忽视医学技术发展和医学理论进步,在传染病疫情控制方面缺乏效率,无力应对公共卫生危机。面对这样的困境,19世纪50-70年代英国政府调整公共卫生管理改革策略。首先,调整中央与地方在公共卫生管理方面的关系,逐步增强地方当局在公共卫生管理方面的强制性权力,构建以地方为中心的公共卫生管理体系;其次,在公共卫生管理中加强与职业医生群体合作,广泛任命医生作为卫生官,注重利用医学手段解决公共卫生问题。这一调整适应了英国地方自治传统,强化了地方政府的公共卫生管理责任,加速了地方公共卫生管理体系建设,为英国现代公共卫生管理体系形成奠定基础。同时,19世纪50-70年代职业医生逐步主导了英国公共卫生管理改革,促进公共卫生管理的“医学化”转向,为英国国民卫生服务体系的创建奠定基础。
[Abstract]:In the 19th century, faced with the deterioration of the public health environment and the outbreak of infectious diseases caused by industrialization, In the 1930s and 1940s, the Chadwick Public Health Management Reform attempted to strengthen the central authority of public health management and strengthen the central supervision of the local government, thus improving the efficiency of the government's public health management. However, the "centralization" of public health management contradicts the British tradition of autonomy and is resisted by local governments in practice, and the construction of public health management system is slow. At the same time, Chadwick insisted on "miasma theory" as the guiding ideology, did not attach importance to the views of doctors, and took environmental cleaning as the main direction of public health management. In practice, he mainly relies on engineers for municipal construction, neglecting the development of medical technology and medical theory, lacking efficiency in infectious disease control, and unable to cope with the public health crisis. In the face of this dilemma, the British government adjusted its public health management reform strategy in the 1950-70 s. First of all, adjust the relationship between central and local authorities in public health management, gradually strengthen the compulsory power of local authorities in public health management, and build a local-centered public health management system. To strengthen cooperation with professional doctors in public health management, doctors are widely appointed as health officers to pay attention to the use of medical means to solve public health problems. This adjustment adapts to the tradition of British local autonomy, strengthens the public health management responsibility of the local government, accelerates the construction of the local public health management system, and lays the foundation for the formation of the modern public health management system in Britain. At the same time, occupational doctors led the reform of British public health management gradually in the 1950s and 1970s, and promoted the "medicalization" of public health management, which laid the foundation for the establishment of the British national health service system.
【学位授予单位】：四川师范大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：K561.4

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