HUMAN DEVELOPMENT REPORT ! BULGARIA 1996
102
health hazards. These are mainly children,
old people, invalids, the chronically ill, the
unemployed.
The relatively limited range of diseases
determining morbidity, the death rate and
invalidism, makes it possible to channel the
prevention, treatment and rehabilitation
measures selectively to them. These are the
cardiovascular diseases, the malignant neo-
plasms, the diseases of the respiratory sys-
tem, traumas and intoxication, tuberculo-
sis,
diabetes,
the sexually transmitted dis-
eases, the psychiatric disorders, some con-
tagious diseases.
The reaffirmation of the Ministry of
Health Care as the carrier of the changes
in the system of health care services is part
of the necessary changes in the health care
system. The regional health care bodies
have to be consolidated. An important step
in the reform is the elucidation of the rights
and obligations of the municipal health care
administrations. There is a strong public
anticipation that the management of the
health care establishments is to be im-
proved. There should be no delay in the
regulation of the private sector in health
care services. One of the important tasks
is the improvement of the training of the
managerial cadre of the health care ser-
vices.
The main emphasis of co-operation
among various groups and institutions has
been the understanding that the health care
system is just the initiator and co-ordinator
of actions, committing a wide range of par-
ticipants for the attainment of the funda-
mental objectives of the national health
care strategy. It is one of the responsible
factors for the health of the Bulgarian
people. The formulation of an adequate
health care policy
and its effective imple-
mentation call for a close co-operation
between the state administration of the
health care services with the trade unions
and the scientific organisations of the medi-
cal personnel
as well as with non-govern-
mental organisations on the municipal, re-
gional, district and national levels.
There is consensus in the country
about the need of the establishment of in-
surance funds in the sphere of pensions,
social welfare and health care services.
Notwithstanding the hardships of the pe-
riod of transition, the objective is the es-
tablishment of a national health insurance
system which is to guarantee the financial
provisions for the needs of the health care
services. What is needed is the further de-
velopment both of the traditional activities
related to sanitation and epidemiological
control, and of health promotion activities.
The reform of medical services has to
respect the citizens right to a choice of a
physician and a dentist within the system
of primary medical aid. An important ob-
jective of the changes is the gradual attain-
ment of equal status of the public and of
the private sectors in health care services.
For the time being, however, what is the
most important is not to allow the further
destruction of the health care system, the
further restriction of the volume and lower-
ing of the quality of the health care services
provided. Within this context, special atten-
tion should be assigned to the consolida-
tion of the primary health care services
units. The technological renovation of the
health care system is of primary importance
for the higher quality of the medical activi-
ties.
The main objective of the policy re-
garding medicines is to ensure for the Bul-
garian people effective, safe and sufficient
quantity of medicines at affordable prices.
Despite the financial hardships, certain
groups of patients or citizens will receive
medicines free of charge, or against par-
tial payment, whereby priority will be given
to life-saving and life-maintaining medi-
cines.
The development of the medical edu-
cation should comply with the require-
ments, ensuing from the reform in health
care services. The information system of
health care should be rapidly reorganized
in view of the new goals of the health care
system. An essential resource for the ac-
Urgent regulation is
needed of the private
sector of health care
services
103
REGIONAL PROBLEMS OF HEALTH AND OF HEALTH CARE SERVICES
celeration of the reforms and for the higher
efficiency of
the health care system is the
international co-operation.
The priorities orienting the work in
fulfilment of the national health care strat-
egy are as follows:
- redution of the cardiovascular dis-
eases;
- higher effectiveness of the preven-
tion and treatment of oncological diseases;
- protection of the health and life of
children and strengthening of their physi-
cal and mental endurance;
- protection of the health of women in
fertility age;
- purposeful care taken of the health
of old people, invalids and socially weak
citizens.
The implementation of the national
health care strategy calls for the most se-
rious attention being paid to the manpower
resources and to finances. Not a single
problem of the health status of individual
groups should be underestimated. The
success of the reform of the health care
services depends on a multitude of fac-
tors: on the trade union organisations, on
the work of humanitarian non-governmen-
tal organisations, on the support rendered
by the international organisations and in-
stitutions, on the medical university circles,
on the Bulgarian National Academy of
Medicine. The task is common, while its
resolution calls for combining the require-
ments of medical, economic and social
efficiency with the requirements of hu-
maneness.
Priorities of the
national health care
services strategy