History of the Soviet Union
Ministry of HealthRussia
The Ministry of Health (MOH) of the Union of Soviet Socialist Republics (USSR), formed on 15 March 1946, was one of the most important government offices in the Soviet Union. It was formerly (until 1946) known as the People's Commissariat for Health. The Ministry, at the all-Union level, was established on 6 July 1923, after the signing of the Treaty on the Creation of the USSR, and was, in turn, based upon the People's Commissariat for Health of the RSFSR formed in 1917.
In 1918 the Commissariat of Public Health was established. A Council of Medical Departments was set up in Petrograd. Nikolai Semashko was appointed People's Commissar of Public Health of the RSFSR and served in that role from 11 July 1918 until 25 January 1930. It was to be "responsible for all matters involving the people's health and for the establishment of all regulations (pertaining to it) with the aim of improving the health standards of the nation and of abolishing all conditions prejudicial to health" according to the Council of People's Commissars in 1921. It established new organisations, sometimes replacing old ones: the All Russia Federated Union of Medical Workers, the Military Sanitary Board, the State Institute for Social Hygiene, the Petrograd Skoraya Emergency Care, and the Psychiatry Commission.
In 1923 there were 5440 physicians in Moscow. 4190 were salaried state physicians. 956 were registered as unemployed. Low salaries were often supplemented by private practice. In 1930 17.5% of Moscow doctors were in private practice. The number of medical students increased from 19,785 in 1913 to 63,162 in 1928 and to 76,027 by 1932. When Mikhail Vladimirsky took over the Commissariat of Public Health in 1930 90% of the doctors in Russia worked for the State.
Spending on medical services increased from 140.2 million rubles per year to 384.9 million rubles between 1923 and 1927, but funding from that point barely kept up with population increases. 2000 new hospitals were built between 1928 and 1932.
The integrated model achieved considerable success in dealing with infectious diseases such as tuberculosis, typhoid fever and typhus. The Soviet healthcare system provided Soviet citizens with competent, free medical care and contributed to the improvement of health in the USSR. By the 1960s, life and health expectancies in the Soviet Union approximated to those in the US and in non-Soviet Europe. In the 1970s, a transition was made from the Semashko model to a model that emphasizes specialization in outpatient care.
The effectiveness of the new model declined with under-investment, with the quality of care beginning to decline by the early 1980s, though in 1985 the Soviet Union had four times the number of doctors and hospital beds per head compared with the USA.The quality of Soviet medical care became low by developed-world standards. Many medical treatments and diagnoses were unsophisticated and substandard (with doctors often making diagnoses by interviewing patients without conducting any medical tests), the standard of care provided by healthcare providers was poor, and there was a high risk of infection from surgery. The Soviet healthcare system was plagued by shortages of medical equipment, drugs, and diagnostic chemicals, and lacked many medications and medical technologies available in the Western world. Its facilities had low technical standards, and medical personnel underwent mediocre training. Soviet hospitals also offered poor hotel amenities such as food and linen. Special hospitals and clinics existed for the nomenklatura which offered a higher standard of care, but one still often below Western standards.