本文選題：英國(guó) + 公共衛(wèi)生管理��； 參考：《四川師范大學(xué)》2017年碩士論文

【摘要】：19世紀(jì),面對(duì)工業(yè)化帶來(lái)的公共衛(wèi)生環(huán)境惡化和傳染病疫情大爆發(fā)的問(wèn)題,英國(guó)政府加大公共衛(wèi)生管理建設(shè)的步伐。19世紀(jì)30-40年代查德威克公共衛(wèi)生管理改革試圖增強(qiáng)中央的公共衛(wèi)生管理權(quán)限,強(qiáng)化中央對(duì)地方的監(jiān)督,從而提高政府公共衛(wèi)生管理效率,但是“中央化”的公共衛(wèi)生管理與英國(guó)自治傳統(tǒng)相矛盾,在實(shí)踐中受到地方政府抵制,公共衛(wèi)生管理體系建設(shè)較為緩慢。同時(shí),查德威克堅(jiān)持以“瘴氣論”作為指導(dǎo)思想,不重視醫(yī)生意見(jiàn),把環(huán)境清理作為公共衛(wèi)生管理的主要方向。在實(shí)踐中,他主要依靠工程師進(jìn)行市政建設(shè),忽視醫(yī)學(xué)技術(shù)發(fā)展和醫(yī)學(xué)理論進(jìn)步,在傳染病疫情控制方面缺乏效率,無(wú)力應(yīng)對(duì)公共衛(wèi)生危機(jī)。面對(duì)這樣的困境,19世紀(jì)50-70年代英國(guó)政府調(diào)整公共衛(wèi)生管理改革策略。首先,調(diào)整中央與地方在公共衛(wèi)生管理方面的關(guān)系,逐步增強(qiáng)地方當(dāng)局在公共衛(wèi)生管理方面的強(qiáng)制性權(quán)力,構(gòu)建以地方為中心的公共衛(wèi)生管理體系;其次,在公共衛(wèi)生管理中加強(qiáng)與職業(yè)醫(yī)生群體合作,廣泛任命醫(yī)生作為衛(wèi)生官,注重利用醫(yī)學(xué)手段解決公共衛(wèi)生問(wèn)題。這一調(diào)整適應(yīng)了英國(guó)地方自治傳統(tǒng),強(qiáng)化了地方政府的公共衛(wèi)生管理責(zé)任,加速了地方公共衛(wèi)生管理體系建設(shè),為英國(guó)現(xiàn)代公共衛(wèi)生管理體系形成奠定基礎(chǔ)。同時(shí),19世紀(jì)50-70年代職業(yè)醫(yī)生逐步主導(dǎo)了英國(guó)公共衛(wèi)生管理改革,促進(jìn)公共衛(wèi)生管理的“醫(yī)學(xué)化”轉(zhuǎn)向,為英國(guó)國(guó)民衛(wèi)生服務(wù)體系的創(chuàng)建奠定基礎(chǔ)。
[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.
【學(xué)位授予單位】：四川師范大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：K561.4

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