A magyar közegészségügy fejlődése a közegészségügyi gondolkodás kialakulásától az állami közegészségügyi rendszer kiépítéséig

Abstract

The evolution of the system of public health institutions in Hungary was strongly affected by foreign and international examples and foreign approaches to healthcare. All over Europe, the 19th century saw an emerging institutional system of modern public health and the spread of a public heath focussed way of thinking. This naturally entailed the modernization and transformation of doctors' approach, the evolution of “the medicine of epidemics” and a shift of focus of doctors' role and general attitude, and, as a result, a “technical” and “theoretical” development of medical science and natural sciences. The change of the general healthcare and medical approach is also detected in the modification of the roles and functions of hospitals. The separation of poverty issues and hospital issues was a milestone in the institutional history of hospitals. Another crucial point was the resulting evolution of the concept of the hospital as an institution providing professional healthcare services. Hospitals were thus transformed into institutions of professional healthcare and centres of healing. The main sections of the first Hungarian Act on Public Health (1876) define the then primary focuses and fields of interest of the evolving field of public health in Hungary. The fact that environmental healthcare came to the fore may be attributed to the effect of the English public health model. In the “official” approach to public health, a shift of focus occurred in the years following World War 1. The core of the process, referred to by Johan Goudsblom as “the democratization of hygiene”, is that – through the professionalization of medical knowledge and techniques – it became possible to focus actions (previously aimed at a general environmental hygiene) to specific smaller problems, phenomena or disease types. With regard to the contemporary development of public healthcare, the role of Rockefeller Alapítvány (Rockefeller Foundation) as a factor and catalyst of development needs to be emphasized, along with the importance of the example, methodological support and, last but not least, the financial support it provided. With slight exaggeration, it could be said that between the World Wars in Hungary healthcare experts were trained with the support of the Foundation's scholarships or at the Hungarian educational institutions and specialised training programmes supported by the Foundation.