The development of the Austrian medical system-250 years ago the "Sanitäts-Hauptnormativ", 150 years ago the "Reichs-Sanitätsgesetz"

Abstract

The first regulations of the healthcare system in the domains and cities of the German Empire were the infection and plague regulations issued in many places from the sixteenth century onwards; however, as early as 1348 the Venetian state formed precise state structures to combat the black death that had broken out in Europe at the time. These were taken over analogously and in part in the Austrian states. Defense measures against the plague became particularly important on the k.k. (imperial-royal) military frontier against the Ottoman Empire. Under Empress Maria Theresa's enlightened absolutism, the state felt obliged to provide the largest possible healthy population with the help of the medical police. The fight against smallpox in Austria is described as an example. Through the collaboration of Maria Theresia with her protomedicus Gerard van Swieten, acodification of the k.k. healthcare system was created. As aquasi preliminary attempt the Empress proclaimed the Main Medical Regulations for Bohemia in 1753, which were supplemented 2 years later by the General Health Regulations for the Austrian Littoral. The result was the comprehensive medical standard for all hereditary lands from 1770. This brought about aregulation of all healthcare professions and their use for public health. Maria Theresa's son and successor introduced afurther development of the administration in the direction of centralization and promotion of social conditions and humanitarian institutions, such as hospitals, infirmaries, childbirth houses and madhouses as well as foundling institutions and orphanages and poor and workhouses as special institutions. He was also very interested in promoting military medicine. The last major step in the development of the Austrian public healthcare system was the Imperial Sanitary Act of 1870. This is also the basis for the current structure of healthcare administration. The sanitary tasks are (and were) regulated in the legislation and enforcement of the (k.k.) State, and the federal states (kingdoms and countries represented in the Imperial Assembly) and the municipalities in, however, still existing complex division of some affairs between federal, state and local authorities.