英国志愿医院现代转型的历史考察(1900～1948)

A Historical Review on the Modern Transformation of the British Voluntary Hospital(1900～1948)

由教会人士与地方上层阶级捐资建立的志愿医院是英国近代医院的典型。在1948年之前,志愿医院是以救济穷人为主的慈善场所。传统医院运营机制下的资格限制、财政危机、缺乏合作等问题,成为志愿医院现代转型的内在动力;二战中紧急医院服务系统的成功运行验证了国家管理医院的必要性和可行性,为志愿医院的转型提供了外在推力。志愿医院借助医院国有化改革完成了从半封闭到普遍性、从自愿捐赠到税收支付、从慈善救济机构到专业医疗机构的现代转型,是为英国现代医院制度的开端。政府责任是英国现代医院制度建立的前提条件;健康公平是现代医院制度的核心价值。

The voluntary hospital was a typical representative of the British hospital in the early modern period. Before 1948, it was a relief and charity institution, and responsible for the sick poor. The restrictions on the qualifications of patients, the financial crisis, and poor management under the traditional hospitalism became the inner motivation for the modern transformation of the voluntary hospital. And, the emergency hospital services proved the necessity and feasibility of government management of hospitals. Through the nationalization of hospitals in 1948, from semi-closed to open, from voluntary contributions to tax payments, from charity transfer to the national health services, it was identified as the beginning of the British modern hospital system. Government responsibility the precondition of the establishment of British modern hospital system. Health equity was the core value of modern hospital system.