20世纪三四十年代国民政府公医制新探

New Exploration on the National Government’s System of State Medicine in the 1930s and 1940s

清末民初,时人已关心县乡卫生建设问题,并率先选择若干个县进行卫生试验。南京国民政府卫生部成立后,接手县乡卫生行政事业,转而开始推动县卫生院的铺设。20世纪三四十年代公医制曾引发社会各界广泛讨论,此后国民政府亦制定了公医制度。全面抗战爆发后,西南、西北地区过于落后的医疗卫生条件,引起了国民政府高层的重视,此后卫生署奉令以“公医制”之名开展县乡卫生行政组织建设,遭遇诸多困境。战后复员阶段,国民政府复有重新规划全国公医事业之举,但限于财力、人力、物力,加之时局急转直下,公医制最终潦草收场。作为一场由国民政府主导的失败的卫生行政试验,其成效与不足之处如今仍然值得再议。

At the end of the Qing dynasty and the beginning of the Republic of China,people at the time had concerned about the health construction of counties and townships,and taken the lead in selecting several counties to carry out health experiments.After the National Health Association of Nanjing National Government was established,it took over the health administration of counties and townships,and began to promote the construction of county hospitals.In the 1930 s and 1940 s,the system of state medicine was widely discussed by all walks of life,and after that the National Government formulated the system of state medicine.After the outbreak of Total War of Resistance against Japanese Aggression,the backward medical and health conditions in the southwest and northwest regions attracted the attention of the senior level of the National Government.Thereafter,the NHA was ordered to carry out the construction of county and township health administration organizations under “the system of state medicine”,which encountered many difficulties.During the demobilization period after the war,the National Government attempted to replan the national public medical undertakings.But due to the limitation of financial resources,manpower and material resources,and the rapidly deteriorating political situation,the system of state medicine finally ended abruptly.As a failed experiment of health administration presided over by the National Government,the system of state medicine’s effectiveness and shortcomings are still worth rediscussing.