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 APPROVED FOR RELEASE: 2009/06/16: CIA-RDP01-00707R000200070023-3

'''FIGURE 27. Hospital beds by category of treatment (U/OU)''' (chart/graph)

their respective fields. Most of them have long been urging greater selectivity among candidates for medical schools in order to raise professional standards. Their efforts may have played a role in the relatively constant number of students enrolled in medical academies between the early 1950's and the late 1960's, a period when total enrollment in higher education more than doubled.

Medical practice and facilities, including ambulance and other emergency transportation, are nationalized and centrally controlled by the Ministry of Health and Social Welfare, which administers the system through appropriate sections of the provincial, district, and local government bodies. Although private medical practice is permitted, such practice is theoretically restricted by, among other factors, the requirement that physicians give priority to the daily 8 hours of work within the state system. In practice, however, many physicians earn a significant portion of needed income by private practice, and the tendency even among less well-paid persons seems to be to seek private rather than state medical services. A program of state-administered compulsory health insurance automatically covers all employees in the socialized sector of the economy and members of their families. In the nonsocialized sector, the majority of organized handicraft workers are covered, and in 1971 the system of nearly free medical and hospital care was extended to most members of the numerous private peasantry. As a result there is no major segment of the population which is not covered. Medical benefits include hospitalization, doctor's care, and dental care, all provided at nominal cost, and between 70% and 100% of the cost of prescribed medicines and drugs.

The cost of providing such medical care, as distinct from sickness and maternity benefits payable during hospitalization, is not included in the budgetary expenditures for social security programs. Rather, it is a component, not separately identified, of budgetary allocations for the public health system as a whole. These allocations, of which about 97% go for operating expenses with the rest for expansion, amounted in 1970 to an equivalent of US$1.37 billion (at the rate of US$1 = 22 zlotys).

The government maintains a system of emergency medical assistance, including stockpiles of equipment and supplies, which covers the whole country. The system includes a network of provincial, district, and local first-aid centers administered by the medical service in cooperation with the Red Cross and local civil defense organizations. Each of the 17 territorial provinces has an ambulance aircraft at its disposal, and emergency landing strips are designated in each rural district. Although the organization of emergency medical aid appears to be adequate, its facilities, and effectiveness are poor. The death rate from auto injuries, for example, is reportedly far higher than even in neighboring Eastern European countries. This is seen by senior medical officials in the government as a reflection of serious inadequacies in the ambulance system. Moreover, continuing shortages of personnel and supplies and a probable lack of communications in rural areas would further hinder the operation of the system in time of natural disaster or other crisis.

2. Sanitation and utilities (U/OU)

Although rapid strides have been made in the availability of water and sanitation services both in urban and rural areas, serious inadequacies remain. In 1950, for example, nearly half of Poland's urban areas lacked a central water and sewerage system; in 1970, between 20% and 25% of urban areas still were not equipped with these utilities. Moreover, many of the existing central waterworks and central sewerage systems are in poor condition, and a shortage of equipment for water purification exists. Except in the large cities, the potability of water remains below Western standards. In most rural areas, water is obtained from open wells, springs, and streams; contamination is frequent because of proximity to human and animal waste. During the regularly occurring flood seasons, contamination of water, even in urban areas, is widespread. As part of the consumer welfare programs of the Gierek regime, ambitious plans exist to construct water reservoirs and other flood

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APPROVED FOR RELEASE: 2009/06/16: CIA-RDP01-00707R000200070023-3