El Ámbito de la Gestión de la Municipalización de los Servicios de Salud

Abstract

The “municipalización”(*) as it is implemented currently, breaks elementary principles of the administration doctrine on which the NHS is based. lt creates new managerial roles, alien to the traditions and actual needs of the national health organization. The framework for the development of a local health program must be the entire health system. Each individual part of the system has an impact at different levels and all are essential for the coherente of any action. The authority needed for the coherence of any action. The authority needed for the primary care programs is delegated at these levels.The "municipalización” has distintive political, ideological and financial objectives. One of the, at a primary care level, is to make medical attention private while leaving preventive actions to the public health system, thus producing a dichotomy that breaks basic principles of integration of services.Although, the "municipalización" promotes a closer relationship with the community and contains desirable social objectives, the closeness of central State power, without a valid delagation and descentralization, equips it with unnecesary and destructivo authoritarianism. Only well studied and accepted reforms of health and municipal structures would enable the achievement of desirable outcomes of the ”municipalización".
(*) A group of administrative reforms in the areas of health and education. Administrative and financial control of these services is permanently delegated to the appointed municipality which is of absolute confidence to the central government.