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the system of medical services for factory, plant, and mine workers in pre revolutionary Russia. The system was introduced, along with zemstvo medicine, in the second half of the 19th century. As a result of the growing workers’ movement, the government in 1866 adopted a special decree requiring industrial enterprises to include hospital facilities for workers’ inpatient treatment. Between 1882 and 1897, legislation was passed pertaining to factory inspection; in 1903, entrepreneurs were made legally responsible for workplace accidents.
In industrial medical practice, the doctors were materially dependent on industrial management, which paid their salaries. Regulations were formulated in vague terms; for example, while the special decree of 1866 required factory owners to build facilities providing one hospital bed per 100 workers, the owners could limit themselves merely to setting aside the required physical plant and equipment. The majority of entrepreneurs ignored these regulations: a quarter of a century later, only one-third of the factories affected by the legislation were found to be in compliance.
The first all-Russian congress of factory doctors, which met in Moscow in 1909, was the first congress held by members of the professional intelligentsia, numbering a majority of Social Democrats in its working group. Under the social security law of 1912, an insurance program was set up to pay the hospital expenses of insured members and, in some cases, of their families as well. However, only approximately one-quarter of all industrial workers were covered under this program; they received sick pay only from the third or fourth day of illness, and they had no insurance coverage at all in the case of an illness lasting more than 26 weeks. Insurance funds were also set up for outpatient treatment, but only ten such programs were in operation in all of Russia by 1917. Although hospitalization insurance programs bore little practical result from the medical point of view, they were important as a legal form of organization of the working class.
REFERENCESKanevskii, L. O., E. I. Lotova, and Kh. I. Idel’chik. Osnovnye cherty razvitiia meditsiny v Rossii v period kapitalizma. Moscow, 1956.
Zabludovskii, P. E. Istoriia otechestvennoi meditsiny, part 1. Moscow, 1960.
M. A. KARLOV