MEDSANTRUD

MEDSANTRUD, the trade union of workers in medical-sanitary and pharmaceutical affairs, which numbered 955.6 thousand members as of October 1, 1935. As a single organization encompassing all diverse groups of medical and pharmaceutical personnel, MEDSANTRUD has no organizational parallel in capitalist countries. Standing on the ground of the international class struggle of the proletariat and setting as its goal the achievement of socialism through the dictatorship of the proletariat, MEDSANTRUD educates and mobilizes the forces of medical workers around the tasks of socialist industrialization of the country, socialist reorganization of agriculture on the principles of collectivization, and in accordance with these tasks, the organization of the entire healthcare system. The germs of MEDSANTRUD already existed in prerevolutionary Russia in the form of small, narrow craft organizations, the majority of which, however, were little revolutionary and stood apart from the organizations of the industrial proletariat. Only the October Revolution and the overcoming of bourgeois ideology among medical workers created the soil for the formation of a single trade union, initially called 'Vsomedikosantrud,' later renamed 'Med-santrud.' Until 1930, the MEDSANTRUD union included workers in veterinary affairs (veterinarians, veterinary paramedics, livestock technicians, and veterinary orderlies), united within the union in a section of veterinary workers. Tasks of the MEDSANTRUD Union. The MEDSANTRUD Union, maintaining a living connection with the working masses, relying in its work on active shock workers, volunteers, and controllers of mass grassroots control, must organize the struggle for fulfillment of the production plan, for increasing labor productivity, improving quality, fostering socialist consciousness and discipline, and for the further raising of the cultural and material level of union members. 'Concentrating their attention on questions of wages, labor norming, improvement of production and increase in labor productivity, improvement of material and living conditions of workers (labor protection, social insurance, housing, supply, nutrition, cultural services), the central committees of the unions and their intermediate levels must conduct all their work on the basis of the most serious study of the production and living peculiarities of individual professions and groups of workers and the most careful examination and investigation of complaints and statements by workers' (from the resolutions of the IV Plenum of the All-Union Central Council of Trade Unions, 1934). The VIII Plenum of the Central Committee of the union (December 1934), by enlarging the MEDSANTRUD union into 9 independent unions, placed at the foundation of its work the tasks specified by the IV Plenum of the All-Union Central Council of Trade Unions. Participation of the union in the organization of healthcare. Carrying out the tasks specified above, the union actively participates in the compilation of plans, estimates, and budgets of healthcare agencies, organizes their elaboration from below, develops counter plans, and mobilizes the creative labor upsurge of the broad masses of medical workers for the fulfillment of the plans of medical institutions, based on the full utilization of all its resources. Carrying out the directives of the Party Central Committee on strengthening the involvement of medical workers in socialist construction, MEDSANTRUD develops extensive work on attracting medical workers to mass production work, organizes production meetings in institutions. Production meetings are conducted on the basis of a special provision concerning them, which provides for voluntary participation by workers in a given medical institution regardless of qualification and position held. Production meetings deal with questions of improving service for patients, increasing the quality of medical care, the most rational use of all internal resources of the institution, proper placement of workers and establishment of workload norms, development of socialist forms of labor (socialist competition and shock work) among medical workers, proper implementation of wage policy, elimination of all shortcomings in the work of the medical institution. Implementing the decisions of the XVII Party Congress on transferring to trade unions the functions of grassroots control, MEDSANTRUD develops work on selecting from the most active workers controllers, whose functions include control over the proper storage and expenditure of food products, medicines, and all other values of the institution, the struggle against theft of socialist public property. Work on mass grassroots control is closely linked with the work of production meetings and is the most widespread form of mass participation of medical workers in managing the production activities of the medical institution. Directing the creative energy of medical workers toward fulfillment and overfulfillment of healthcare plans, the union fights to strengthen labor discipline and raise the quality of work, educating union members. Weak labor tempering among new cadres, penetration of backward petty-bourgeois sentiments among individual medical workers, and weak union-educational work by individual levels of the union were a direct cause in individual cases of bureaucracy, inattentive, insensitive attitude toward service for patients, careless attitude toward equipment and materials. In these cases, the union, along with educational work, conducting comrade-production courts over the perpetrators, took measures of influence up to expulsion from the union. The union widely develops work among workers for their submission of rationalization proposals and through production meetings exercises control over their implementation. Mass-production work is directed toward implementing the 6 historical conditions of Stalin, put forward at the meeting of economic managers in 1931, and elements of economic calculation applicable to the nature of work in a medical institution. As a stimulus for the development of competition and shock work, the bonus system is widely practiced for the best shock workers. The Stakhanovite movement, which is a result of the victories of socialism, marking a new stage in socialist competition, its highest form, served as a powerful impetus to a new upsurge in the production activity of the broad masses of medical workers. The Stakhanovite movement raised socialist competition in medical institutions to the highest level, where a broad movement of excellence developed. Work 'excellently' is spreading among medical workers. An 'excellence' worker provides excellent quantitative and qualitative examples of production work, introduces rationalization proposals and inventions, properly organizes his own labor and that of his immediate assistants, ensures maximum efficiency of work. Excellence in medical institutions is aimed at ensuring high-quality, most effective service for patients and providing them with qualified medical care. The movement of excellence has encompassed all groups of medical workers. The ranks of excellence workers are increasingly being joined by professors, physicians, paramedics, midwives, pharmacists, nurses, orderlies, and other groups of workers. In many medical institutions, the practice of conducting 'shifts of excellence workers' is implemented. The purpose of conducting 'shifts of excellence workers' is to eliminate existing shortcomings in work, raise medical care and medical service for patients to a high level, and consolidate this experience in daily work. In auxiliary institutions and enterprises—in pharmacies, laundries, kitchens, laboratories—the development of the Stakhanovite movement has produced Stakhanovites from among these workers who significantly exceed the norms established for them. The development of Stakhanovite methods of work has significantly increased the interest of workers in improving their qualifications. In this connection, technical training and passing examinations for the technical minimum have been widely developed, especially among middle and junior medical personnel. The introduction of Stakhanovite methods of work has revealed large hidden reserves and directed them toward more effective work of medical institutions. The number, qualification, material and legal position of medical personnel in tsarist Russia. The number of medical personnel in 1913 was: physicians—24,031, paramedics—27,466, dentists—4,692, dental surgeons—2,531, midwives—13,287, pharmacists—12,197, nursing and service personnel—about 70,000. In total there were about 154,000 people. In government, city, zemstvo and other institutions, a little more than 10,000 physicians were employed. The remaining physicians served nowhere and either owned their own private clinics or engaged in private practice. This fact to a large extent explains the character of the medical community at that time. Zemstvo and city administrations carried out unlimited by law exploitation of the labor of medical workers. The position of junior personnel was especially difficult. Their work lasted 13-14 hours a day, not including night duty, with a salary often only from 6 to 10 rubles a month; only some workers used housing provided by the institution. Leaves were not provided. In case of illness, salary was not retained. The working day of paramedical, obstetric, and nursing personnel averaged 11-12 hours. Hospital middle personnel usually did not have a free day per week. The salary of this personnel was 300-400 rubles per year. The pay for nurses reached 10 rubles a month in 25 zemstvos. The position of physicians was somewhat better.

The average salary of zemstvo doctors was 100-125 rubles per month. The development of 40 budgets of medical families in 1910 showed the following: the average salary of the surveyed doctors was 1,318 rubles per year, with the lowest salary being 1,104 rubles and the highest-1,680 rubles. Pharmaceutical personnel were mainly employed in private pharmacies, where there was also significant exploitation of labor. According to data from a questionnaire conducted in Petersburg in 1912 by the professional association of pharmaceutical employees, the working day with double shifts, including night duty, averaged 12.5 hours. In pharmacies where double shifts did not exist, the working day was even longer. The average salary of pharmacists was (according to data from the pension fund for 1910) 55 rubles 33 kopecks, with pharmacists receiving 107 rubles, pharmacy assistants-64 rubles 78 kopecks, apprentices-26 rubles 76 kopecks. Auxiliary pharmacy personnel (attendants) received 8-12 rubles per month, for which they also had to work night duty. The legal position of medical personnel was extremely abnormal and humiliating (see also Medical personnel). History of the professional movement of medical workers. Associations of medical workers-before the creation of M. Organization of doctors. The special position of doctors in tsarist Russia isolated them from other groups of medical workers and from the entire proletariat and contributed to the consolidation of bourgeois ideology in their midst. Their movement did not proceed along the line of creating organizations built on a class basis, but along the line of formalizing social aspirations common to the entire bourgeois intelligentsia. The zemstvo doctors showed the greatest activity, occupying a significant place among the zemstvo 'third' element. Revival in the medical profession occurred in 1905, when there were a number of their expressions of sympathy for the revolutionary movement (greetings from Moscow doctors to striking postal-telegraph employees, protests against military courts in Kronstadt, etc.). However, this movement did not go beyond the demands common to the entire bourgeois intelligentsia. When the proletariat took the leading role in the revolutionary movement, the intelligentsia recoiled from the revolution and made a deal with tsarism. Doctors also took this path in 1905. The socio-political position of doctors before 1917 was formalized at the Pirogov congresses convened from time to time. While officially appearing as apolitical, these congresses actually adhered to the political line of liberal bourgeoisie. After the February Revolution, doctors began to build new organizations closer to the type of trade unions. In March 1917, unions of doctors from hospital institutions, city service emerged in Petrograd; somewhat later-doctors of the army and navy, railway hospital funds, factory and plant, etc. In May 1917, these small unions merged into the Council of the Professional Union of Petrograd Doctors. Along with doctors serving in city, zemstvo, and state institutions, the Council also united doctors engaged in private practice, as well as owners of private clinics. Similar organizations arose in other cities. In Moscow, a trade union of Moscow and province doctors was formed, consisting of nine autonomous sections. The October Revolution was met with sharply negative attitudes from medical organizations, as well as from the majority of the medical profession, especially the urban one. In some places, particularly in Moscow, some doctors participated in the sabotage of city employees and went on strike with them, protesting against the transfer of power to the soviets. Individual medical unions at this time united into the All-Russian Union of Professional Associations of Doctors (VSPOV), which set itself the task of developing issues of public medicine and protecting the professional interests of doctors. VSPOV firmly held a caste position, striving to maintain the position that doctors held under the bourgeois system. It did not trust the existing Soviet health authorities and sought to win independence from them. On the question of uniting with other unions of medical workers, VSPOV also took a sharply negative position. When M. was formed, the delegate assembly of VSPOV decided: 'to propose to all doctors (already in the union) to immediately leave the union Vsomedikosan-trud; to form a cadre of agitators, directing their activities against the union; to increase membership fees for expenses on agitation.' A stubborn struggle began, which ended in the defeat of VSPOV. At the end of 1919, it was dissolved by a resolution of the VTsSPS, and in August 1920, the I Congress of doctors formalized their entry into M. and the formation of the medical section within it. Societies of feldshers. Feldshers showed greater activity in building professional organizations. As early as the early 1880s, a society of feldshers 'Mutual Aid' was formed in Odessa. Later, a similar organization arose in Moscow. The associations of feldshers in their initial period pursued mainly the tasks of mutual aid. The latter developed in the following directions: a) allowances and scholarships for the upbringing of children; b) funeral allowances for the families of society members and c) allowances for widows and orphans. The Moscow society also cared about finding positions for its members. Subsequently, feldsher societies focused mainly on regulating the legal position of feldshers. They did not engage in direct struggle with city and zemstvo administrations to improve the working conditions of feldshers; they submitted reports and petitions to departments on legal issues. Revival in the professional movement of feldshers occurred in 1905, when, in connection with the general revolutionary upsurge in the country, there were a number of open clashes between them and the administrations of institutions. In April 1905, the first delegate meeting of representatives of feldsher societies was held in Moscow; it was decided to create an all-Russian union and convene an all-Russian congress of feldshers. In September 1905, the second delegate congress was held in Kiev, at which the charter of the union of societies of physician assistants was approved. The ensuing reaction stopped the further growth of these organizations and the development of their activities. Gradually, all leadership passed to delegate congresses, which were convened 4 times between 1910 and 1917. Before the revolution, feldsher societies united about 4,000 members. After the February Revolution, feldsher societies began to rapidly reorganize along the lines of workers' trade unions, connected with inter-union centers, sent their representatives to soviets of workers' deputies, etc. The political position of these organizations was generally as follows: they supported the Provisional Government and had a negative attitude toward the dictatorship of the proletariat and the power of the soviets. Company feldshers had their own independent organizations, created soon after the February Revolution and having a semi-military character. Their main task was to regulate the procedure for military service of company feldshers. This group as a whole was more revolutionary. Union of Sisters. From the beginning of the February Revolution of 1917, separate initiative groups of 3-4 sisters working in the army began to form spontaneously. The first initiative group was organized on the western front in February 1917, and in April a front congress was convened. In March, a similar group arose in Leningrad, in April the Moscow department of the union was organized, and in early May a union was created on the southwestern front with a board in Kiev. In June, the first congress of sisters of the northern front was convened, and in August the first congress of sisters of the Caucasus was held. Gathering at the congress of workers of the Red Cross, representatives of individual sister organizations agreed at a special meeting to convene the I All-Russian Congress of the Union of Sisters, which was convened in August 1917. The central board elected at the congress worked in the direction of uniting all sisters. It succeeded in February 1918 in introducing in the Commissariat of Labor provisions on working conditions and wage norms and a number of other measures. Subsequently, lekpomy joined this union. At the time of the merger, the union united 56 departments with coverage of about 18,000 people. Unions of pharmacists. Organizations of pharmaceutical employees already existed at the end of the 19th century. These were mainly mutual aid societies. In Moscow in 1895, the Russian Pharmaceutical Mutual Aid Society was created, which existed until the February Revolution. The unification of employees was mainly facilitated by acute dissatisfaction with the harsh working conditions. In 1892, a strike occurred in the large pharmacy of Frein in Moscow on the issue of depriving employees of percentages from income, which they had previously received. The strike ended in defeat for the employees, and some of them were forced to leave work. Gradually, the number of such conflicts increased. In 1902, the Northern Pharmaceutical Society was formed in Petersburg. The pension and assistance fund created in 1889 was of great importance for the movement of pharmaceutical employees and for awakening their activity. A stubborn and prolonged struggle flared up around the fund. Employees set themselves the goal of displacing pharmacists from the management of the fund and taking it into their own hands. In connection with the struggle for this fund, employee organizations won the sympathy of the entire mass of pharmaceutical workers.

The Revolution of 1905 fundamentally changed the previous direction of activity of these organizations. A wave of strikes swept across the country in pharmacies, leading to a significant improvement in the position of employees. The main demands in the strikes were: double shifts and reduction of the working day to 6 hours (excluding night duty), compensation for night duty with a free day, and an increase in wages. In addition to the economic struggle, pharmaceutical employees also participated in political strikes, had their representatives in the St. Petersburg Council of Workers' Deputies, and joined inter-union associations. During the period of reaction, organizations of pharmaceutical employees survived only in a few major centers. The journal 'Life of the Pharmacist', which first appeared in Kiev and then in St. Petersburg, played a major role during this period. After the February Revolution, societies of pharmaceutical employees were reorganized into unions of pharmacy employees. Their membership reached 4,798 people. At the same time, a campaign began to improve working conditions and increase wages. Strikes occurred in a number of cities. In St. Petersburg, pharmacies did not work for more than a month, in Moscow for 14 days. In August 1917, the First All-Russian Congress of Pharmaceutical Employees was held, which founded the All-Russian Organization of Pharmacy Workers. At this time, the slogan of municipalization of pharmacies gained great popularity among employees. Politically, the organization of pharmacy workers at this time also supported the Provisional Government and had a negative attitude toward the power of the soviets. Only after the October Revolution, starting from mid-1918, they gradually took the position of the dictatorship of the proletariat, and the leadership of the union began to pass to the Bolsheviks. Movement of junior personnel. The voice of junior medical personnel-orderlies, nurses, nannies, attendants-was completely unheard before 1905. The Revolution of 1905 gave an impetus to the strike movement among junior medical personnel. However, these demonstrations took place only in major centers. The movement reached its greatest development in St. Petersburg. It covered all major city hospitals. Demands were put forward for the implementation of hospital autonomy, i.e., collective management of hospitals on an elective basis, an increase in wages, improvement of housing conditions, better treatment, abolition of fines, etc. In individual cases, they demanded the removal from service of administrators who oppressed junior personnel. This movement led to some improvement in the position of junior medical personnel. Fines were abolished, wages were somewhat increased. The defeat of the Revolution of 1905 meant for hospital workers a return to previous forms of exploitation and disenfranchisement. Their position became even worse during the war. Hospital institutions underwent hidden militarization. After the fall of autocracy, these workers therefore showed great energy in building their organizations. In March and April 1917, a number of unions of this personnel had already emerged, which from the very beginning took a revolutionary path and were under the leadership of the Bolsheviks. These organizations were just as conscious in their approach to the question of creating a single union of medical workers, built on production principles, in which they actively participated. Creation of M. After the October Revolution, when under the leadership of the Bolsheviks trade unions began to energetically carry out reorganization on the basis of the consistently implemented production principle, this process also captured the unions of medical workers. The VTsSPS recognized the need to unite the latter into a single union. This line met energetic support from the feldsher organizations. In the fall of 1918, the first united conference of the then existing unions of medical workers was held. Organizations of physicians, pharmacy and veterinary workers refused to unite at that time. The final formation into a single union took place at the I congress, held 2-7/XI 1919 in Moscow. At the end of 1919, the unions of pharmacy and veterinary workers changed their position and recognized the need to merge into the single union organization. This was implemented at the II congress of the union in 1920 (25/XI-2/III), by whose resolution the pharmacy and veterinary sections were created. In August 1920, at the I congress of physicians, the entry of physicians into the single union and the creation of the medical section was also formalized. However, this entry was formalized with certain reservations: the I congress of physicians adopted a resolution which emphasized that physicians were not affiliated with the political position of the union, since they were entering it as a 'non-partisan organization,' and that 'they consider the decisions of union congresses binding on themselves in the order of professional discipline.' Having joined the union, the medical majority thus retained a hostile political line toward the union. This was particularly evident at the II congress of physicians, held 10-14/V 1922, when the congress openly and explicitly appeared as an opponent of the union and its political position and recognized the need for a 'decisive change in the policy of the union in the direction of abandoning the methods previously used for carrying out party policy to the detriment of purely professional work.' The decisions of the congress caused an outburst of indignation throughout the union and met with a united rebuff. Among physicians, a stratification soon began, which led to a change in the political position of the section. At the III congress in October 1924, the latter fully joined the political position of the union. This congress thus completed the unification of all groups of medical workers on the basis of Bolshevik principles of the labor movement. Composition of the union. The movement in the numerical composition of the union is characterized by the following data (in thousands): Table 1. Date Number of members Date Number of members 263.4 414.8 581.4 334.3 832.7 851.3 408.8 410.7 517.5 548.5 568.6 1/X 1930 1/X 19.11 » 1/X 1932 » 1/X 1933 » 1/I 1934 » 1/VII 1934 » 1/X 1934 » 1/IV 1930 » 1/VII 1935 » 1/X 1935 » 580.6 620.9 707.0 773.8 783.7 847.7 852.1 897.3 933.3 955.6 During the Civil War, the membership of the union grew rapidly, reaching 600,000 people by the end of 1921. From the end of 1921 and the beginning of 1922, the membership decreased significantly, reaching slightly more than half by the end of 1923. The main reasons for such a sharp reduction are: a) curtailment of some military-sanitary institutions, consequently a decrease in the number of workers; b) reduction of staff in civil medical-sanitary institutions, which were to a large extent 'bloated'; c) conduct of re-registration and exclusion from the union of persons who had switched to other occupations and left work in medical institutions. From the beginning of the restoration period, and especially from the beginning of the reconstruction of the national economy, the successful course of socialist construction ensured the continuous growth of the network of health care in the country, which led to a steady increase in the membership of the union. The number of women in the union increased from 59% in 1923 to 71.2% on 1/I 1935. During the period 1923-29, there was a significant number of unemployed among union members, reaching 80,000 people in 1928, or 15% of the entire union membership. There was also a large number of unemployed physicians in cities, despite the fact that staff positions in medical districts in rural areas and in remote regions remained unfilled. From the second half of 1929, unemployment among medical workers rapidly decreased. This reduction was due to the steady growth of the health care network, based on the overall growth of the entire national economy. At present, unemployment has not only been completely eliminated, but there is an acute shortage of medical workers, especially qualified ones. Organizational structure of the union. The primary cell of the union-the local committee-is created in all institutions with 25 or more workers. In larger institutions, in addition to the local committee, trade union organizers are created by departments. In institutions with fewer than 25 workers, a trade union representative is elected, who performs the functions of the local committee. In areas uniting 2 or more collective farms, district committees are created, which exercise direct leadership of lower-level organizations by the Central Committee of the union. On the basis of the resolution of the IV plenum of the VTsSPS, stemming from the decision of the XVII Congress of the VKP(b) on bringing leadership closer to the localities, a fundamental reorganization of the union organization M was carried out. As a result of this, the union was decentralized, and 9 independent Central Committees of the union were created for the republics-RSFSR, Ukrainian SSR, BSSR, Georgian SSR, Azerbaijani SSR, Armenian SSR, Uzbek SSR, Tajik SSR, Turkmen SSR; each Central Committee is directly subordinate to the VTsSPS and its center is located in the corresponding republican center. The number of medical workers (in thousands) by individual republics-see table 2. Table 2. Union republics RSFSR Ukrainian SSR BSSR Georgian SSR Armenian SSR Azerbaijani SSR Uzbek SSR Turkmen SSR Tajik SSR Total 1/X 1/IV 1/VII 1/X 1934 1935 1935 1935 604.5 631.9 660.1 676.2 161.1 172.0 169.6 179.4 18.2 20.1 21.0 21.8 21.5 23.5 24.5 25.0 4.2 4.2 4.4 4.7 15.2 15.7 16.3 16.4 20.0 22.2 24.1 24.3 4.3 4.5 4.6 4.8 3.1 852.1 3.2 3.7 3.0 897.3 938.3 955.6 Under the union there were sections of physicians, pharmacy and veterinary workers, with the first 2 sections liquidated at the beginning of 1930, and the section of veterinary workers transferred to another union.

At present, for the better service of individual professions, sections of physicians and pharmacists have been reorganized within the MEDSANTRUD union; the latter differs from the previously existing section of pharmaceutical workers in that it includes only pharmacists, whereas previously all pharmaceutical workers were included, including packers, cashiers, etc. The composition of medical workers by profession can be seen in Table 3. Table 3. Professional composition of workers united by the union as of January 1, 1934. Name of profession Medical doctors .... Dental doctors ....... Orderlies and midwives . Medical sisters........ Pharmacists ....... Orderlies and nurses ... Other service personnel ......... Total workers . ! Total members of the union . Including students . 53 705 7 175 41 040 77 821 15 633 151 482 1G2 539 514 395 516 007 49 4S8 Georgian SSR Azerbaijani SSR Armenian SSR 20 075 176G 2 355 17 044 1 607 16 585 2 808 2 486 2 282 5 994 58; 41 0»1 5 525 4 812 5 011 43 750 4 541 4 312 3 685 1 100 149 895 17 462 15 790 14 659 3 438 147 907 16 353 18 024 14 836 3 975 13 453 2 488 Uzbek SSR Tajik SSR Turkmen SSR On rail transport Total in USSR 6 559 94 342 56" 11 844 4 6', 6 68 879 2 371 Б7С 6 310 112 504 1 556 26 393 4 7C0. 1 616 12 815 232 183 5 137 1 012 12 393 240 130 16 203 3 692 5 4C9 45 332 786 275 15 986 3 118 4 454 43 033 783 698 1 808 - - 70 963 collectives having the right to a local committee, district committees (raykom) are created. In small districts and cities, district groups-city groups are organized. In regions, territories, and republics, corresponding regional (territorial, republican) committees of the union are created, which are the highest union bodies of the region (territory, republic). The leading body of the union is the central committee (TsK of the union). Until 1934, there was one TsK, which united medical workers of the entire USSR. However, its unwieldiness deprived it of the possibility of ensuring proper work; throughout the USSR, MEDSANTRUD unites: 41 regional, territorial, and republican departments, 26 road committees on rail transport, 1,910 city and district organizations, 11,623 local committees, and 306 trade committees at higher educational institutions and technical schools. Union bodies - local committees, district groups - are elected at a general meeting of union members by institutions and districts, raykoms and city committees - at district and city conferences, while regional committees (territorial committees) and the TsK of the union - at regional (territorial), republican congresses, before which they report. Term of office: for local committee, district committee - 1 year, for regional and central committees - 2 years. In addition to the paid apparatus of union organizations, volunteer activists are widely involved in all union levels from local committee to TsK. A significant growth of the volunteer activist force occurred as a result of the implementation of the decisions of the 4th plenum of the VTsSPS, which established a reduction of the apparatus by 42% at the TsK and middle levels and the attraction of volunteers to daily union work. Wages of medical workers and its regulation. Regulation of wages is carried out through state norm-setting for medical workers of institutions on the state and local budget, which eliminates the unevenness in payment of homogeneous groups. Regulation of wages for medical workers of institutions on commercial accounting is carried out through the conclusion of general agreements and collective contracts. Wages of medical workers grow from year to year. In addition to base rates, periodic supplements are established: for doctors working in rural areas, 20% for every 3 years of work, in addition for all workers of psychiatric hospitals, for doctors of sanitary organizations and medical workers working in remote areas. However, the level of wages of medical workers remained low and leveling was present in the system itself. In 1935, on the initiative of Comrade Stalin, wages of medical workers were significantly increased. The historic resolution of the USSR Council of People's Commissars and the VKP(b) Central Committee of March 4, 1935, which is a major stage in the construction of Soviet healthcare and creates the prerequisites for its further growth, provides for, in addition to a significant increase in rates, in some cases by 100% and more*, also the complete elimination of leveling, creates a difference in wages between more qualified and less qualified workers, creates an incentive for workers to systematically improve their qualifications. The growth of wages of medical workers, provided for by the resolution of the USSR Council of People's Commissars and the VKP(b) Central Committee of March 4, is characterized as follows: for doctors, the wage rate ranges from 275 rubles to 750 rubles, which is about 460% compared to the 1924 rate. For middle medical personnel, the rate ranges from 135 rubles to 300 rubles and is about 500% compared to the 1924 rate. For junior medical personnel, the rate ranges from 00 rubles to 120 rubles and is about 450% compared to the 1924 rate. In addition, a percentage bonus is established for workers in infectious, psychiatric institutions, for workers in the most remote areas of the Soviet Union. The Union M., carrying out great work to ensure the correct implementation of the new wage rates, links this work with measures to strengthen labor discipline, proper organization of labor in medical institutions, and improvement of the quality of care and service for patients. Working hours, rest and protection of ^labor. For medical workers in the USSR, the shortest working day is established compared to the level of the working day for medical workers in capitalist countries. The length of the working day in the USSR established for a doctor ranges from 4 to 6 hours a day, for a paramedic, midwife and medical sister - from 4 to 7 hours a day, for junior medical personnel and service personnel - 6-8 hours. The level of the working day is determined depending on the conditions and nature of work in the institutions. In institutions where work is associated with great stress and care in work (in psychiatric, X-ray, tuberculosis and other institutions), a shorter working day is established. A shortened working day is also established for work at night. Medical workers enjoy, by virtue of their work, annual two-week vacations. In addition, the law provides for additional vacations for workers in X-ray, psychiatric, infectious institutions, for laundresses and other workers, as well as for doctors and middle medical personnel working in rural areas and remote locations. During vacation time, the worker's wage is preserved, paid by the institution when going on vacation. In accordance with current legislation and collective contracts concluded between union organizations and the administration of the institution, medical workers are issued hygienic and special clothing, and other protective devices and special food (milk, butter) depending on the peculiarities and nature of the institution and harmful working conditions. The Union M., through its grassroots levels, exercises control over the correct implementation of labor legislation and working hours at the local level; takes measures against detected violations and creates all conditions to prevent them. The work of union organizations has significantly increased in connection with the transfer to them of the functions of labor bodies after the merger of the People's Commissariat of Labor and the VTsSPS. Social insurance. The care of the party and government for the systematic improvement of the material and living conditions of workers and working people, expressed in measures to transfer to trade unions the work of social insurance, has led to a significant improvement in the service of medical workers through social insurance measures. The budget for social insurance of medical workers grows from year to year. If the total budget for social insurance of the MEDSANTRUD union of the RSFSR (without other union republics) in the income and expenditure parts amounted to 95.7 million rubles in 1934, then in 1935 it amounts to 147.8 million rubles. Expenses for temporary disability, additional types (childbirth, nursing, burial), as well as pensioning amounted in 1934 to 21,955 thousand rubles, and in 1935 to 46,569 thousand rubles. For prevention (rest homes, sanatoriums and resorts, etc.) in 1934, 2,256 thousand rubles were spent, and in 1935, 5,199 thousand rubles. The Union M. conducts all work on social insurance through its grassroots organizations, organizing around payment points an insurance activist force, with the help of which it exercises control at home over the correct use of the patient's regime, assistance and help to the patient in the quickest restoration of health. The Union M. serves pensioners, working and non-working, regularly pays them the established benefit and carries out significant preventive work. Service of living conditions. The Union M. carries out work to serve the material and living conditions of its union members. For this, it organizes through all levels of union organizations control over the implementation of measures provided for by legislation. Soviet legislation provides for free provision of apartments, heating, lighting and water supply to all qualified medical personnel working in rural areas. To improve the housing conditions of other groups of workers, the Union M. promotes the development of housing cooperation among them. Such organizations exist in a number of large cities (Moscow, Kharkov, Sverdlovsk, etc.).

The MEDSANTRUD Union assists in the development of public dining facilities at medical-sanitary institutions, organizing cafeterias and buffets. At all major medical institutions, cafeterias have been organized, while in smaller institutions, buffets have been opened that provide lunches, breakfasts, and dinners at reduced prices to medical workers. The MEDSANTRUD Union organizes for the children of its members children's nurseries, gardens, and playgrounds, creating them both at larger institutions and as cluster facilities serving children from groups of institutions. These institutions are maintained at the expense of social insurance funds, the administration of the institutions, and the shared participation of parents. The Union works to develop suburban and peri-urban farming among medical workers, both individually and collectively, thereby ensuring significant groups of workers with agricultural products, mainly vegetables and others. The MEDSANTRUD Union provides one-time assistance to its members, issuing through mutual aid funds both repayable and non-repayable loans. One-time monetary assistance is also issued from the Union's fund. Mutual aid funds are established at all institutions with 25 or more workers. For workers at institutions without independent mutual aid funds, district or city funds are organized under the district or city committee of the Union. Mutual aid funds operate on the basis of a special charter and have an elected board. The funds of mutual aid consist of voluntary membership contributions of ¹/₆-1% of wages. Upon leaving the mutual aid fund, the participant is returned at least 75% of all membership contributions they have made. Participation of medical workers in mutual aid funds is voluntary. The MEDSANTRUD Union conducts significant work in serving its members with rest homes, sanatoriums, and resorts. To meet the demands of its members, tickets to rest homes, sanatoriums, and resorts are purchased at the expense of social insurance funds, the annual budget (membership dues), as well as from the funds of the workers themselves. Additionally, MEDSANTRUD Unions open their own sanatoriums and rest homes for their members. Such sanatoriums and rest homes are owned by the Central Committee of the Union of the RSFSR in Kislovodsk, Khost, Tuapse, and Alushta. The Central Committee of the Union of the Ukrainian SSR has a sanatorium in Odessa. The Moscow, Leningrad, Ivanovo, and West Siberian organizations have their own rest homes. Cultural and political-educational work. The MEDSANTRUD Union conducts diverse cultural-political and educational work among its members, adapted to the cultural-political level of different groups of members—doctors, paramedics, nurses, orderlies, cleaners, etc. The Union organizes schools and circles to eliminate illiteracy and semi-literacy, circles, lectures, and discussions to raise the political level of its members. For more prepared members, it organizes circles on Marxism-Leninism, dialectical materialism, and party history. The MEDSANTRUD Union works to improve professional qualifications by developing various forms of mass-production propaganda and conducting socio-medical examinations, which consist of workers studying specific topics on medical service and patient care according to a special program and taking examinations on these issues at a special conference of learners. The MEDSANTRUD Union works to meet the cultural needs of its members, developing various forms of artistic self-activity among them, organizing diverse circles—choirs, musical, dramatic. All cultural-political and educational work is conducted in clubs, red corners, and various circles organized in institutions. All MEDSANTRUD Unions of the USSR have 47 clubs with 35,250 members. Of the 47 clubs, 32 have libraries, 23 have radio installations, 27 have film installations, and 19 have gardens and areas for summer work. Of the 1,939 grassroots organizations counted, 36.6%, or 710, have red corners. Physical culture is increasingly developing in the MEDSANTRUD Union. Physical culture circles are organized at larger medical institutions and collective teams at city and district committees. Among physical culture participants are top masters of sports. Work in serving members with books has significantly developed, for which libraries are organized locally at clubs, red corners, and institutions. In addition to libraries at clubs, there are 93 libraries directly affiliated with the unions. According to a survey covering 60 libraries, they have 366,660 books. Of all libraries, 36.7% have library bases from which mobile libraries are compiled, aimed at bringing books closer to readers, especially those working in districts and rural areas. The number of readers continuously grows. In addition to distributing literature—newspapers and magazines—the publication of wall newspapers in collectives is widely practiced. Wall newspapers are published by the self-activity of the workers themselves and aim to agitate for and propagate the tasks and measures of the party, government, and trade unions and to highlight the best examples and shortcomings in the work of the institution. A special editorial board is elected to publish wall newspapers. Finances of the Union. The Union's funds consist of membership dues paid by members and interest from capital and securities. Until 1933, members paid 2%. By a resolution of the party, government, and VTsSPS on reducing deductions and dues, dues were reduced to 1%. This reduction in deductions became possible due to the growth in the number of trade union members in the USSR and the reduction of their paid apparatus by involving a broad active of volunteers in the daily work of the unions. This reduction in deductions is also one of the measures aimed at improving the material and living conditions of the members. Despite the reduction in membership dues from 2% to 1%, the main funds of the Union budget are still directed to the material-living and cultural service of the members. The continuous increase in the number of Union members and growth in their wages lead to an increase in the Union budget. Comparative data on the income and expenditure of the budget of the MEDSANTRUD Union of the RSFSR for 1934-35 are characterized as follows (in thousands of rubles): Table 4. Budget 1934 1935 Expenses for admin.-household needs ... for cultural service 8,322.2 3,462.6 1,786.1 543.6 2,639.9 11,351 2,846 4,049 2,400 2,056 Expenses for material-living service (without social insurance) ..... For other measures and deductions to central organs .... Thus, if in 1934 only ¹/₄ of all Union funds (without social insurance) went to serving the cultural and living needs of members, then in 1935 more than half of all funds were spent on these needs. The Union's press. The Central Committee of the MEDSANTRUD Union of the RSFSR publishes the journal 'Medical Worker,' which is published once a month with a circulation of 15,000 copies. The journal was founded in 1919. The Central Committee of the MEDSANTRUD Union in Ukraine publishes together with the People's Commissariat of Health of the Ukrainian SSR the newspaper 'For Socialist Healthcare,' which is published with a circulation of 12,000 copies. The main task of the journal 'Medical Worker' and the newspaper 'For Socialist Healthcare' is to mobilize the broad trade union active of medical workers and through them all medical workers to fight for the general line of the party, to fulfill the tasks of building a classless socialist society, and to propagate the teachings of Marx-Engels-Lenin-Stalin. By identifying the best examples of work at local levels, the journal and newspaper popularize them among all workers and fight for their widespread implementation. International work. MEDSANTRUD Unions, through Profintern, maintain connections with revolutionary trade union organizations of capitalist countries. Since medical workers abroad are usually organized in unions together with municipal workers, an international united propaganda committee of these unions has been organized. The work consists of establishing connections both by correspondence with individual organizations and medical workers and by receiving delegations coming to the USSR. Among medical workers of the Soviet Union, MEDSANTRUD Unions conduct broad international educational work in clubs, red corners, and through their press.