Around the middle of the 20th Century three countries introduced systems designed to provide primary health care to all their citizens: the UK, China and Cuba. All three nations had emerged from devastating conflicts with a political commitment to more equal societies. All achieved success in reducing health inequalities. Through universally applied public health programmes, education, and free family health care, each country combated the ravages of infectious diseases and ignorance, lowered childhood mortality and improved the expectation of life.
Half a century later, China’s barefoot doctors are a distant memory. In the UK the social contract that underpins the NHS is under threat. Only Cuba has kept the faith, to the advantage of the health of its citizens who enjoy a first world expectation of life for a third world cost.
When I worked for VSO in 1970s, Mao’s barefoot doctor system was the model for provision of healthcare in poor countries. Villagers, sometimes traditional herbalists, were given simple training and with the support of their communes provided free basic personal and public health care to their communities. The evidence is that it worked.