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Therefore, planning of health facilities and hospitals

Therefore, it would be ideal to plan the hospital services on area-wise basis. However, this cannot become possible without active involvement of the Government. Apart from erstwhile USSR, Chile and Great Britain, where complete regionalization of medical care has taken place, few other countries have reorganised the hospital system along these lines.

Understanding the concept of regionalization is necessary because regional planning of health facilities and hospitals is something to which health planners have aspired for many years. Through its application, it is thought that construction of new hospitals and health centres can be tailored to the requirements of the users and that the necessary rational distribution of buildings and facilities will be obtained, enabling health services to be delivered according to a system in which different levels of competency adapted to the needs of the patients can be distinguished. If regional planning is to become a functioning reality, it should be based on a full and detailed study of the objectives and functions of the health system. It will also be necessary to give a role in the planning process to representatives of the groups that receive the services. Although regionalization of hospital services is theoretically possible to be enforced by law it has been implemented to full in a few countries only, because of several obstacles such as multiplicity of ownership (Government, semi government, private, charitable, etc.

) difficulty in coordination between private and public institutions, problems of movement of personnel and staff, prestige, bureaucratic obstacles, and lack of continuous effort and team approach. Therefore, introduction of the concept is a complex process not easy to achieve. A WHO working group had identified that in order to put into operation true regionalized system, it is essential that some prior conditions be met. It is easier to bring about in those countries which have a planned economy and a decentralised economic and social development adminis­tration. It is also very useful, when there exists a political and administrative body with executive and coordinating authority over the regional services, not only in health but also in the educational, housing, welfare and other fields. Even when these ideal conditions do not exist, it is still possible for countries to establish a regionalized health service provided a firm political decision is taken and is backed by legislation.

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