Abstract
I indicator of the failure of a health system is people living without medical services and physicians who are unemployed and this is the present situation in many countries. I manifestation of this problem is an increase in the supply of physicians beyond the capacity of health systems to fully absorb them and Mexico is no exception to the recent problems of physician utilization. The number of medical students expanded greatly in 1967 because of the growth of enrollments in existing schools along with an increase in the number of medical schools. Then in the early and mid-1970s there was a slowdown in the marked growth that health care had experienced during the previous decades. Now the problem of unemployment and underemployment has begun to appear among university graduates. A Ministry of Health study shows that there have been 120000 medical graduates from 1970-85 but only 70000 new posts in health care organizations of both the public and the private sectors. In 1982 Dr. Guillermo Soberon Acevedo Minister of Health called for a "structure change in health." The objective was to create a more equitable effective and efficient health care system. The 1st step was to amend the Mexican Constitution to recognize a social right to the protection of health. Additionally a new General Health Law was passed and National Health Program was approved. This legal framework has necessitated the implementation of innovative oranizational strategies. Decentralization has been 1 of the most important strategies. Gradually the power and resources to operate health services are being transferred from the central government to each of the 31 states and the Federal District (Mexico City). The Ministry of Health has been redefined as the integrative nucleus for the National Health System and has taken on functions that strengthen its unique role: strategic planning enforcement of norms and standards of care financial management and research and development. This last function includes the development of human resources. As the training of physicians and other types of health personnel is carried out by universities in Mexico it has been necessary to build cooperative bridges between the health sector the main employer of such personnel and the universities and other educational institutions which produce health personnel. The Interinstitutional Commission for the Development of Human Resources in Health 1 of these bridges has made it possible to program the quantity and quality of health personnel that Mexico requires. In terms of health personnel the priority that has been given to primary health care adds a qualitative dimension to Mexicos need for quantitative adequacy.