ABSTRACT
The rapid growth in knowledge which has led to the development and application of new technology has contributed to immense improvements in medical care and opened up exciting new possibilities in the care and treatment of the sick. None the less the health care industry remains a labour-intensive one; it may be feasible to attach the sick individual to a machine for diagnosis, evaluation of progress, and treatment, but it is still necessary to ensure that trained and qualified people are involved in running the machines. Hence doctors make the decisions to initiate a course of therapy, nursing staff take charge of the daily care and comfort of the patient, and specialized technicians maintain and operate the plant and machinery. Of all the resource inputs in any health care system, staffing resources usually account for the lion’s share of expenditure and this is valid no matter how the system is organized. In the United Kingdom some three-quarters of total health expenditure goes on salaries and wages; in the USA 30 per cent of total health expenditure covered physicians’, dentists’, and other professionals’ services in 1982.1 In Japan in the same year it has been estimated that remuneration of physicians in all types of facilities accounted for 48.8 per cent of expenditure.2
