(November 1954)
I. Regarding the Key Points of the Central Health Ministry’s Report to the Central Authorities and the Draft Guidelines for Traditional Chinese Medicine Work:
Chairman Mao instructed that this report was very well written, particularly commending the method used to review the work of the Health Ministry: more than twenty meetings had been held, numerous opinions were solicited from the grassroots level, and a thorough bottom-up examination had been conducted. Only in this way could problems be truly resolved. Simply issuing directives from above was insufficient; it was essential to rely on criticism originating from below to ensure comprehensive and effective solutions. Addressing issues solely from the top inevitably led to one-sidedness. By combining top-down guidance with bottom-up critique, a more holistic perspective could be achieved, resulting in fully correct resolutions. He noted that this approach had been successfully employed at the National Financial and Economic Conference earlier that summer, where major issues had been effectively addressed. The Cultural Committee had also utilized this method to examine the Health Ministry’s work, with equally positive outcomes. Such an approach should be encouraged.
II. Chairman Mao pointed out that the health-care workforce was vast—over two hundred thousand government health workers alone—charged with overseeing the birth, aging, illness, and death of more than five hundred million people. This constituted a monumental undertaking of immense importance, placing a heavy responsibility upon them.
III. Chairman Mao stated that while significant achievements had been made in national health care over the past few years, substantial shortcomings also remained. He emphasized that the most serious deficiency lay in a lack of political awareness and political work, as well as insufficient application of Marxism-Leninism and socialist principles.
Was there an excess of technical expertise? Not necessarily. Both medical practice and patient care faced numerous unresolved problems. [1]
This is a transmission of Chairman Mao Zedong’s instructions on health work, delivered during the Central Political Bureau’s discussion of the Party Group Report of the Central Health Ministry.

IV. Most importantly, Chairman Mao stressed that the Party must exercise leadership over all areas of activity, including health care. He observed that certain members of the Health Ministry’s Party leadership regarded health work as a highly specialized technical field, believing that since the central authorities lacked technical knowledge, they would be unable to resolve complex issues even if reported. Consequently, many critical matters were neither submitted for instruction nor reported. Similarly, some harbored a dismissive attitude toward the leadership of the Cultural Committee, viewing its members as mere cultural figures unfamiliar with medicine. These notions were entirely erroneous. Chairman Mao argued that, by such reasoning, Commander-in-Chief Zhu De could not possibly serve as commander of the army, navy, and air force, as he did not personally operate tanks, fly aircraft, or man artillery pieces. Nevertheless, Zhu De was able to fulfill his role because military affairs were guided by political leadership. “If you don’t understand a particular field,” Chairman Mao remarked, “then you cannot lead me”—a mindset prevalent not only within the health sector but elsewhere as well. In our armed forces, the longstanding tension between military command and political oversight had only been resolved through prolonged struggle. The health sector must make every effort to rectify this issue.
The Party must lead absolutely everything: aircraft and artillery, opera performers of all roles, and the processes of life, aging, sickness, and death—that is, military affairs, the economy, education and culture, public health, and all other domains. No specialized area should be exempt from Party leadership. For example, even theatrical performance requires Party guidance. Chairman Mao illustrated this point by noting that a certain performer might excel in portraying female roles but lack proficiency in male, clown, or other character types; moreover, even within female roles, he might specialize exclusively in one particular subcategory. Such narrow specialization would render him incapable of providing meaningful leadership. Were he to assume a leadership position, he would fail to perform effectively. However, the Party can guide both the development and enhancement of dramatic arts.
On what basis does the Party exercise leadership? Chairman Mao explained that leadership is fundamentally political leadership; all leadership work is, in essence, political work. Without politics, there can be no true leadership. Those serving as health ministers inherently occupy positions of leadership, which means they are engaged in political work. Chairman Mao criticized the previous division of responsibilities among several deputy ministers, whereby one was assigned to handle political matters while another focused on technical operations, deeming this arrangement flawed. In old China, bureaucrats distinguished between administrative and military offices. We, however, must not adopt such a dichotomy; all leaders must engage in political leadership. If a leader confines themselves solely to technical concerns, fixating exclusively on procedures like subcutaneous or intramuscular injections, political considerations will inevitably be marginalized, leading to a loss of political guidance. Leaders must possess a solid understanding of Party principles and mass work, rather than limiting their attention to medical duties while neglecting political engagement.
Health care must remain under the leadership of the Party and may never establish itself as an independent domain beyond the Party’s purview. Chairman Mao inquired of Premier Zhou Enlai how often important documents of the Health Ministry had been reviewed and approved by the State Council. Premier Zhou replied that such instances were rare. Chairman Mao commented that if an organization functions as an autonomous kingdom, it falls outside your control!
V. Chairman Mao also strongly criticized the Health Ministry’s lack of collective leadership and outlined how such leadership ought to be practiced. He acknowledged Comrade Koukou’s proactive and responsible attitude, indicating that the core leadership team was sound. However, acting independently or blindly—ignoring Party leadership and the political guidance of operational matters—was detrimental. Independent action also meant forgoing collective decision-making. As everyone knows, collective leadership is the highest principle guiding our Party’s governance. In his self-criticism, Comrade Koukou admitted that on many crucial issues, decisions were often made unilaterally without proper deliberation by the organization, reflecting a tendency toward arbitrary rule. Chairman Mao pointed out that this kind of individualistic approach would undermine effective work and isolate the individual. Such behavior did not signify strong personal character; rather, it represented weakness. He instructed that leaders must patiently consult with others, engaging in dialogue with the masses and with representatives from all levels—top, middle, and grassroots. The notion of being infallibly correct was entirely untenable. True strength lay in reasoned argument and persuasive ability. Party group meetings should be meticulously prepared, with open-minded receptiveness to diverse viewpoints, emulating the methods employed in central-level meetings.
VI. Chairman Mao underscored the pervasive presence of bourgeois ideology among leaders in the medical sector, manifesting as resistance to Party leadership, a dearth of political consciousness, weak mass perspectives, and aversion to collective decision-making. This bourgeois mentality was quite widespread throughout the national health workforce and must be resolutely criticized.
VII. Following the inspection of the Central Health Ministry’s work, initial changes had begun to take effect. However, comrades still lacked sufficient confidence, necessitating firm resolve from the leadership. Chairman Mao noted that while Comrade Koukou undoubtedly bore primary responsibility for the ministry’s shortcomings and errors, these could not be attributed solely to him; other colleagues also shared a measure of accountability. He expressed hope for a thorough transformation in the ministry’s leadership and asked Comrade Koukou whether he possessed the requisite determination. Comrade Koukou affirmed that he did. …Chairman Mao emphasized that the key to success lay in elevating the quality of ideological transformation, ensuring that this meeting proceeded smoothly and instilled confidence in all participants.
VIII. Concerning several issues related to policy direction, the central authorities generally concurred with the various policies and tasks proposed in the report.
Regarding traditional Chinese medicine, Chairman Mao stated that TCM represents one of China’s major contributions to the world. TCM developed on the foundations of agriculture and handicrafts, whereas Western medicine emerged from modern industrialization. The invaluable experience accumulated by TCM must be inherited and promoted, while its irrational elements should be discarded. Western medicine, too, contains inaccuracies and exhibits tendencies toward mechanical materialism. In the future, as medical science advances, a unified medical system guided by dialectical materialism should be established. Disparaging TCM is wrong, yet exaggerating its significance is equally inappropriate. Pilot programs could be initiated in TCM hospitals. With respect to continuing education for TCM practitioners, it would be beneficial for them to acquire foundational knowledge in basic medical sciences, supplemented by courses emphasizing clinical experience in TCM. Hospitals might invite TCM physicians to provide consultations and, after successful treatment, learn from their expertise. The terms “Western medicine” and “traditional Chinese medicine” are ill-suited.
IX. Urban and industrial sanitation, as well as urban healthcare, require reform—a genuine revolution.