[State reform and Flemish health policy].

Three subjects are discussed: firstly, the most important stages in the process of federalization, secondly, the organizational structures and the activity of the ministry of the Flemish Community, thirdly, the position of the Royal Academy of Medicine of Belgium within the new structures of the ministry. With regard to the federalization process an outline of the history of the constitutional reforms is given with special attention to the redistribution of the responsibilities concerning health care. Furthermore, future perspectives concerning curative care, preventive care and health education are examined. Regarding the organizational structure and the activities of the ministry of the Flemish Community, the following aspects are treated: the basic organization, the difference between horizontal and vertical departments, the function of the superstructure and of the Board of Permanent Secretaries. Three other important pillars of the development of the organization are explained, namely the charter of the ministry of the Flemish Community, the homogeneous plans for organization and development and the new personnel management. Attention is finally focused on the scientific activities of the Royal Academy of Medicine of Belgium. Its problems with regard to understaffing as well as the budget of the institution as part of the institutional concerns of the administration of Health within the ministry of the Flemish Community are dealt with.