In 1971 the country had a total of 16,183 physicians, 1.9 for every 1,000 inhabitants. The number of physicians had more than doubled in the twenty years since 1952; most of them, therefore, were between the ages of twenty-five and forty-five. The number of other medical personnel had expanded along the same lines. In 1971 there were 2,464 pharmacists; 26,381 nurses; 6,016 midwives; and 5,012 feldshers. Feldshers are paramedics trained to perform a variety of medical functions, including simple surgery, in the absence of a fully qualified physician. Many rural health centers are in the charge of feldshers and receive periodic visits from specialized physicians.
Physicians and auxiliary medical personnel are all employed by the state in the national health service. They are classed as nonproductive workers, therefore their salary scales are lower than those for productive workers. This has been causing a great deal of dissatisfaction and is the principal reason for the serious shortage of medical personnel. One Bulgarian newspaper in 1971 reported the case of a hospital administrator trying to recruit women streetcleaners to fill the many vacancies for nurses and aides in the hospital. The streetcleaners refused because their wages and working conditions were better than those for the more highly skilled positions in the hospital.
Incomes and retail prices are controlled by the government and set in accordance with the overall economic plan. The cost of living, therefore, is also controlled and has been relatively stable. Several increases in the minimum wage during the 1960s were paralleled by price increases for some of the essential commodities and services. In 1973 the minimum monthly wage was raised to 80 leva per month (for value of the lev--see Glossary), and basic wages for the lowest categories of workers and employees were also raised to bring them into line with wages in comparable kinds of work. At the same time, prices of certain foods were reduced, whereas prices of some other essential goods were raised.
Although the incomes of most Bulgarians have generally kept pace with the rise in the cost of living, a chronic scarcity of consumer goods and services and periodic food shortages have forced a comparatively low standard of living on the population. As in other communist countries, the consumer industry has been neglected in favor of other branches of the economy. Even after the government began to place greater emphasis on the production of consumer goods in the 1960s, rising demand outstripped production capabilities. Even the basic needs of the population often could not be met because of poor planning or the inflexibility of the central planning system, which does not react effectively to changing market conditions. It is not uncommon to have excessive inventories of certain sizes of clothing or footwear while other sizes are in short supply. Retail outlets are either unwilling or unable to replenish their supplies of missing sizes until the overall stock of the item is almost depleted, regardless of consumer demand.