Full text : Report of the Royal Commission on National Health Insurance

MAJORITY REPORT.

function of the optician would thus in the case of nsured
 persons, be limited to the making-up of the spectacles
prescribed by the eye-specialist.
91. We may perhaps be allowed here to make one observation,
 even if it relate to a matter somewhat beyond our legitimate
frontiers. In the case of midwifery and dentistry, we have
recently seen the State compelled to make arrangements for
ltmiting the practice of these professions to those possessing the
requisite professional qualifications. In each case it has been
necessary to provide for the inclusion in the Register at the
outset of most, or of all, of those previously in practice,
whether qualified or not. Such a situation, even if inevitable,
 may lead to not a little friction and professional unhappiness
 in the transitional period. The larger the volume of
unqualified practice, the greater will be the difficulty of establishing
 matters on a satisfactory basis, and if in the case of any calling
within the range of medical services it may ultimately be
necessary in the public interest to prescribe the conditions of
entry, much may be gained by taking the necessary step while
the problem is still easily manageable. While expressing no
opinion on the question, it is perhaps a matter for consideration
whether problems similar to those which led to the Registration
of Midwives and to the Dentists Act of 1921 are not in process
of being engendered elsewhere. Two such examples which occur
to us are those of the opticians and the masseurs.

TH oSPITALS AND (CONVALESCENT HOMES.

92. Nearly £538,000 was available in England in 1924 for this
benefit, but only about 40 per cent., or £990,000, was expended
in the period. Payments under this heading do not necessarily
relate to specific applications by members, but may, in schemes
consequent upon the first valuation, take the form of an annual
payment to a hospital or home for the purpose of securing treatment
 of members therein. The benefit is limited to in-patients.
The payment of travelling expenses, in whole or in part, is included
 within its scope. A common method of administration is
for the hospitals to send periodically to the societies concerned
lists and particulars of members who have received treatment
and for the societies to pay the hospitals at an agreed rate, frequently
 25s. or 30s. a week per patient.

93. We have received evidence as to these arrangements from
the British Hospitals Association (App. LVI), the Sheffield
Joint Hospitals Council (App. LVIID, and the Middlesex
Hospital (App. LIX). Attention is directed to the fact that the
treatment of insured persons by insurance practitioners is incomplete
 because it is not satisfactorily linked up with provision for
treatment in hospitals. It is represented that while any payment
 made by societies with additional benefit schemes
            
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