0
MAJORITY REPORT.
—
already controls most of the health services. We have also
considered the statement submitted by the Board of Education
on the school medical services; and Sir Thomas Legge of the
Home Office has described to us in considerable detail the
medical services in the factories. We are told that co-ordina-
tion is effectively secured between Departments by consultation
and other official machinery (see Brock, Maclachlan and Francis,
Q. 24,025-24,196). Similarly, we are told that within the Ministry
of Health itself the various branches are maintained in effective
relationship (Kinnear, Q. 24,197-24 201). We are glad to be
reassured on this point, but we would suggest that, as the various
national schemes are advanced along the lines of their natural
development, it will be essential to secure at each stage the
utmost degree of co-ordination at the centre.
124. Tn the second place there emerges prominently the
problem of the multiplicity of the local authorities whose work
we have described in Chapter TV. Here again, approaching the
question from within our Reference, we have to consider the
future of the Insurance Committees, with their related bodies,
the Local Medical Committees and the Panel Committees. A
full account of the duties of these three groups of bodies is given
in Appendix I, Section C, to our Minutes of Evidence. We will
turn first to the Insurance Committees.
THE INSURANCE COMMITTEES.
125. If, as we think, there is to be a concentration of local
health functions in the hands of a single Authority, the powers and
duties of the Insurance Committee would naturally pass to that
Authority. We have come to the conclusion that a change in
this direction may justifiably and conveniently be made in the
immediate future, the functions of the Committees being
transferred to the appropriate municipal and County Authorities.
In view of the importance of this proposal we devote a large
section of Chapter XII to its discussion and to a review of the
evidence directed to the activities of the Insurance Committees.
Here we need only say that though Insurance Committees and
their staffs have done their work well, and at the outset some
advantage undoubtedly resulted from the attention and energy
which specially instituted bodies could devote to the launching
of the new scheme, yet owing to a variety of causes, there is not
now work of a quality or volume to Justify the continued existence
of this separate organisation. That, of course, is not the main
argument from the point of view expressed in this Chapter. We
would urge unification as the ultimate aim even if the work of
Insurance Committees were in fact substantial. But it is not ;
and we are thus spared the necessity of advocating on one
principle the disappearance of a system which justifies its
existence on another.