fullscreen: Report of the Royal Commission on National Health Insurance

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.
	        
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