189 
MAJORITY REPORT. 
of medical benefit must depend to a very great extent upon the 
cordial acceptance of the financial terms of the contract by the 
medical profession and upon their approval of the Regulations 
under which their daily duty towards the insured persons is 
carried on. We will accordingly devote some space to a review 
of these matters. 
THE METHOD AND SCALE OF REMUNERATION. 
420. A full account of the course of the arrangements for 
remunerating the insurance practitioners since the inception of 
the Scheme up to the present date will be found in paras. 105 
to 142 of Section C of Appendix I to the Minutes of Evidence. 
The earlier parts of this are now mainly of historical interest but 
we may describe briefly the arrangements since the beginning 
of 1920, when the so-called ‘‘ floating sixpence ’’ was abolished, 
with the consequence that the discussion of the capitation fee 
became simplified by the elimination of the drug factor. 
On that footing the Insurance Acts Committee of the 
British Medical Association, acting on behalf of the general body 
of insurance practitioners, claimed that the fee should be 13s. 6d. 
The Minister, acting for the Insurance Committees, who, in fact, 
make the individual contracts, did not accept this figure but 
offered 11s. The difference was referred: to arbitrators who 
determined the latter figure and this remained in force from 1st 
January, 1920, to. the end of 1921. During 1922 and 1923, a 
reduction to 9s. 6d. was accepted by the Profession on the ground 
of the urgent necessity for national economy. On a further 
proposal by the Minister for the reduction of the fee to 8s. 6d. for 
three years, or 8s. for five years, there was again resort to arbitra- 
tion with the result that 9s. was determined for the three years 
ending 31st December. 1926. 
421. New terms must be settled before the end of 1926 
and, obviously, must take account of any change (whether 
resulting from our recommendations or otherwise) in the nature 
and volume of the services to be rendered by the practitioners 
under their contract. 
422. Although the Minister's offer was for less, and the 
doctor’s claim for more than was, in fact, awarded at the last 
arbitration, and although the Approved Societies made at the 
time very strong representations for a more substantial reduc- 
tion of the fee, the award appears to have given, on the whole, 
as much satisfaction as is possible in such circumstances. In 
assessing the effect of the award upon the actual remuneration 
of practitioners with lists of various sizes, the existence of the 
large mileage grants must be kept in mind. These provide 
substantial additions to the capitation income of many rural 
practitioners. An account of the scale and methods of alloca-