MAJORITY REPORT. 
+9 
——— 
making arrangements with the District Nursing Associations who 
are already doing the work for so many other people.” 
(Smith Whitaker, Q. 23.971). 
MEDICAL AND SURGICAL APPLIANCES. 
101. The provision of medical and surgical appliances is, we 
are told, a fairly widely adopted benefit, for which in the 
period from July, 1921, to December, 1922, the sum of £69,804 
was available in England, but out of which only £3,348 
was spent, or just over 4% per cent. Appliance means a medical 
or surgical appliance other than a dental or optical appliance or 
those other appliances already prescribed as part of medical 
benefit by the Regulations. It has been held to cover such 
diverse articles as a motor ambulance, a bath chair, surgical boots, 
artificial limbs, trusses and hot-water bottles. For the most 
part it is not an expensive benefit, though the average cost per 
case in some societies has been between 30s. and 40s. Sometimes 
the whole cost is paid by the Society ; sometimes only half above 
a fixed maximum, for example, £4. 
OTHER SUGGESTED ADDITIONAL BENEFITS. 
102. We understand that suggestions have been made to the 
Department from time to time advocating the inclusion of 
massage, electrical and radiant heat treatment, laboratory 
facilities, specialist treatment, and spa treatment, in the list of 
additional benefits (Ministry of Health, App. I,"B. 219). We 
ourselves have received strong representations from witnesses as 
to the first and last (See Apps. LXVIL and XCVI). The Ministry 
of Health representative, in particular stated—‘¢ There can be no 
doubt as to the value of massage and electrical treatment, 
particularly for cases of after effects of injuries and rheumatic 
conditions by which a large amount of prolonged incapacity for 
work is produced. . . . Sucha service might be provided as 
an additional benefit . . . but it would not be practicable 
to provide a satisfactory service unless you had security for 
effective organisation. . . . Such a service would be more 
economically and efficiently provided as a part of statutory 
medical benefit.’ (Smith Whitaker, Q. 23,973.) 
TUBERCULOSIS. 
103. Having concluded our review of the additional benefits 
of a medical nature we may now pass on to refer briefly to the 
treatment of tuberculosis. This has been the subject of repre- 
sentations to us from the London County Council (App. 
LXXXIV), the Joint Tuberculosis Council (App. XCIID) and 
the Cambridgeshire Tuberculosis After-Care Association (App 
LXXXIID). Institutional treatment of Tuberculosis was 
removed from the Insurance Scheme in 1921 and entrusted to