MAJORITY REPORT. 
7 
of central control which took place when the Ministry of Health 
was established was unaccompanied by any corresponding 
unification or co-ordination of existing medical services locally 
. . . At every stage medical benefit overlaps with one or 
other of the large number of existing forms of medical service 
.. . and this duplication of effort between the Insurance Act 
and existing medical services is a grave source of weakness and 
expense.” The National Conference of Friendly Societies, 
representing four million State insured members and a total 
voluntary membership of 7,400,000, has submitted to us the 
interesting and important conclusions contained in paragraphs 
34 to 41 of Appendix XXVI from which we quote the 
following :— 
* Few will deny that it is highly wasteful and inefficient 
to allow six or more separate organisations for medical 
services (all paid for wholly or mainly out of public funds) 
to exist side by side, as they do to-day, with consequent 
overlapping, friction and duplication of expense. 
“This becomes all the more marked when it is 
remembered that for one-third of the entire population there 
is, in addition, a general practitioner service provided in the 
form of medical benefit under the Insurance Act. 
** Notwithstanding all these various medical services, there 
exists little or no provision for specialists’ and consultants’ 
services for the fifteen million insured persons, whilst for 
the twenty millions or so dependants of insured persons 
there is no general medical service except that of the Poor 
Law. 
* Owing to lack of means, it is impossible for the poorer 
classes to obtain the services of doctors on fee-paying terms, 
and for this reason it was deemed necessany to introduce a 
system of compulsory insurance to include free doctoring. 
It is submitted that the need is equally great to-day for 
similar provision for the remainder of the population below 
an income limit of, say, £250 a year, including the 
dependants of such persons, as well as those of insured 
persons. 
“If this were done by merely extending medical benefit 
on its present basis to dependants of insured persons, it 
would : 
(a) Greatly intensify the overlapping of services 
already referred to ; 
“* (b) Be extremely costly, because a large number 
of panel practitioners would be, in effect, working full- 
time on payment basis devised for part-time work ; 
‘“ (¢) Leave out of the scheme at least one and a half 
millions of persons including not only the destitute, but 
a number of non-insured persons, such as hawkers, 
small shop-keepers, &e. 
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