MAJORITY REPORT. 
the health service should be available. They do not appear to 
have contemplated the possibility that in some areas the pro- 
portion of the population who would be embraced within the 
scheme under any income limit likely to be acceptable to the 
industrial classes, would be so large as to afford a strong argument 
on grounds of public economy for the replacement of the contract 
system by a whole-time salaried service. 
180. The National Association of Trade Union Approved 
Societies appear to have accepted the insurance principle, and 
indeed, desire to extend it in several important respects (see App. 
XCII, paras. 102-104). The National Conference of Friendly 
Societies approve, as we have indicated above, a complete 
reorganisation of all health services on a public basis financed 
entirely from rates and taxes. 
131. Mr. Alban Gordon makes the following statement : — 
““ My own personal predilection would therefore be in 
favour of abandoning altogether any attempt to base a 
National Medical Service on insurance funds, to abolish 
medical benefit altogether, relieving the Insurance Act con- 
tributions proportionately, and to finance a National Medical 
Service out of taxation, national and local. The incidence 
of such taxation would, in the long run, be very much the 
same as that of the contributions under the National Insur- 
ance Act, the remitted or substituted portion of which would, 
therefore, counterbalance that increase in general taxation. 
““ At the same time it cannot be denied, from the point 
of view of political expediency, that it might be unwise to 
hand back to the insured persons and their employers a 
sum of eight million a year, which they are now paying 
without complaint, only to re-levy the same sum in the 
form of increased taxation in some other direction whizh 
might be strongly resented. Furthermore, the insurance 
funds now contain an exceedingly large sum of money by way 
of accrued surpluses on the first two quinquennia, a large 
portion of which is proper to be used for medical and allied 
purposes. Some of this might well be utilised as a capital 
sum to defray in whole or in part such expenses consequent 
upon the inauguration of the National Medical Service as 
are of a capital nature, e.g., primary health centres, such 
as are contemplated in the Dawson Report, additional 
hospital accommodation, and conversion and improvement 
of existing hospital buildings, &c.”” (App. XIII, 46,47.) 
Tae ‘“ Means TrsT.”’ 
132. In connexion with these views we may give a brief 
outline of the operation of what is called the ** means test ’’ as it 
appears in the various health services. In the Insurance system