MAJORITY REPORT. 442. On questions of procedure for dealing with complaints against practitioners, the British Medical Association made certain suggestions for the alteration of the Regulations, and also formulated certain principles which they considered ought to be observed in the exercise of the powers possessed by the Minister under the present Regulations. The alterations of Regulations suggested were : (1) that all complaints against a practitioner should, in the first instance, be sent to the Chairman of the Local Medical Committee and the chief administrative medical officer of the Liocal Authority ; (2) that only such cases as could not be settled by them with the acquiescence of both parties should proceed further; (3) that questions of general conduct, detrimental to the service, or of giving false certificates should be reported upon in the first instance by the Local Medical Committee ; (4) that an appeal to the Courts should be possible not only on the ground of improper procedure as at present, but on the ground that the penalty inflicted was out of proportion te the offence; (5) that in the case of proposed re- moval from the service the practitioner should have the right of appeal to a duly constituted central professional committee, and that the Minister of Health, in cases where this right was exercised, should not be able to remove the practitioner from the service unless the central professional committee advised thie course. (App. XLVII, 41.) 443. The first two of these proposals involve entrasting to a purely medical body the duty of considering whether the com:- plaint against a practitioner should, or should not, be proceeded with. Such an arrangement appears to us highly undesirable, and we gather that it was not pressed by the witnesses who appeared on behalf of the Association (Q. 15,226). We are also not satisfied that there is any good reason for the exclusion of the lay element from the primary investigation of the class of cases referred to in (3). 444. The fourth proposal involves placing upon the Courts of Law the responsibility for deciding questions of a kind which, In our opinion, can be more appropriately decided by a Minister who ig answerable to Parliament for the manner in which he exercises his discretion. The fifth proposal we are also unable to accept. We appreciate that removal from the medical list may be, and usually is, a very severe penalty, but it has fo be remembered that the ground of removal is that the retention of the practitioner would be prejudicial to the efficiency of the medical service of the insured persons, and it would, in our judgment, be contrary to sound constitutional practice that the Ministers responsibility to Parliament for the maintenance of an efficient service should be delegated to an outside body, whether professional or otherwise. 445. The four principles which the Association submitted for our consideration, not as requiring alterations in the Regulations,