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        <title>Report of the Royal Commission on National Health Insurance</title>
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      <div>MAJORITY REPORT. 
9 
a general practitioner. The definition given in the Regulations 
now in force is as follows :(— 
“ The treatment which a practitioner is required to give 
to his patients comprises all proper and necessary medical 
services other than those involving the application of special 
skill and experience of a degree or kind -which general 
practitioners as a class cannot reasonably be expected to 
possess.”’ (Clause 8 (1) of Part I of the First Schedule to the 
Medical Benefit Consolidated Regulations, 1924). 
59. We were so much impressed by this limitation—imposed 
as it was by regulations and not explicitly in the Act itself—that 
we examined the official witnesses of the Ministry of Health on 
the point at some length. We were told (Brock, Q. 995) that 
the apparently narrow view taken was based on the advice given 
to the Insurance Commissioners by their legal advisers at the 
inception of the Scheme. This was to the effect that the pro- 
visions of Section 24 of the 1924 Act (Section 15 of the 1911 
Act) were not consistent with anly other view. The Act gave 
every duly qualified medical practitioner a right to come upon the 
medical list, and it contemplated that every insured person would 
have one medical attendant but not more than one at a time, 
and that if the insured person did not himself choose a doctor, 
he might after a certain time be allocated to a doctor by the local 
Insurance Committee. Thus the effect of the provisions of the 
Act was that the insured person was entitled to receive 
from one doctor, and from one doctor only, the whole of 
““ medical benefit &amp;gt;’ whatever that phrase might mean. In 
these circumstances it appeared to the legal advisers and 
to the Department that the scope of medical benefit must 
be construed as limited to services within the competence 
of the average general practitioner. Further, though the 
medical lists included a certain number of men with special 
experience, whose competence in certain directions was therefore 
above the average, it was felt that if all doctors were to receive 
the same rate of remuneration, as practical considerations were 
found to require, a uniform obligation and a uniform con- 
tent of service were implied; and that it would not be 
equitable to require one man, because he happened to possess 
some special skill, to render a wider range of service than was 
required from the majority of his fellow practitioners engaged 
under the insurance contract. 
60. Though this limitation of the service has been from time 
to time commented upon (see Brock and Smith Whitaker, 
Q. 1080-1101) and though on all sides a fuller conception of 
medical benefit has been urged upon us by witnesses, no attempt 
to challenge it in the Courts has ever been made during the 13 
years of its operation. We may fairly assume, therefore, that 
it is valid on legal grounds and we recognise the general and</div>
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