4.6 MAJORITY REPORT. Cn is welcomed, nevertheless owing to various causes no payment is made from insurance funds in respect of a large proportion of those insured persons who receive treatment. ven in the case of those for whom insurance payment is made, the amount con- tributed is only a part of the average cost per occupied bed per week. No payment at all is made in respect of the general out- patient work which the witnesses urge ‘‘ is of great economic value not only to the State as a whole but also to Approved Societies in particular, by enabling members to return to their work more quickly after illness or accident *’ (British Hospitals Association, App. IVIL, 7). In connexion with this last point we examined witnesses to ascertain whether insurance practi- tioners were evading their proper work by sending their patients unnecessarily to the out-patient departments of the hospitals. But we are assured that this is niot so to any extent, and that “‘ the tendency is for the out-patient department to become more and more consultative, and patients appreciate the value of the benefit of treatment by the consulting staff of the hospitals *’ (British Hospitals Association, App. LVII, 10). We are told that, whereas in the past patients attended at the out-patient department almost entirely of their own volition, the number coming now on the advice of their medical attendants is about 50 per cent. of the total. 94. The contention of the hospitals is, therefore, for a fuller measure of financial assistance in respect of all insured persons using the hospitals in any way. Af the same time they are opposed tc any encroachment on their voluntary status, and the British Hospitals Association suggest that ‘‘there should be no contract to treat, but . . . that the important role filled by the voluntary hospitals in supplementing the work of the panel prac- titioners and in furnishing the additional services. |. should be recognised by practical assistance from insurance funds >’ (App. LVIIL, 14). 95. The figures of costs submitted by the Sheffield Joint Hospitals Council in App. LVIIT are of interest. It appears that, in 1923, in respect of three general hospitals in Sheffield, the total cost of providing services to patients (3,221 in-patients and 15,269 out-patients) who were insured persons was £28,870, while the total amount received from insurance funds was only £4,300. In considering these figures it must, however, be borne in mind that, had there been no Insurance Scheme, the hospitals would still have borne the cost and would have been without the substantial relief which the Insurance Funds have brought. Further, the insured persons, like other citizens, make voluntary contributions to the funds of the hospitals through subscriptions, collections, club arrangements and the like; and they receive from the hospitals no preferential treatment over the rest of the population.