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