Report of the Royal Commission on National Health Insurance

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Monograph

Identifikator:: 1740277147

URN:: urn:nbn:de:zbw-retromon-132094

Document type:: Monograph

Title:: Report of the Royal Commission on National Health Insurance

Place of publication:: London

Publisher:: Stationery Office

Year of publication:: 1926

Scope:: XII, 394 S.

Digitisation:: 2020

Collection:: Economics Books

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Document type:: Monograph

Structure type:: Chapter

Title:: Chapter X. Proposals for extending medical benefit

Collection:: Economics Books

MAJORITY REPORT. Yori schemes. Here we need only say that our exclusion of these elements from any immediate provision of a generally available medical benefit is dictated in the main by financial considerations —though, of course, we have carefully considered from every point of view the relative claims of the various possible extensions on the available funds. 968. We conclude, then, that the extended medical benefit to be recommended for immediate adoption should add to the general practitioner service only the three elements stated in paragraph 263 above. We now proceed to describe these in detail, to indicate methods of administration, and to give estimates of the cost involved. In this connexion we direct special atten- tion to the statement which the Ministry of Health have sub- mitted to us in Appendix CII, dealing with the numerous dis- cussions of these problems between the National Health Insurance Commissioners and the medical profession and also to the examination of Mr. Brock and Dr. Smith Whitaker in Questions 23,830 to 23,846. The problem is obviously no new one, and but for the War would probably have been solved many years ago. Provision oF EXPERT TREATMENT OR ADVICE FOR PERSONS ABLE TO TRAVEL. - 269. The services which specialists can render to supplement or assist the work of the general practitioner include (1) advice as to diagnosis, (2) advice as to treatment which the practitioner can himself properly undertake, and (3) treatment of a kind which only a specialist can give, or for which special resources of equip- ment and skilled assistance such as that of masseurs or electricians, are requisite. 270. A difficult question of principle emerges at the outset. Services of this kind are, to a certain extent, already available for insured persons, as for other members of the community, In the out-patient departments of hospitals. Do the services thus obtained fall short of the requirements of a satisfactory service for the whole insured population? If they do, is some scheme of Supplementation of these services practicable and desirable? Or are we driven to the conclusion that the specialist out-patient service must be provided completely irrespective of what the hospitals are already doing? 271. Dr. Smith Whitaker, in answer to questions on these points, replied :—‘* The local authorities, whatever they were, who had to carry out the organisation would Probably adopt a variety of methods, some in one place and some in another, but generally we doubt whether a system Which was based on contracts with the hospitals for providing the services would work satisfactorily. The insurance authority,

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