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

182 MAJORITY REPORT. number of clinics, using hospital premises for the purpose, whenever these could be obtained. We are aware of the objections of the medical profession to a general system of clinics, even clinics under professional control, and we have always before us the importance of securing the willing en-cperation of the profession at each advance in the public arrangements. We therefore think it would be undesirable at this stage to attempt a uniform system and that full opportunity should be given for composite local schemes. 285. If arrangements were made for the work to be done at the physician’s or surgeon’s consulting room, no question of employment of additional nurses or other ancillary staff need arise. So far as arrangements were made with hospitals, they would usually be able to provide the requisite staff, as part of the contract for the use of their premises. In so far as it might be found necessary to establish new clinical centres, nurses, masseurs and electricians would have to be employed. METHOD OF REMUNERATION OF CONSULTANTS AND SPECIALISTS. 286. If the work were done at the doctors’ consulting rooms they would probably prefer to be paid a fee per case. It would, however, be possible, even under that arrangement, to pay on a time basis, the arrangement being that a fixed number of cases would be summoned to attend at the consulting room at a specified time, this being the number which would normally occupy about 21 hours. A fixed fee would be paid for the session. Where treatment was given at centres at which various specialists attended, the proper method of remuneration would be on a time basis. FSTIMATE OF COST OF PROVISION FOR PERSONS ABLE TO TRAVEL. 287. The Ministry of Health have submitted to us an estimate of the cost of providing this part of the service on the basis of sessions at fixed centres at which the specialist and the insured persons would attend. The costs to be provided for include (1) the fees for physicians and surgeons, (2) payment of ancillary staff, including nurses, masseurs and electricians, (3) rent of premises, (4) travelling expenses for insured persons, (5) cost of administration. 988. The estimate has been based upon inquiries made by the Regional Medical Officers and on statistics published by certain hospitals. The conclusion of the Ministry is that for the insured population of 13} millions in England and Wales the cost would not, on the lowest assumptions as to number of persons referred and other factors of cost, fall below £487,000, and would be unlikely to exceed £940,000 per annum. This is, of course, a wide difference. It is mainly due to different assumptions as to the proportion of the insured population that would be referred to the specialist.

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