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 XII. Consideration of certain major problems

Collection:: Economics Books

MAJORITY REPORT. 188 co erm —— tion of these grants is given in paragraphs 163 to 169 of Appendix I, Section C. PoiNTs FROM THE EVIDENCE. 423. We may now conveniently give some extracts from the evidence submitted to us on these matters. 424. Dr. Smith Whitaker, in reply to a suggestion that the figure should be based very largely on the amount of the remuneration the doctor received in pre-war days, with a reason- able loading for the rise in the cost of living, remarked, ‘‘ Is the question not really this, what does the general practitioner, as a class, consider the value of his time and skill? Our service has to compete with other sources of income that are open to him, and in the result it is a kind of balance of the inducements to different doctors throughout the country.” (Q. 1447.) He added, that it was difficult to say whether effective comparisons could be made with other professions in this matter. (Q. 1448.) 425. Mr. Alban Gordon, in referring to the financing of the extensions of medical benefit, refers to ‘* the present method of remuneration of panel practitioners, which is not only, in ny opinion, generous in itself but is unduly generous in the case of the urban practitioner possessing a large panel *’ (App. XIII, 56). In answer to Q. 7834, he states, ‘‘ 1 think the present system . . . is bound to be either unjust to those who have too little work or unduly generous to those who have a great deal.” 426. The British Medical Association state that they are " convinced that the capitation fee is still too low . . > and that ‘“ the extra amount allowed for rural conditions requires feconsideration.”” (App. XILVII, 59.) We may refer also to App. XL VIII, 60-62, where the views of the Medical Practi- tioners’ [nich are ‘set forth. CONSIDERATIONS AS TO FUTURE NEGOTIATIONS. 427. The immediate problem arising from the above con- Siderations and from the course of the evidence falls into two Parts : (1) Assuming the same services are given, has any change 10 the economic or other circumstances arisen since 1923 to justify & variation of the capitation fee? (2) If extended services are Sven, what is the fair reward for them ? 428. We do not think that it falls within our province to Make a recommendation under ‘either head. This is a subject Which clearly must be discussed between the Minister and the Medical Profession in settling the terms of service to take effect at January next. The point to which we direct attention is the frequency of the review of the rate of remuneration. On this ~ 4.709 (3 9

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