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 IV. The related schemes of social welfare

Collection:: Economics Books

MAJORITY REPORT. Tar T00AL SYSTEMS OF ADMINISTRATION. 34. When, however, we turn to a consideration of the local administration of these health services we find a multiplication of local administrative bodies and a considerable division of func- tions due to some extent no doubt to historical causes. It is true that the work relating to public health, maternity and child welfare, tuberculosis, and venereal diseases are controlled by one local authority and administered under one chief executive officer, namely, the Medical Officer of Health. But there remain under other independent local authorities the school medical service, the Poor Law medical service, the Insurance Service and in certain cases the Port Sanitary service. Further the medical inspection of factories stands outside the supervision of any local authority. The problems raised by the Port Sanitary service appear to be of such a special nature that probably nothing is lost by the existence of a separate authority, though in point of fact the I.ocal Authority in certain cases also acts as the Port Sanitary Autho- rity. Where, however, as often happens, the natural port area covers several municipal areas a joint and specially constituted authority is necessary. The administration of the school medical service stands, of course, in the closest relation- ship to the educational work of the local Education Authority, under whose direct control it is placed. The systems under which medical provision is made locally for the sick poor and for the insured population are entirely separate from each other, both in administration and in the financial arrangements which they require, the one being sup- ported by the local rates and the other by the contributions of the workers and their employers supplemented by grants from the Exchequer. Hach, however, must be locally managed and in respect of each the present method of administration must shortly come under review, the first in connexion with the pending reform of the Poor Law, and the second as a consequence of recommendations which we have decided to make and to which we refer at some length in a later chapter. The question naturally arises whether in the course of developments in these directions, an opportunity will arise to effect a measure of local unification which in the circumstances would be considerable in its scope and consequences. We note the possibilities in this respect, though it does not fall to us to consider them in any detailed manner. 35. We now proceed to give a very brief outline of the various services under review. TUBERCULOSIS. 36. The national scheme for the treatment of tuberculosis is administered locally by the Councils of Counties and County

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