MAJORITY REPORT.

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of some general rules which would determine the order of
priority. A recommendatory benefit is open to the administrative
objection that it creates expectations which can only be pattially
 fulfilled and is, therefore, likely to give rise to a continuous
agitation for increased financial provision.
356. But, apart from the administrative or social objections,
the proposal seems to us open to criticism on medical grounds.
The fundamental difficulty is that the selection has to be made
by lay administrators on the basis of reports by doctors
who are each reporting on their own patients and necessarily can
have no opportunity of considering the cases in relation to one
another. It must in practice be extremely difficult for any
committee, even with expert guidance, to arrive at any true
estimate of the relative needs of a number of cases on the basis
of reports which in the nature of things cannot be relative.
 Further any system of priority must tend to give
a preference to the cases in which the need for treatment is most
obvious because they have been so long neglected. In practice
it would mean that most of the money would be spent on the
treatment of <* end-results,”’ and however long such a scheme remained
 in operation the dental state of the younger insured
people at the end of the time would be nearly as bad as at the
beginning.
357. So long as Approved Societies are administering an additional
 benefit with only a limited amount of money available, the
selection of cases on the basis of urgency is justifiable, and
Societies could not be blamed for adopting the method of selection
which promises most immediate reduction of their sickness
benefit claims. But the establishment, as a permanent part of
the insurance system, of a dental benefit which made no provision
for conservative treatment would be open to grave criticism.
Theoretically this difficulty could be avoided by a suitably devised
table of priority, but in practice this would be very difficult to
frame, and the tendency of any system of selection must be, as
already explained, to concentrate the expenditure on the cases
least hopeful from a medical point of view. It has to be remembered
 also that a statutory benefit is judged by a standard very
different from that applied to additional benefits. An additional
benefit is in the nature of a windfall ; it is befter than nothing,
and the insured person thinks himself lucky to get it. But a
statutory benefit is on a different footing, and is subject to far
more critical scrutiny. A selective benefit which makes no
adequate provision for the treatment of early cases would be in
our opinion a most unfortunate policy to adopt.

CoST OF A RESTRICTED SERVICE.

358. As already indicated, an unrestricted dental service could
not be provided for less than 4s. a head per annum. Indeed, it