MAJORITY REPORT. 
59 
of the Ministry that in any reorganisation of the local 
administration of the Insurance Medical Service this end should 
be kept in view? *’—‘ The answer to both parts of the question 
is yes.”” (Maclachlan, Q. 24,169.) 
120. This large volume of representative evidence leads us to 
the general conclusions that whatever may. be the changes which 
are made in the Insurance scheme in the near future, the trend 
of the development will be towards a unified health service, and 
that in determining future changes full account of this tendency 
should be taken. 
SECTION E.—SOME GENERAL CONSIDERATIONS. 
121. We do not feel that it is for us to explore in any detail 
the problems of the future to which this principle of unification 
must necessarily give rise if it is accepted. That there will be 
many and difficult questions so ensuing must be evident to all 
who look with any wide view at the diversity of services of a 
medical nature now provided or supervised by the State. Such 
problems as the nature of the services, the manner in which they 
should be inter-related, the range of persons for whom they shall 
be available, the financial arrangements by which they will be 
supported, the appropriate division of the work between the 
central and local authorities—all these are problems which 
confront the students of our social system and to which, we think, 
a solution must ultimately be found. 
122. But though these matters cannot be dealt with at the 
moment, and are perhaps in any case beyond our Terms of 
Reference, we are glad that our proceedings have afforded the 
opportunity to many witnesses to state their views thereon. 
Such general expression given from a number of different points 
of view, e.g., that of the Medical Profession, that of the Approved 
Societies and Insurance Committees, that of persons so peculiarly 
interested in these developments as the Medical Officers of 
Health, that of independent observers and critics, cannot but be 
a valuable contribution to the consideration of these difficult 
problems and should be of assistance to those who at some future 
date will attempt their solution. ‘We who approach these matters 
from the point of view of the medical benefit provided under 
the Insurance Scheme, need only consider one or two matters 
of somewhat more limited range. 
CENTRAL AND LiocAL CO-ORDINATION. 
123. In the first place we may mention the question of 
co-ordination of effort in and between the Central Departments. 
On this point we have examined the official witnesses of the 
Ministry of Health which, as we have pointed out in Chapter IV, 
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