162 
MAJORITY REPORT. 
capitation rate, the extra attendances required for the latter group 
being set off against the fewer attendances required by the 
former. The present cost of medical benefit in Great Britain 
is about £9,000,000 a year, and on the assumptions indicated 
above the extra cost of extending benefit to dependants would 
be about £9,500,000 a year. 
369. This is a very large sum, and one which far outruns any 
margin in the present contribution. Even if on other grounds 
it were felt that this extension merited the first place in the 
order of priority, the cost appears to us to be prohibitive having 
regard to our general views on the financial position. An 
addition of £9,500,000 to the charges on the Benefit Funds 
would mean an addition of between 2d. and 3d. to the weekly 
contribution even supposing that a corresponding addition to the 
State grant would be forthcoming. Such large expenditure 
cannot, we think, be contemplated in present circumstances. 
370. But quite apart from cost, there are certain general con- 
siderations of policy which lead us to the conclusion that this 
extension is undesirable if it were proposed within the ambit of 
the present Insurance Scheme. Before we proceed to examine 
this matter we may give a short summary of the evidence we 
have received on the question. 
PoINTS RAISED IN EVIDENCE. 
371. The Loyal Order of Ancient Shepherds (App. XLIV, 35) 
urge the provision of medical benefit to the dependants of insured 
persons and are of the opinion that this could be made a first 
step towards the establishment of a Public Medical Service. 
They express the view that insured persons would be willing 
to pay an increased contribution to meet the cost of this benefit. 
The Independent Order of Rechabites (App. VIII, 30; Q. 6310) 
think that the provision of medical benefit to dependants would 
be a distinct advantage to public health and would tend to 
remove the overlapping which at present exists between the 
Public Health Services. The Coventry Insurance Committee 
(Q. 12,299-12,300, 12441-12,442) state that the effect of the 
non-provision of the benefit to the dependants of insured 
persons is to set up different standards of health in the 
community. The Cheshire Insurance Committee (App. XXXIV, 
B, 21-24; Q. 12, 626-12,630) suggest an increase of the contribution 
for the purpose of providing medical benefit to dependants. 
The British Medical Association (App. XLVII, 13-15; Q. 14,845- 
14,876, 14911-14913) suggest that medical benefit should be avail- 
able only to persons with less than a certain income, and that if 
this income limit is fixed sufficiently low the dependants of 
such persons should be included. Mr. Cohen (App. LXXVI, 
6-7) urges the provision of the benefit, and points out that 
““ the burden of the illness of a wife or child, borne as it is