182 
MAJORITY REPORT. 
number of clinics, using hospital premises for the purpose, 
whenever these could be obtained. We are aware of the 
objections of the medical profession to a general system of clinics, 
even clinics under professional control, and we have always 
before us the importance of securing the willing en-cperation of 
the profession at each advance in the public arrangements. We 
therefore think it would be undesirable at this stage to attempt 
a uniform system and that full opportunity should be given for 
composite local schemes. 
285. If arrangements were made for the work to be done at 
the physician’s or surgeon’s consulting room, no question of 
employment of additional nurses or other ancillary staff need 
arise. So far as arrangements were made with hospitals, they 
would usually be able to provide the requisite staff, as part of 
the contract for the use of their premises. In so far as it might 
be found necessary to establish new clinical centres, nurses, 
masseurs and electricians would have to be employed. 
METHOD OF REMUNERATION OF CONSULTANTS AND SPECIALISTS. 
286. If the work were done at the doctors’ consulting rooms 
they would probably prefer to be paid a fee per case. It would, 
however, be possible, even under that arrangement, to pay on a 
time basis, the arrangement being that a fixed number of cases 
would be summoned to attend at the consulting room at a specified 
time, this being the number which would normally occupy about 
21 hours. A fixed fee would be paid for the session. Where 
treatment was given at centres at which various specialists 
attended, the proper method of remuneration would be on a 
time basis. 
FSTIMATE OF COST OF PROVISION FOR PERSONS ABLE TO TRAVEL. 
287. The Ministry of Health have submitted to us an estimate 
of the cost of providing this part of the service on the basis of 
sessions at fixed centres at which the specialist and the insured 
persons would attend. The costs to be provided for include (1) 
the fees for physicians and surgeons, (2) payment of ancillary 
staff, including nurses, masseurs and electricians, (3) rent of 
premises, (4) travelling expenses for insured persons, (5) cost 
of administration. 
988. The estimate has been based upon inquiries made by the 
Regional Medical Officers and on statistics published by certain 
hospitals. The conclusion of the Ministry is that for the insured 
population of 13} millions in England and Wales the cost would 
not, on the lowest assumptions as to number of persons referred 
and other factors of cost, fall below £487,000, and would be 
unlikely to exceed £940,000 per annum. This is, of course, a 
wide difference. It is mainly due to different assumptions as to 
the proportion of the insured population that would be referred 
to the specialist.