MAJORITY REPORT.
Yori
schemes. Here we need only say that our exclusion of these
elements from any immediate provision of a generally available
medical benefit is dictated in the main by financial considerations
—though, of course, we have carefully considered from every
point of view the relative claims of the various possible extensions
on the available funds.
968. We conclude, then, that the extended medical benefit to
be recommended for immediate adoption should add to the
general practitioner service only the three elements stated in
paragraph 263 above. We now proceed to describe these in
detail, to indicate methods of administration, and to give estimates
of the cost involved. In this connexion we direct special atten-
tion to the statement which the Ministry of Health have sub-
mitted to us in Appendix CII, dealing with the numerous dis-
cussions of these problems between the National Health
Insurance Commissioners and the medical profession and also to
the examination of Mr. Brock and Dr. Smith Whitaker in
Questions 23,830 to 23,846. The problem is obviously no new
one, and but for the War would probably have been solved many
years ago.
Provision oF EXPERT TREATMENT OR ADVICE FOR PERSONS
ABLE TO TRAVEL.
- 269. The services which specialists can render to supplement
or assist the work of the general practitioner include (1) advice as
to diagnosis, (2) advice as to treatment which the practitioner
can himself properly undertake, and (3) treatment of a kind which
only a specialist can give, or for which special resources of equip-
ment and skilled assistance such as that of masseurs or
electricians, are requisite.
270. A difficult question of principle emerges at the outset.
Services of this kind are, to a certain extent, already available
for insured persons, as for other members of the community,
In the out-patient departments of hospitals. Do the services thus
obtained fall short of the requirements of a satisfactory service
for the whole insured population? If they do, is some scheme of
Supplementation of these services practicable and desirable? Or
are we driven to the conclusion that the specialist out-patient
service must be provided completely irrespective of what the
hospitals are already doing?
271. Dr. Smith Whitaker, in answer to questions
on these points, replied :—‘* The local authorities, whatever
they were, who had to carry out the organisation would
Probably adopt a variety of methods, some in one place
and some in another, but generally we doubt whether a system
Which was based on contracts with the hospitals for providing the
services would work satisfactorily. The insurance authority,
