MAJORITY REPORT. 
15% 
pr —S 
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 pat- 
tially 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 rela- 
tive. 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 re- 
mained 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 addi- 
tional 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 remem- 
bered 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