hy 
MAJORITY REPORT. 
“—— 
9. The second main cause leading to amendment of the Act 
is to be found in the War and its economic consequences. It 
1s a striking tribute to the general soundness of the lines on 
which the original Act was constructed that its administration 
was able to bear the severe strain imposed by war conditions 
at so early a date in its history. In relation to National Health 
Insurance the War did. not merely occasion great difficulties in 
carrying on a scheme largely dependent on voluntary work and 
still in its early’ stages, but it raised problems calling for legis- 
lation to secure a measure of adaptation to the new conditions 
brought about, among many changes, by the absorption of so 
large a proportion of the population in the Forces, the grant of 
war pensions to disabled men and the general rise in the level 
of wages. 
THE AMENDING ACTS. 
10. Without entering into any detail, it may be convenient to 
refer briefly to some of the more important amending Acts 
passed during the period under review. The earliest Act was 
that of 1913, the immediate object of which was to make pro- 
vision by Exchequer grant for the additional cost of medical 
benefit. At the same time, the opportunity was taken to give 
effect to a certain number of minor amendments the need for 
which had been disclosed in the early period of the operation 
of the Act. In 1915 and 1917 two Acts were passed in order 
to effect an adjustment in the rate of benefit payable to discharged 
soldiers in receipt of total disability pensions. Much more 
important was the Act of 1918, which followed the Report of the 
Departmental Committee on Approved Society Finance and 
Administration. The okject of this Act was primarily to give 
effect to certain financial adjustments in the Scheme designed 
to strengthen the position of the weaker Societies ; but it also 
introduced a large measure of simplification in regard to a con- 
siderable number of administrative details. Of later measures 
two, passed in 1919 and 1920, were occasioned by changing 
economic conditions, the first raising the limit for insurance of 
non-manual workers from a rate of remuneration of £160 to 
£250 a year, and the second increasing the rates of contributions 
and of benefits. Apart from these, it is only necessary 
to refer generally to the Acts dealing with the cost of medical 
benefit and to mention as of special interest the Act 
which made provision for prolongation of insurance in certain 
cases in order to meet the hardship occasioned by the general 
prevalence of unemployment. It was inevitable that this con- 
siderable volume of uncoordinated legislation should add not a 
little to the difficulties of administration and it was of material 
advantage to all concerned when in 1924 the whole of the 
existing legislation relating to National Health Insurance (with 
the exception of certain temporary provisions) was consolidated