21.2 
MAJORITY REPORT. 
(Kinnear, Q. 23,689-690, 23,781). We may also point out 
that there are other illnesses, such as neurasthenia, in respect of 
which an almost equally strong case could be made for a similar 
concession. Any modification of the kind suggested would add 
seriously to the difficulties attending medical certification and 
the determination of claims for benefit. We accordingly do not 
think that this suggestion for the special case of the tuberculous 
persons can be recommended. 
MeDICAL CERTIFICATION. 
504. It is indispensable to the proper administration of sickness 
and disablement benefits that the incapacity of the insured person 
who is claiming benefit should be medically certified at frequent 
intervals, and the provision of certificates is accordingly one of 
the duties undertaken by the insurance practitioners under their 
contracts with the Insurance Committees. Under the present 
arrangements a certificate is supplied at the outset of incapacity, a 
second, if necessary, after not more than seven days, and there- 
after once weekly ; but in cases of prolonged incapacity, where 
the doctor does not regard it as necessary to see the patient more 
freqiently than once in four weeks, it is open to him, with the 
concurrence of the Society, to give certificates separated by this 
interval. 
505. Tt has been submitted to us in the evidence of the British 
Medical Association that these periods should be extended at 
the option of the practitioner to 14 days in the case of sickness 
benefit and 42 days (or in rural areas three months) in the case 
of disablement benefit (App. XLVII, 53). In examination, it 
appeared that proposals to this effect had been made by the 
profession to the Approved Societies but had not been accepted. 
We have not ourselves thought it necessary to recall witnesses 
from the Societies to give evidence upon the point, in view of 
the facts which were brought out in the investigations of the 
Actuarial Committee. These facts, had they been available 
to the profession when its proposals were being formulated 
must. we think, have raised in the minds of the medical witnesses 
the same doubts as to the wisdom of this proposal as they have 
in ours. The First Report of the Actuarial Committee shows, as 
we have elsewhere explained, a constant and serious rise in the 
sickness claims of women and in the disablement claims of both 
sexes; and it is pointed out, moreover, in the Appendix to that 
Report (para. 11), that of those who receive disablement benefit 
in the course of a year, a large proportion rising, at the ages 
under 40, to 40-50 per cent., ** go off the funds’ during the 
year, thus showing that those in receipt of this benefit at any 
time are, as a class, very far from being a body of permanently 
sick persons. In these circumstances the need seems to be for 
more. rather than less. supervision, and it is impossible for us