18 
MAJORITY REPORT. 
maintenance under the Poor Law. It will be seen that in that 
statement there is furnished an account both of the central and 
the local administrations of these services, and that the costs 
to the Exchequer and to the local rates are given separately. 
The Scottish Board of Health have dealt with the corresponding 
problems in Appendix CV. In Appendix CIX the Board of 
Education have given an outline of the School Medical Service, 
and in Sir T. M. Legge’s statement (Appendix XTII) will be 
found an account of the system of medical inspection in factories. 
We have thought it advisable to supplement most of this material 
by oral examination, being satisfied in our minds that the inter- 
relationship of all the health services is one of the most important 
questions before us. 
32. Inasmuch as the descriptive statements referred to above 
are published in full in the Appendix to the Minutes of Ividence 
taken before us, it is not necessary to enter into the matter here 
in any elaborate detail. It may not, however, be out of place 
to furnish a short summary of each of these services similar in 
scope to that already given in Chapter II in the case of the 
Insurance Scheme ; and to comment in passing on one or two 
points of interest which have emerged. 
Tae CENTRAL CONTROL. 
33. In the first place, it may be observed that unity of adminis- 
tration at the centre is provided for in England and Wales by 
the single control of all these health services (except the school 
medical service and the inspection of factories), which is vested 
in one Department, namely, the Ministry of Health. So far as 
the schools are concerned, the Department actually supervising 
the work—the Board of Education—acts in this matter as the 
agent of the Ministry of Health, and the two Departments have 
a Chief Medical Officer in common. The Minister of Health, 
we are informed, has, in fact, in pursuance of a provision in the 
Ministry of Health Act, 1919, delegated the administrative 
arrangements to the Board, which continues to act subject to 
the suzerainty of the Minister. We were assured in evidence 
that effective co-ordination at the centre has been secured 
and that the high intentions with which the Ministry of 
Health was established have, so far as six years allow, not 
remained without fulfilment. We may quote the following 
extracts from the Kvidence. ‘‘ There is a very considerable 
measure of co-ordination by means of frequent consultations 
between the various heads of the Divisions as well as by reason 
of there being one Minister and one Permanent Secretary in the 
Ministry to whom all the heads of the Divisions are responsible.’’ 
(Kinnear, Q.24,199.) ‘‘ The arrangements for co-ordinating the 
work of the Ministry are such, I think, as to secure a continuance 
of this process as opportunity arises.” (Kinnear, Q. 24.211.)