MINORITY REPORT. 
315 
which, with 6d. added in respect of the domiciliary treatment of 
Tuberculosis, made available a sum of 9s. per head per annum 
for medical benefit. An Exchequer grant in respect of medical 
benefit continued until the 31st March, 1922, since when the 
cost of medical benefit has been met from insurance funds, in- 
cluding the statutory State grant of two-ninths of the cost. 
This change was made in pursuance of a recommendation of the 
Committee on National Fconomy under the Chairmanship of 
Sir Eric Geddes. 
78. At the commencement of the Act, when the estimated 
cost of medical benefit was 6s. per head, each Insurance Com- 
mittee was to enter into agreement with each Approved Society 
as to the sum to be paid by the Society to the Committee in 
respect of the cost of medical benefit for its members resident in 
the area (Section 15 (6) of the Act, 1911). This arrangement 
being impracticable, the organisation of medical benefit was 
undertaken by the Central Department. 
79. While we agree that the modifications in the method of 
administration were necessary we suggest that the removal of the 
duties from the Tiocal to the Central Authority has obscured the 
intentions of Parliament expressed in Section 15 (7) of the Act 
of 1911, now Section 85 of the Act of 1924. That Section, which 
has never been repealed, provides that the Treasury and the Local 
Authorities may bear some part of the cost of medical benefit 
beyond the statutory grant. 
80. There is moreover a further reason why the provisions of 
the Act in this respect should be considered. We have already 
indicated our complete agreement with our colleagues in their 
recommendations to transfer the administration of medical benefit 
to Local Authorities. We feel, however, that to bestow powers 
and duties of such importance and magnitude upon the Local 
Authorities without any direct financial responsibility, is a 
departure from the principles of local government hitherto 
considered essential in this country. We take the view also that 
the Central Authority exercises its powers of enforcing economy 
on and of encouraging desirable developments by Local 
Authorities by reason of the financial arrangements between the 
two Authorities and we should be more confident of securing 
efficient development and of enlisting local interest if the usual 
financial principles operated in respect of medical benefit. 
81. We therefore disagree with our colleagues that the first 
charge on the margin should be the balance of the cost of the 
present medical benefit and we recommend that the cost of the 
present medical benefit in excess of the sum of 9s. 6d. per 
insured person per annum provided in the Act of 1920 should be 
borne by the Treasury and the Local Authorities as provided by 
Section 85 of the Act of 1924. The aggregate cost of this balance 
is estimated at £21 millions. 
34709 
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