MAJORITY REPORT. 
Tar T00AL SYSTEMS OF ADMINISTRATION. 
34. When, however, we turn to a consideration of the local 
administration of these health services we find a multiplication 
of local administrative bodies and a considerable division of func- 
tions due to some extent no doubt to historical causes. It is true 
that the work relating to public health, maternity and child 
welfare, tuberculosis, and venereal diseases are controlled by one 
local authority and administered under one chief executive officer, 
namely, the Medical Officer of Health. But there remain under 
other independent local authorities the school medical service, the 
Poor Law medical service, the Insurance Service and in certain 
cases the Port Sanitary service. Further the medical inspection 
of factories stands outside the supervision of any local authority. 
The problems raised by the Port Sanitary service appear to be of 
such a special nature that probably nothing is lost by the existence 
of a separate authority, though in point of fact the I.ocal 
Authority in certain cases also acts as the Port Sanitary Autho- 
rity. Where, however, as often happens, the natural port area 
covers several municipal areas a joint and specially constituted 
authority is necessary. The administration of the school 
medical service stands, of course, in the closest relation- 
ship to the educational work of the local Education 
Authority, under whose direct control it is placed. The 
systems under which medical provision is made locally 
for the sick poor and for the insured population are entirely 
separate from each other, both in administration and in the 
financial arrangements which they require, the one being sup- 
ported by the local rates and the other by the contributions of the 
workers and their employers supplemented by grants from the 
Exchequer. Hach, however, must be locally managed and in 
respect of each the present method of administration must shortly 
come under review, the first in connexion with the pending 
reform of the Poor Law, and the second as a consequence of 
recommendations which we have decided to make and to which 
we refer at some length in a later chapter. The question 
naturally arises whether in the course of developments in these 
directions, an opportunity will arise to effect a measure of local 
unification which in the circumstances would be considerable in 
its scope and consequences. We note the possibilities in this 
respect, though it does not fall to us to consider them in any 
detailed manner. 
35. We now proceed to give a very brief outline of the various 
services under review. 
TUBERCULOSIS. 
36. The national scheme for the treatment of tuberculosis is 
administered locally by the Councils of Counties and County