318

MINORITY REPORT.

effected and that further improvement would follow the extension
of medical benefit to the whole nation. ‘Illness is now coming
under skilled observation and treatment at an earlier stage than
wag formerly the case,” is the considered view of the British
Medical Association, a development ‘which, however desirable
among the insured population, must be even more desirable for
young children and mothers. ‘The public health is the
primary asset of the nation’s welfare, whether measured by
capacity, employability and production or by length of days or
by personal well-being.”” (Annual Report of the Chief Medical
Officer, Ministry of Health, 1924, Para. 586) and * Wise progress
 is not to be looked for in the curtailment of public medical
services . . . . but for their prudent establishment and where
necessary their extension on sound lines . . . . Public assistance,
insurance and education are the three great principles which seem
to lie at the foundation of a public health service.” (Para. 587).
92. So far from agreeing with the argument that the provision
of medical benefit to dependants would postpone or impede the
establishment of a fully developed public medical service as foreshadowed
 in the Majority Report, we feel confident that it would,
on the contrary, further the realisation of that scheme. We
therefore recommend that Medical Benefit should be provided for
the dependants of insured persons and that the immediate expenditure
 should be met by the Exchequer and the local rates
in equal proportions.

RATES OF SICKNESS AND DISABLEMENT BENEFITS.

93. The inadequacy of the rates of these benefits would, in
our judgment, be sufficient reason for recommending an increase,
but attention was drawn to the disparity between the rates of
benefit under the National Health Insurance Act and the Unemployment
 Insurance Act by witnesses representing the Department,
 Friendly Societies and Trade Union Approved Societies.
Qir Walter Kinnear referred to the difference as °° rather
anomalous >’ and ‘as difficult to defend,” and expressed am
opinion (Q. 473) which supports the view of the Hearts of Oak
Benefit Society, that ‘** formerly people on the border line of
incapacity would tend to go on the sick fund. They will not do
s0 now, because it pays them to receive unemployment benefit *’
(Q. 3368). Our colleagues repeatedly express their opinion
“that it is difficult to justify a less generous provision for the
invalid than for the man who is in good health, whose circumstances
 certainly involve smaller expenditure.”
94. The necessity for uniformity in the rates of benefit does
not dispose of the whole matter. We think it not unreasonable
to suppose that unemployed persons will delay in obtaining
medical advice and treatment under the Health Insurance Act,
lest they should be disentitled to the higher rates of the Unem-