MAJORITY REPORT.
9
a general practitioner. The definition given in the Regulations
now in force is as follows :(—
“ The treatment which a practitioner is required to give
to his patients comprises all proper and necessary medical
services other than those involving the application of special
skill and experience of a degree or kind -which general
practitioners as a class cannot reasonably be expected to
possess.”’ (Clause 8 (1) of Part I of the First Schedule to the
Medical Benefit Consolidated Regulations, 1924).
59. We were so much impressed by this limitation—imposed
as it was by regulations and not explicitly in the Act itself—that
we examined the official witnesses of the Ministry of Health on
the point at some length. We were told (Brock, Q. 995) that
the apparently narrow view taken was based on the advice given
to the Insurance Commissioners by their legal advisers at the
inception of the Scheme. This was to the effect that the pro-
visions of Section 24 of the 1924 Act (Section 15 of the 1911
Act) were not consistent with anly other view. The Act gave
every duly qualified medical practitioner a right to come upon the
medical list, and it contemplated that every insured person would
have one medical attendant but not more than one at a time,
and that if the insured person did not himself choose a doctor,
he might after a certain time be allocated to a doctor by the local
Insurance Committee. Thus the effect of the provisions of the
Act was that the insured person was entitled to receive
from one doctor, and from one doctor only, the whole of
““ medical benefit >’ whatever that phrase might mean. In
these circumstances it appeared to the legal advisers and
to the Department that the scope of medical benefit must
be construed as limited to services within the competence
of the average general practitioner. Further, though the
medical lists included a certain number of men with special
experience, whose competence in certain directions was therefore
above the average, it was felt that if all doctors were to receive
the same rate of remuneration, as practical considerations were
found to require, a uniform obligation and a uniform con-
tent of service were implied; and that it would not be
equitable to require one man, because he happened to possess
some special skill, to render a wider range of service than was
required from the majority of his fellow practitioners engaged
under the insurance contract.
60. Though this limitation of the service has been from time
to time commented upon (see Brock and Smith Whitaker,
Q. 1080-1101) and though on all sides a fuller conception of
medical benefit has been urged upon us by witnesses, no attempt
to challenge it in the Courts has ever been made during the 13
years of its operation. We may fairly assume, therefore, that
it is valid on legal grounds and we recognise the general and