MAJORITY REPORT. 
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£30,000 was spent in the year. It is not a costly benefit, the 
average charge per case being, we are told, about 15s. While 
there is a general consensus of opinion as to its value we have 
encountered, especially in the professional evidence, a strong 
conflict of opinion as to the method by which it should be pro- 
vided. The British Medical Association (App. XLVI, App. C; 
Q. 15,006, 15,116-15,117, 15,145-15,154), the Council of British 
Ophthalmologists (App. LXIII, 2-3; Q. 17,777-17,778) and the 
Ophthalmic Benefit Committee (App. LXIV, 3-7; Q. 17,940 and 
17,955) insist that in any case of ocular disorder or visual defect 
the benefit should only be available on the recommendation of a 
medical man basing their contention on the intimate connexion 
between the state of the eye and the general health of the body. 
They submit that the training of the general practitioner fits him 
to determine whether this recommendation should be made, and 
that for the purpose of dealing with any cases requiring special 
advice or treatment there is a sufficiently large number of medical 
men with training or experience in ophthalmology adequately 
covering the whole country. On the other hand the Institute of 
Ophthalmic Opticians (App. LX, 14-21; Q. 17,491-17,495, 17,506- 
17,507, 17,510), the Joint Council of Qualified Opticians (App. 
1.XI, 27-32; Q. 17,698, 17,677-17,689, 17,694-17,697) and the 
British Optical Association (App. LXII; Q. 17,717 and 17,723) 
have urged that direct access to the optician should be allowed as 
in the case of the dentist, and have supported their argument by 
drawing attention to the training now required by these organisa- 
tions and by citing the evidence of medical men. They also 
contend that ‘¢ the medical practitioner’s knowledge of optics is 
not iso thorough as that of the optician ”’ (J.C.Q.O., Q. 17,660), 
and while admitting the superior skill of the ophthalmic surgeon 
state that the number of such surgeons would be inadequate for 
coping with the work. We feel that this is a very contentious 
matter, on which it is difficult for laymen to pass judgment. But 
we understand that the Ministry of Health, acting on the advice 
of their medical advisers, have taken the view that the medical 
practitioner must intervene and in this conclusion we think we 
must concur. For a full statement of the views of the Ministry of 
Health on this difficult problem we refer to the reply by Dr. Smith 
Whitaker to Q. 23,956. 
89. We are also informed that it has been clearly laid down by 
the Ministry and accepted by the medical profession that any 
work which might be involved in recommending a case as proper 
for the receipt of this benefit is included within the scope of the 
obligation already imposed on insurance practitioners towards the 
insured persons on their lists, and that consequently no question 
of any increased cost to the insured person obtaining the recom- 
mendation can arise (Ministry of Health, App. I, C, 67). Where 
such a recommendation has been granted or forwarded to the 
approved society, it is for that body to decide what steps shall be