4.6 
MAJORITY REPORT. 
Cn 
is welcomed, nevertheless owing to various causes no payment is 
made from insurance funds in respect of a large proportion of 
those insured persons who receive treatment. ven in the case 
of those for whom insurance payment is made, the amount con- 
tributed is only a part of the average cost per occupied bed per 
week. No payment at all is made in respect of the general out- 
patient work which the witnesses urge ‘‘ is of great economic 
value not only to the State as a whole but also to Approved 
Societies in particular, by enabling members to return to their 
work more quickly after illness or accident *’ (British Hospitals 
Association, App. IVIL, 7). In connexion with this last point 
we examined witnesses to ascertain whether insurance practi- 
tioners were evading their proper work by sending their patients 
unnecessarily to the out-patient departments of the hospitals. 
But we are assured that this is niot so to any extent, and that 
“‘ the tendency is for the out-patient department to become more 
and more consultative, and patients appreciate the value of the 
benefit of treatment by the consulting staff of the hospitals *’ 
(British Hospitals Association, App. LVII, 10). We are told 
that, whereas in the past patients attended at the out-patient 
department almost entirely of their own volition, the number 
coming now on the advice of their medical attendants is about 
50 per cent. of the total. 
94. The contention of the hospitals is, therefore, for a fuller 
measure of financial assistance in respect of all insured persons 
using the hospitals in any way. Af the same time they are opposed 
tc any encroachment on their voluntary status, and the British 
Hospitals Association suggest that ‘‘there should be no contract 
to treat, but . . . that the important role filled by the 
voluntary hospitals in supplementing the work of the panel prac- 
titioners and in furnishing the additional services. |. 
should be recognised by practical assistance from insurance 
funds >’ (App. LVIIL, 14). 
95. The figures of costs submitted by the Sheffield Joint 
Hospitals Council in App. LVIIT are of interest. It appears 
that, in 1923, in respect of three general hospitals in Sheffield, 
the total cost of providing services to patients (3,221 in-patients 
and 15,269 out-patients) who were insured persons was £28,870, 
while the total amount received from insurance funds was only 
£4,300. In considering these figures it must, however, be borne 
in mind that, had there been no Insurance Scheme, the hospitals 
would still have borne the cost and would have been without the 
substantial relief which the Insurance Funds have brought. 
Further, the insured persons, like other citizens, make voluntary 
contributions to the funds of the hospitals through subscriptions, 
collections, club arrangements and the like; and they receive 
from the hospitals no preferential treatment over the rest of 
the population.