r
v)
(0
}
MAJORITY REPORT.
the Public Health Authorities, by whom it has been greatly
developed and made available for the whole community.
Domiciliary treatment, however, remained as part of the service
which the insurance practitioner contracted with the Insurance
Committee to give to his insured patients. In this Chapter we
need do no more than point out that the removal of the
institutional treatment of tuberculosis marked a distinct change
in the conception of the responsibility of the State in this matter
as in place of provision for a restricted class, who in part
paid by insurance contributions for the service provided, there
was substituted a provision available for the whole population
and supported entirely by rates and taxes. We may quote the
following reply to a question we put to the Ministry of Health
representative on this question. ‘‘ An effective scheme for the
treatment of tuberculosis cannot be confined to one section of
the community, and the placing of the responsibility for the
treatment of all sections upon one local authority has had the
substantial advantages of (1) preventing local administrative
overlapping, (2) simplifying supervision by the Central Depart-
ment, and (3) enabling due attention to be given in the further
development of local tuberculosis schemes, to the needs of other
sections of the community, besides the insured, and especially
children. Even from the point of view of insured persons this
is an advantage as their dependants constitute the larger part
of the non-insured section of the community.” (Maclachlan,
Q. 24,092.)
SECTION C.—THE MEDICAL SIDE OF MATERNITY
BENEFIT,
104. No survey of the health services under the Insurance Act
would be complete if it omitted to take account of maternity
benefit. It is true that this is a cash benefit administered directly
by the Approved Societies, and that it differs from the additional
treatment benefits in that there is no control of the application of
the money given. Yet the money does in large part go to pay for
the services of doctor and midwife and the underlying purpose
of the benefit is to promote the health of mother and child at
the critical period of pregnancy and childbirth. Having regard
to the great importance of skilled advice and treatment at that
time, we feel confident that any development of this benefit will
be in the direction of an increase of the service element provided
under appropriate conditions of control. Accordingly we proceed
to a consideration of the maternity provision and the evidence
that we have received in this connexion.
EVIDENCE AS To MATERNITY BENEFIT.
105. Taking the professional evidence first, we find that the
British Medical Association in this as in the general problems