Full text: Report of the Royal Commission on National Health Insurance

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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
	        
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