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

MAJORITY REPORT. 
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1 
TaE LiocAL, MEDICAL AND PANEL COMMITTEES. 
126. Passing now to the consideration of the Local Medical 
Committees and the Panel Committees, we would observe in 
the first place that these bodies have proved a valuable element 
in the medical side of the Insurance Scheme. The principle 
of having in each area a representative body of medical men, 
to whom professional questions are referred and by whom many 
of the administrative problems affecting the insurance 
practitioners are considered, has evidently been acceptable to 
both lay and professional opinion. It might be held that the 
same results would be obtained by the presence of elected or 
co-opted medical members on the local administrative bodies. 
But we think—and evidently the framers of the Scheme 
thought also—that something more than this was desirable ; and 
that to secure the full co-operation of the Medical Profession, 
so necessary to the scheme of medical benefit, the independent 
position given by the two statutory and purely professional 
Committees was essential. It is true that in most cases the 
two Committees have the same personnel, and indeed we are 
told that the Ministry has ii many areas recognised the Panel 
Committee as the TLiocal Medical Committee. Yet each 
represents a distinct idea, the former the effective voice of the 
practitioners in contract with the Insurance Committees, the 
latter the combined experience and opinion of all types of medical 
men in the area whether “‘ on the panel’ or in the most 
exalted specialist practice.” Under such an extension of medical 
benefit as we recommend in Chapter X and even more so in any 
larger developments of the future, the two Committees will 
necessarily tend to coalesce and become, if they are continued, 
the single expression of professional wisdom in the area. We do 
not doubt that they will be continued in any immediate develop- 
ments, and equally we see in them the hint of a local professional 
committee working side by side with the single local health 
authority in all parts of the country. 
AVAILABILITY AND FINANCE. 
127. Much of the evidence we have received on the general 
subject with which we are now dealing has been directed towards 
two highly important problems, namely, the classes of persons for 
whom the public and insurance medical services should be avail- 
able, and the manner in which the costs of such services should be 
met. At one extreme are those who would limit the services 
strictly to the necessitous and finance them from public funds, 
leaving the rest of the population to make their private arrange- 
ments. Af the other are those who advocate the provision of a 
complete service for the whole population without distinction of 
class or means, the cost being defrayed entirely from Hxchequer 
orants and local rates.
	        
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