1.8() 
MAJORITY REPORT. 
a 
to him, and a statement of the points on which specialist 
opinion is desired. Such an arrangement is already in 
force where cases are referred to the Regional Medical 
Officer or to the Tuberculosis Officer. This system has 
received the cordial approval of the medical profession. The 
obligation thus placed on the insurance practitioner would be 
accompanied by a similar definite obligation on the specialist. 
The practitioner should receive a report on any person treated 
by the specialist, with advice as to further treatment, and also 
in cases not needing specialist treatment, advice as to diagnosis 
or as to the treatment which the practitioner himself should carry 
out. 
979. The provision of specialist services in this way as part of 
medical benefit would result in :— 
(1) A substantial increase in the availability of such 
services, 
(2) A substantial increase in the proportion of cases in 
which general practitioners would avail themselves of such 
services. 
(3) A greater disposition on the part of insured persons to 
obtain benefit. 
(4) An exchange, not as now in a proportion of cases only, 
but in all cases, between the practitioner and the specialist, 
of the information which each should have, and definite 
guidance for the practitioner as to both diagnosis and treat- 
ment. 
REACTIONS ON EFFICIENCY OF GENERAL PRACTITIONERS. 
980. These in themselves would be great advantages, but of 
equal importance, in their ultimate bearing on the health of 
insured persons and of the community generally, are the 
prospective indirect effects of such a system in improving the 
efficiency of the general practitioner. It has been long 
recognised that he suffers great disadvantages in the maintenance 
of his professional efficiency, through the isolation experienced 
under present conditions of practice. A large proportion of 
practitioners have few opportunities for coming into contact with 
those who are devoting themselves to the study and practice of 
particular branches of medicine and surgery. Unless they have 
mixed practices with a fair proportion of persons of means there 
are few opportunities of comparing the expert’s view on a case 
with their own. Of the real deficiencies in their methods which 
would be observed by a competent colleague, they are thus neces- 
sarily unaware. 
281. In a system under which specialist services and general 
practitioner services were welded into one scheme, the conditions 
of general practice in this respect would be completely changed.