hE
MAJORITY REPORT.
a carefully built-up service organised on a single local basis in
which all varieties of preventive and curative work find their
appropriate place. (For an outline of the substance of the
English reports see Q. 24,170-24 172.)
THE PROFESSIONAL FVIDENCE.
117. From the evidence we have received from a wide variety
of witnesses similar conclusions may be drawn. For example,
the British Medical Association say : ** It is essential, not only
that the attention of all practitioners should be directed con-
tinually to the preventive aspects of their work, but that the
existing machinery and medical officers of the Public Health
Service should be brought into close and organic connexion with
the Insurance Scheme.” (App. XLVIL, 3); and again : “It
is desired to make all such benefits and services (i.e., pathological
facilities, treatment for tuberculosis and venereal disease and for
certain infective fevers, the treatment of certain conditions of
children of school age, provision in connexion with maternity
and infant welfare) an integral part of the Insurance Scheme
or to bring them into proper relationship thereto ** (App. XLVI,
20). The Society of Medical Officers of Health point out
that their service, primarily concerned in the preservation
of health generally, has from the beginning recognised the im-
possibility of adequately discharging its function in dissociation
from measures for the restoration of health to individuals.” ** I¢
has become evident that the present system of National Health
Insurance suffers great limitations in its possibility for promoting
health, and that profound changes are required if the improve-
ment in the health of the people is to continue to be aided and
not impeded by it.” ‘‘ The scheme . . . 1s, to a great
extent, isolated from the other schemes of the State in operation
and doing essentially similar work . . . the relationship of
such work to that done by local authorities should be of a most
intimate nature.” *¢ Centrally it is true that the administrations
are amalgamated in one Government Department, but such an
amalgamation is of comparatively little value if the practical and
detailed working of each in local areas is il] co-ordinated or
impossible * (App. LVI, 1-9). * The need for some genuine
co-ordination of all the medical agencies in every area has long
been severely felt, and the intricate and costly nature of the
provision necessary for the people constitutes an additional reason
for a full co-operation of all the institutions and personnel taking
part in this work.” (App. LVI, 11; Q. 16,934-16,940, 16,972-
16,974.)
TeE TAY EVIDENCE.
118. These are professional opinions. From the lay side come
similar recommendations. For example, Mr. Alban Gordon
says in paragraphs 86-41 of Appendix XIIT.— The unification
