It has been an unfortunate flaw in the magnificent scheme of Insurance
that this vital fact was not allowed for, that the old-fashioned notion
that treatment rather than prevention is the object of medicine was
still perpetuated, and that nothing was done to co-ordinate the
Insurance scheme with the existing Health Services.
It seems probable that in a Service of State medical officers the
solution may ultimately be found. Such a solution would, indeed,
immensely increase the value of the Insurance scheme, and, in the end,
confer far greater benefits than at present on the millions of people who
would come under its operation. For there can be no doubt the Club system
is not only unscientific; it is also undemocratic. It perpetuates what
was originally a semi-charitable and second-rate method of treatment of
the poorer classes. A State medical officer, devoting his whole time and
attention to his State patients, has no occasion to make invidious
distinctions between public and private patients.
A further advantage of a State Medical Service is that it will facilitate
the inevitable task of nationalising the hospitals, whether charitable or
Poor-law. The Insurance Act, as it stands, opens no definite path in this
direction. But nowadays, so vast and complicated has medicine become,
even the most skilful doctor cannot adequately treat his patient unless
he has a great hospital at his back, with a vast army of specialists and
research-workers, and a manifold instrumental instalment.
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