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of between 40 and 80 members. Middlesex Insurance Committee now has 80
members; one-fifth of this number represent the County Council, of whom two
must be women; in addition there are 3 medical men. So there are 2 members
of the County Council on the Insurance Committee for each parliamentary
division, besides the 2 women and the 3 medical men.
"Apart from expenses rendered obligatory by the ever-changing orders and
regulations, the ordinary working expenses of approved societies and insurance
committees call for full enquiry. There is ground for believing that the
administrative expenses of many insurance committees are quite unnecessarily
high. Some committees are almost as lavish in their printing and postage
accounts as the Commissioners, and from time to time instances of reckless
waste come to light which would be ludicrous, if they were not signs of a
carelessness leading to serious extravagance. Under sanatorium benefit there
is little doubt that in some areas persons in advanced stages of phthisis have
been sent to expensive sanatoriums simply to satisfy a popular fancy, without
the least chance of cure and when much cheaper forms of treatment might have
been used with equal benefit. It may not be easy or even possible to calculate
how far the complexities that have been uselessly woven around the Act are
responsible for the waste of money in administration, but it is quite certain
that the working of the Act could be made infinitely simpler, and that the
result would be an enormous saving in administration expenses." From " The
British Medical Journal," 19th December, 1915.
The scheme of the County Council provides for the treatment of both the
insured and the non-insured over the whole County. The Insurance Committee
pays to the County Council, so far as its sanatorium funds allow, the actua|
cost of maintenance of insured patients in institutions, and a proportion of the
upkeep of the dispensaries. The treatment of insured persons began in July,
1913, and of non-insured persons in November, 1913. A revised agreement for
60 years has been arrived at, limited to the provision of 60 sanatorium beds and
40 hospital beds. Above these 100 beds the cost of institutional treatment for
insured persons will fall on the County rate.
The funds available for the maintenance of patients come now from
four sources :—
1. yd. per head per insured person per annum from the Insurance
mittee, estimated to produce £10,500.
2. A contribution, where possible, from non-insured persons towards the
cost of their treatment.
3. One moiety of the balance from the Imperial Exchequer.
4. One moiety of the balance from the County Fund.