H.—3l

Cost of Benefits The following is a statement of the expenditure on the various classes of benefits during the year, the figures for the previous year being shown in parentheses :— Maternity benefits— £ Public hospitals .. .. .. .. 133,946 Private hospitals .. .. .. .. 210,675 Medical practitioners' fees .. .. .. 158,409 Mileage fees, medical practitioners .. .. 5,647 Obstetrical nurses .. .. .. .. 11,117 St. Helens hospitals .. .. .. .. 10,940 £530,734 (£513,939) Medical benefits — £ Capitation fees .. .. .. .. 42,400 General medical services .. .. .. 1,161,326 Special arrangements .. .. .. .. 23,855 Mileage fees, medical practitioners .. .. 59,442 £1,287,023 (£1,179,331) Hospital benefits— £ Treatment in public hospitals .. .. 1,689,233 Out-patient treatment .. .. .. 83,412 Private hospitals .. .. .. .. 259,489 Treatment in approved institutions .. .. 56,504 Mental hospitals .. .. .. .. 187,942 Other institutions .. .. .. .. 54,120 £2,330,700 (£2,158,146) Pharmaceutical benefits— £ Chemists .. .. .. .. .. 933,490 Medical practitioners .. .. .. .. 6,231 Institutions .. .. .. .. .. 40,516 £980,237 (£762,198) Supplementary benefits — £ Radiological services .. .. .. .. 128,842 Massage .. .. .. .. .. 32,152 Nursing .. . . .. . . . . 7,717 Specialists .. .. .. .. .. 1,324 £170,035 (£137,823) £ Gross expenditure .. .. .. .. 5,298,729 Less credits-in-aid — £ Hospital benefits .. .. .. 64,012 Supplementary benefits .. .. 3 — 64,015 Net total .. .. .. £5,234,714 Pharmaceutical Benefits The cost of this benefit continues to increase, and represents an expenditure of 12s. 3d. per head of the population, as against 9s. per head in the previous year, exclusive of the medicines supplied to in-patients of public hospitals. Part of the increased amount is due to the same cause as operated in the previous year —viz., the extensions of the Drug Tariff, following extensions of the British Pharmacopoeia and British Pharmaceutical Codex, and the increase in costs of drugs. Apart from these two factors, the feature which has been in evidence since the inception of the pharmaceutical benefits—viz., the rise in the actual number of prescriptions—is still very marked. This rise has occurred despite any apparent deterioration in general health, and certainly without any increase in population, and is very disquieting. During the year the prescription frequency per head of population was 2-8. Cases of unnecessary, irregular, and expensive prescribing were brought to the attention of the Advisory Committee, and appropriate action taken on the Committee's recommendation. Disciplinary action has been necessary against certain contractors because of irregularities in connection with the supply of medicines. Pricing Office procedure was very difficult during the year owing to the impossibility of obtaining suitable and sufficient staff. The position has been very acute in some districts, and has resulted in considerable delay in the adjustment of final payments to contractors. It is possible that staff difficulties will ease considerably during the ensuing year.

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