More than half of the total 26,000 medical practitioners in England and Wales engage in contract practice under the National Insurance Act. Over one-third of the medical officers of health were district medical officers. Many voluntary hospitals receive payment from local authorities for work done for school children, for cases of tuberculosis, of venereal disease, etc. This does not necessarily imply a future absorption of the voluntary into officially supported hospitals. There is much to be said for the continuance of independent voluntary hospitals, which accepts payment for patients on an insurance basis. Hospital treatment for the rapidly increasing proportion of patients needing institutional treatment is urgently required and given available poor law beds could be supplied on a greatly increased scale. The increasing need for hospital treatment is a natural result of the great advances in surgery. The medical work and the care of children, aged persons, feeble-minded and insane, now undertaken by Boards of Guardians.