A mental effort is needed to realize the distance traveled in the public provision of medical assistance in the United Kingdom by the state and by voluntary organizations, including the committees of hospitals, convalescent homes, dispensaries, etc., prior to the passing of the National Insurance Act of 1911. I have already given some illustrative figures regarding hospitals. The _Lancet_ some years ago gave a statement of the number of attendances of patients at voluntary hospitals in London during the year 1908. Assuming that each out-patient made five attendances, that all in-patients had previously been out-patients and that no patient received a hospital or dispensary letter more than once in the year, it could be inferred that a number equivalent to one in four of the total population of London had received free medical aid in these voluntary institutions during that year. And this did not include the large mass of treatment given gratuitously in poor-law infirmaries, public-health fever and tuberculosis hospitals, and lunatic asylums. The majority of the medical profession in Great Britain is engaged in either whole-time or part-time service for the state or for local authorities. Of the 24,000 medical practitioners in England and Wales, some 5,000 are engaged as poor-law doctors, some 4,000 or 5,000 in the public-health service, possibly 500 in the lunacy service, some 1,300 in the school medical service, and smaller numbers in various other forms of medical service for the state. This is exclusive of the general practitioners who undertake contract work under the National Insurance Act, and who cannot fall far short of three-fourths of the total membership of the profession. It should be noted that many doctors hold several appointments. The state has, quite apart from National Insurance, given a rapidly increasing amount of medical assistance to the public. 1. Under the Poor Law, every destitute person is entitled to gratuitous medical attendance, at home or in an institution, and after a fashion has received this during the last century. 2. The institutional treatment of lunacy has grown to an extent which permits the treatment in an asylum of every certified lunatic. 3. The treatment at the expense of the state of feeble-minded persons is rapidly increasing. 4. Public health authorities provide institutional, and to a limited extent domiciliary, treatment of infectious diseases, this treatment being given, as in the preceding cases, in nearly every instance gratuitously.