Report of the Royal Commission on National Health Insurance

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Monograph

Identifikator:: 1740277147

URN:: urn:nbn:de:zbw-retromon-132094

Document type:: Monograph

Title:: Report of the Royal Commission on National Health Insurance

Place of publication:: London

Publisher:: Stationery Office

Year of publication:: 1926

Scope:: XII, 394 S.

Digitisation:: 2020

Collection:: Economics Books

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Document type:: Monograph

Structure type:: Chapter

Title:: Chapter XII. Consideration of certain major problems

Collection:: Economics Books

159 MAJORITY REPORT. 343. We have given long and careful consideration as to whether we should recommend that this improved provision for maternity should receive second place in the extensions to be recommended by us, the first place having been allotted to the provision of a specialist and consultant medical service. We fully recognise the importance, in the interests of the health of the nation, of doing everything possible to insure that women should have skilled attention during pregnancy and childbirth, and we were impressed by the evidence submitted to us as to the failure of the present maternity benefit to effect any reduc- tion in the rate of maternal mortality. Finally, however, we came to-the conclusion that the second place in our recom- mended extensions should be given to the provision of allowances to the dependants of insured persons in receipt of sickness or disablement benefit, and that extended provision for maternity should be given the third place, with the result that it cannot be included in the extensions which will become immediately practicable under the financial re-adjustments which we recom- mend in Chapters VII and IX of our Report. It was with considerable reluctance that we arrived at this decision. Apart from the claims, on its own merits, of the proposal for giving allowances in respect of dependants, we were influenced by the consideration that it was of the utmost importance that any scheme for making better provision for maternity should be linked up in the closest possible way with the maternity and child welfare work of the Local Authorities. There might, therefore, be some advantage in refraining from change until the T.ocal Authority has become (as we propose) responisible for the insurance medical service as well as the other public health services, and has had time to take stock of the position on bot: sides of its work and to familiarise itself with the new problems which will arise. THE PROBLEM OF MAINTENANCE. 344. Turning now to the other aspect of the question as repre- sented to us by witnesses, viz. : the provision of maintenance for mother and child, we have found some difficulty in arriving at a reliable estimate of the cost which would be involved and we foresee many difficulties in the administration of such allowances as are proposed. On this matter also we sought the guidance of the Actuarial Committee. In reply it was pointed out to us that the problem of intention to resume work must necessarily arise, and that calculations could not be made authoritatively until the method of dealing with that problem had been settled. The aim of the advocates of this part of a maternity scheme is to provide for the wage-earning woman So as to recompense her for the definite pecuniary loss incurred by her withdrawal tem- porarily from employment by reason of her pregnancy and con- fnement. The difficulty of determining whether or not a par-

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