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

168 MAJORITY REPORT. Tr —_———— 381. Sanatorium benefit was, until 1921, administered by the Insurance Committees, but in that year was discontinued, the responsibility for the institutional treatment of tuberculous insured persons being transferred to the Local Authority, which already dealt with the uninsured, and the responsibility for domiciliary treatment remaining part of the content of medical benefit. MEDICAL BENEFIT. 382. Taking the above five points in order, we have first to consider medical benefit. The normal arrangement by which medical benefit is made available to insured persons is that the Insurance Committee form a list of the doctors and a similar list of the chemists in the area who are willing to treat or to provide medicines for insured persons at a scale of remuneration and under conditions agreed upon by the Committee subject to the approval of the Minister. Tt was originally intended that these contracts should be framed locally, and that they might vary considerably in nature according to the particular conditions of the several areas. It was found, however, that in practice the whole of the arrangements leading up to the contracts had to be made centrally by discussion between the Departments and representative bodies of practitioners and chemists. The terms so agreed form the basis of the local contracts throughout the country. Tiocal modifications are of a comparatively unim- portant character (App. I, C, 35-36). 383. Thus what might have been a very responsible and difficult piece of work has in fact so far as the Insurance Committees are concerned, been reduced to a routine capable of being performed by the local officials under a minimum of supervision by the Committees. The really responsible part of the duty is performed by the Central Departments. And once the lists are drawn up and the contracts signed, what remains for local action is merely the keeping of the index register up to date, keeping similarly the list of insured persons for whom each doctor is responsible, calculation and issue of the periodical pay- ments to doctors and chemists and issue of the medical cards—all of which are essentially matters of machinery. 384. Another matter under this head in which the work of Insurance Committees has been substantially curtailed by the force of circumstances is the pricing of chemists’ prescriptions. Originally it was intended that each Committee should do this work for its own area. But in consequence of the uniform tariff agreed upon centrally, it was found much more convenient and much more economical to set up ** Pricing Bureaux » to do this work on a uniform method for large areas of the country. In England and Wales there are 15 of these bureaux; in Scotland one for the whole of that country. The duty of the Insurance Committees in this matter is thus reduced to the routine opera-

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