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

MAJORITY REPORT. insurance practitioners and on the present procedure for the investigation of complaints against practitioners. 436. The procedure for dealing with complaints is described in Appendix I, C, 40-56. The criticisms will be found in Appendix XLVII, 35-43, Q. 15,213-15,220 and Appendix XLVIII, 43 and 47, Q. 15,504-15,511, 15,519-15,627, 15,682 15,712, 15,715-15,728. 437. We refer particularly to the lengthy evidence which the Medical Practitioners’ Union App. XLVIII, 43 and 47; Q. 15,504-15,511 and 15,519-15,627) submitted on the subject of the complaints procedure. Much of this evidence is directed to similar points to those put forward by the British Medical Association, though in a more emphatic form. We deal with the whole subject on its general bearings below. We would, however, remark here that the privileged position, which the Medical Practitioners’ Union urge should be granted to practi- tioners under the complaints procedure, is one which we do not think could be conceded on any grounds of public policy; nor do we think that the witnesses of the Union were able in oral examination to sustain effectively the demands which they put forward. 438. The witnesses appearing on behalf of the British Medical Association classified the conditions of service of insurance Practitioners in two categories—and we appreciate the import- ance of the distinction—namely, conditions affecting the pro- fessional relation between doctor and patient and conditions relating to the fulfilment of the doctor's contractual obligation to keep records and to perform other similar duties specified in his agreement and the Terms of Service. (App. XI/VII, 40.) As to the latter category, it is admitted that in cases where the hon-fulfilment of the obligation is established, disciplinary action 1s justifiable and, indeed, inevitable, though certain changes are advocated in the machinery of investigation. But it is Suggested that questions affecting the relations of doctor and patient should not be made the subject of disciplinary Procedure, on the ground that, with the present unrestricted choice of doctor, the patient has an effective remedy in his own hands. This contention we find ourselves wholly unable to accept, first, because we are not satisfied that the freedom of choice of insured persons can be relied upon as sufficient to Produce the requisite result, and secondly, because the entire abrogation of the Minister's responsibility for the efficiency of the service rendered by insurance practitioners to their insured Patients is, in our view, inconsistent with the fulfilment ‘of the duties placed on the Minister by the’ Health Insurance Act, and With sound principles of administration of a publicly provided Service. . 54709 (1

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