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. 191 judgment to the best of his ability, his professional skill having been, in the words of one of the witnesses, °° carefully and properly given to the patient,” the Minister should not go into the question whether the line of treatment which was adopted is in accordance with any particular professional doctrine as to what is or is not the best line of treatment in such cases. From inquiries that we have thought it necessary to make we gather that the Minister accepts this view and would not regard it as part of his duty, when considering, as the Regulations require, whether a proper standard of treatment has been given, to enter into questions on which professional opinion might differ as to the efficacy of particular methods of diagnosis or treatment. This, however, is subject to the qualification stated, that the prac- titioner has, in fact, exercised his professional skill with reason- able care, and this appears to be a matter of which cognisance must be taken in the exercise of the Minister's disciplinary powers. 448. Evidence which we have heard in connexion with some of the foregoing points has brought to our notice one matter in respect of which the present practice appears to us to be open to criticism. We find that in cases in which representations have been heard by an Inquiry Committee, and the Minister, after considering their findings, has decided not to remove the praci- tioner from the Medical List, it is not unusual for grant to be withheld without any further hearing being allowed to the prac- titioner. (Q. 24,000.) It has been pointed out to us that this procedure is contemplated by the present Regulations, which were settled after consultation with the Insurance Acts Com- mittee of the British Medical Association. But on the merits we are clearly of opinion that no grant should be with- held until the practitioner has heen given an opportunity, if he wishes, of making oral representations and so of bringing to the Minister's notice any mitigating circumstances which in equity should be taken into consideration before any penalty is imposed. The task of the Inquiry Committee is to investigate definite allegations, and for the purpose of ascertain- ing the facts it is not relevant to consider whether there are extenuating circumstances. It follows, therefore, that if the Minister decides that the facts established by the Inquiry Com- mittee do not warrant removal, but do appear to call for some lesser penalty, a new issue arises, and considerations may properly be taken into account which were not relevant to the major issue of removal from the List. For this reason we think that before any penalty other than removal is imposed, the doctor should be given an opportunity of a further hearing. If such an arrangement necessitates any alteration of the existing Regulations, a point which appears doubtful (Q. 24,000), we recommend that the necessary amendment should be made at the first convenient opportunity ; but if the present Regulations

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