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 XIII. Miscellaneous questions

Collection:: Economics Books

254 MAJORITY REPORT. CONTRACT ADMINISTRATION PAYMENTS. 620. Our attention has been directed to an arrangement which exists in certain Societies whereby out-of the amount available to the Society for purposes of administration a lump-sum payment is made to the parent body with which the Society is associated, and in return for that payment the parent body carries out the administration of National Health Insurance on behalf of the Society. We are informed that the arrangement is in every case expressly authorised by the rules of the Society, and that the terms of the agreement and the rates of payment are subject to annual review and are approved by the National Health Insurance Joint Committee. Although the number of Societies which have made arrangements of this kind is small, they have an aggregate membership of about 6% millions, or nearly half the total insured population. We may quote from the evidence of Sir Walter Kinnear on the subject :— ‘“ We have a limited number of cases, possibly not more than a dozen in number, where a certain proportion, not the whole, of the administration allowance is paid over with the sanction of the Minister to what I might call the inde- pendent side of the organisation. As a rule we insist that the cost of certain services which are peculiar to National Health Insurance, such as medical referees, sick visitors, and matters of that kind must be paid for and retained on the Approved Society side of the organisation. But certain Societies have represented to us that they have common organisation and common staffing in the offices, and they said it would be a businesslike arrangement for us to allow a proportion of the administration allowance to be handed over to the parent body and the latter would contract with the Ap- proved Society to give the services of their whole organisation to the benefit of the Approved Society for that sum, apart from any special services which are peculiar and can be ren- dered only for the purpose of National Health Insurance. That is a system which has been in force for a good many years, and T am not inclined to think it is abused. It is true that at headquarters we have no means by which we can analyse how the amount is spent, once having fixed upon a lump sum. We have simply to look at the cost of that Society as compared with the ‘cost of other Societies, and endeavour as best we can to decide whether that lump sum which is agreed upon is a fair and equitable amount. I do not think the system has been abused; I do not think that the Society is placed at any serious disadvantage by the arrangements; but, of course, it is open to the criticism that there is a very considerable expenditure over which we have no supervision or no auditorial rights.” (Q. 23,527.) 621. We recognise that an arrangement of this kind may have some advantages from the business point of view, and we

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