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

MAJORITY REPORT. 261 MEDICAL INSTITUTIONS. 640. While the Insurance Act contemplated that Medical Benefit should normally be provided by medical practitioners under contract with Insurance Committees, it provided for two possible deviations from the standard arrangements. In the first place it authorised Insurance Committees where they saw fit, to allow insured persons to make their own arrangements for receiving Medical Benefit, and where the circumstances were sufficiently exceptional to justify the adoption of this course a con- tribution was made towards defraying the cost of the Medical Benefit so obtained. The second exception related to medical institutions which had been providing medical attendance to the working classes in the past, and provision was made, safeguarding existing rights, whereby under certain conditions these institu- tions might be incorporated in the machinery for providing Medical Benefit. It is with the second of these exceptions that we are here concerned. 641. Under Section 15 (4) of the 1911 Act such systems or institutions for the provision of medical attendance and treat- ment, as were in existence at the date of the passing of the Act, might be approved by an Insurance Committee and the Department for the purpose of providing Medical Benefit. Insured persons who were members of these approved institutions might then receive their medical benefit through the institution, the actual cost of the treatment, or the capitation fees in respect of members so treated, whichever is the less, being paid to the institution out of insurance funds. The majority of these institutions are bodies which were formed by associations of the Friendly Societies for the purpose of provid- ing medical attention and treatment to their members prior to the passing of the 1911 Act. 642. We are informed (Brock and Smith Whitaker, Q. 24,009- 24,012; British Medical Association, Q. 15,222) that the treatment given to members of these institutions is as a rule inferior in quality to that provided under the normal panel arrangements, and we are also given to understand (British Medical Association, Q. 15,221; Brock, Q. 24,009) that administration and control by lay committees has proved in many cases to be ineffective. ~ Any disciplinary action taken by Insurance Committees following upon complaints made by members of the Institutions cannot be brought to bear directly on the individual doctors responsible as these are the servants of the institutions. The Minister has power to with- draw approval in any case in which he is not satisfied that an Institution is conducted in such a manner as to comply with the terms of service of insurance doctors, but this would not be an appropriate penalty in cases of complaint by an insured

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