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

is el MAJORITY REPORT. person, and we are informed that so far there has been no case in which the penalty has been imposed. 643. After careful consideration of all the evidence before us we think that this method of providing medical attention and treatment is an anomalous feature in a scheme of which the cardinal principle is a contract between Insurance Committees on the one hand and individual independent doctors on the other, and that it introduces lay control over professional men in an undesirable form. On the other hand we consider it necessary to have regard to the recognition by Parliament of these insti- tutions at the time when the scheme was introduced, and to the fact that there is no evidence of failure sufficient to justify a recommendation on our part that the recognition of the insti- tutions for the purposes specified should now be withdrawn. The original Act, it will have been noted, restricted recognition to those institutions then in existence, clearly designing that this method of providing Medical Benefit should be exceptional and should be regarded as an unavoidable inheritance from the past. We do not consider either that that uecision should be reversed, or that power should now be given to recognise further mstitu- tions beyond a small group of a special type, to which we refer in paragraph 648 below. On the question of the control over the salaried doctors in the institutions, we feel that that must neces- sarily continue to be exercised by their employers who are the committees of the institutions, though at the same time we think that no rule of an institution should purport to debar a member of the institution from carrying an appeal as to his medical treatment to the Insurance Committee in the area. 644. Our attention has been directed to the peculiar position of the medical institutions in South Wales specially set up under Section 24 (3) of the 1924 Act for the provision of medical treat- ment and attendance to persons who are allowed to make their own arrangements for Medical Benefit. 645. A distinction is to be drawn between those medical institutions which were in existence before the date of the passing of the original Act and which have been approved under Sec- tion 15 (4) of that Act (Section 24 (4) of the 1924 Act), and those new institutions which, although they are not entitled to recogni- tion under Section 24 (4), are set up for the provision of medical benefit under what is known as ** collective own arrangements allowed by Insurance Committees under Section 24 (3). In these cases the Insurance Committees in effect allow insured persons to make their own arrangements to receive medical benefit through an institution which is debarred from recognition as such under the Act. With regard to the latter type of institution, the British Medical Association, in their evidence, objected to the fact that they were under lay control, and stated (Q. 15,222) that * their influence has been very detrimental indeed to the

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