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:: Minority report

Collection:: Economics Books

MINORITY REPORT. 315 which, with 6d. added in respect of the domiciliary treatment of Tuberculosis, made available a sum of 9s. per head per annum for medical benefit. An Exchequer grant in respect of medical benefit continued until the 31st March, 1922, since when the cost of medical benefit has been met from insurance funds, in- cluding the statutory State grant of two-ninths of the cost. This change was made in pursuance of a recommendation of the Committee on National Fconomy under the Chairmanship of Sir Eric Geddes. 78. At the commencement of the Act, when the estimated cost of medical benefit was 6s. per head, each Insurance Com- mittee was to enter into agreement with each Approved Society as to the sum to be paid by the Society to the Committee in respect of the cost of medical benefit for its members resident in the area (Section 15 (6) of the Act, 1911). This arrangement being impracticable, the organisation of medical benefit was undertaken by the Central Department. 79. While we agree that the modifications in the method of administration were necessary we suggest that the removal of the duties from the Tiocal to the Central Authority has obscured the intentions of Parliament expressed in Section 15 (7) of the Act of 1911, now Section 85 of the Act of 1924. That Section, which has never been repealed, provides that the Treasury and the Local Authorities may bear some part of the cost of medical benefit beyond the statutory grant. 80. There is moreover a further reason why the provisions of the Act in this respect should be considered. We have already indicated our complete agreement with our colleagues in their recommendations to transfer the administration of medical benefit to Local Authorities. We feel, however, that to bestow powers and duties of such importance and magnitude upon the Local Authorities without any direct financial responsibility, is a departure from the principles of local government hitherto considered essential in this country. We take the view also that the Central Authority exercises its powers of enforcing economy on and of encouraging desirable developments by Local Authorities by reason of the financial arrangements between the two Authorities and we should be more confident of securing efficient development and of enlisting local interest if the usual financial principles operated in respect of medical benefit. 81. We therefore disagree with our colleagues that the first charge on the margin should be the balance of the cost of the present medical benefit and we recommend that the cost of the present medical benefit in excess of the sum of 9s. 6d. per insured person per annum provided in the Act of 1920 should be borne by the Treasury and the Local Authorities as provided by Section 85 of the Act of 1924. The aggregate cost of this balance is estimated at £21 millions. 34709 Ky

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