Metadata: Report of the Royal Commission on National Health Insurance

MAJORITY REPORT. 
) QAR 
of any scheme so submitted, and the present limitation of the 
period to five years rests solely on provision made in the scheme 
itself, as submitted to the Minister by the Society or Branch, 
570. It has been suggested to us that it is desirable to place a 
definite statutory limit on the period for which a scheme of 
additional benefits should continue to operate. Under the existing 
provisions of the Act there is nothing to prevent a scheme 
operating indefinitely, subject to a provision suspending its opera- 
tion if a deficiency is disclosed on a subsequent valuation. But 
the period over which the benefits of a scheme will extend con- 
stitutes an essential element in fixing the rates of those benefits, 
and consequently no scheme can be framed until its duration has 
been first determined, and the necessary data for the actuarial 
calculations thus completed. In these circumstances, it has been 
found necessary to require Societies to include the period for 
which the scheme is to run as an essential condition of any 
scheme submitted for the approval of the Minister. It has been 
suggested that a matter of such importance ought not to be left 
for regulation in this indirect manner, and that the Minister 
should be explicitly vested by the Act with the necessary powers. 
571. We agree that the incorporation of this condition in the 
Statute is desirable, and we recommend accordingly that provision 
should be included in Section 75 of the Act which will limit the 
period of currency of schemes for the distribution of additional 
benefits to such period as may be fixed by the Minister. 
PROPORTION OF SURPLUS CERTIFIED AS DISPOSABLE. 
572. Tt was brought to our notice (Kinnear, Q. 23,651) that 
difficulty had arisen with regard to the large amounts of surplus 
which in many cases had been certified as disposable on the 
second valuation of Societies. The recent experience of the great 
majority of the Societies and the profit margins in sight in regard 
to their future working were such as to lead the Valuers to the 
conclusion that in these cases the whole of the surpluses shown 
were disposable. On the other hand, it had been decided, for 
sound administrative reasons, that the additional benefit schemes 
to be made after the valuation should be limited to a period of five 
vears, and it was clear that if the disposable surpluses resulting 
from a period of great and, as it well might prove, exceptional 
Prosperity were allowed to be spent in a single quinquennium 
there might be a grave risk of the additional benefits being gener- 
ally raised to a level at which they could not be permanently 
maintained. Such an eventuality might occasion considerable 
disappointment in future to the insured classes, and might further 
entail a serious measure of disorganisation in so far as arrange- 
ments might have been entered into for the provision of treat- 
ment benefits. In these circumstances an arrangement was 
made between the Ministry of Health and the Scottish Board
	        
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