Full text: Report of the Royal Commission on National Health Insurance

MAJORITY REPORT. 
267 
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available to the Government Auditor as to the manner in which 
the sums are used by the Institutions. As an illustration of the 
former type we may instance the United Women’s Benevolent 
Association (see Gordon, App. XIII 28, 30; United Women’s 
Insurance Society, App. XXIV 22-81), and of the latter type 
the outstanding example is the National Insurance Beneficent 
Society, a body from whom we received some interesting evidence 
(App. XVIII; Q. 8814-9208). This body carries on its work 
not only under Section 26 but also as an agent for Societies in 
administering treatment benefits under approved schemes of 
additional benefits, and has adopted a two-sided constitution the 
full purpose of which we are not altogether able to appreciate. 
660. We are informed by the Ministry of Health (App. I, B, 
229-252 ; Kinnear, (). 843-857, 23,603-23,615) that in 1922 a sum 
of £10,000 was paid to charitable institutions by 138 centralised 
Societies, and that in 1923 the sum so paid was over £30,000 
including a payment by one Society of over £11,500. The 
Ministry also informs us that the section is open to objection on 
the grounds (1) that it is used by some Societies to provide bene- 
fits in the nature of additional treatment benefits to members 
immediately on transfer from other Societies, and so encourages 
unfair competition ; (2) that inasmuch as the contribution con- 
tains no margin for payments of this nature, the financial 
stability of Societies may be endangered; and (3) that it is a 
violation of the spirit of the provision that additional benefits 
shall not be distributed among members other than those 
entitled thereto by statute. It was therefore suggested to us that 
the section should be repealed and that payments to charitable 
institutions should not be made except out of surplus funds. The 
Scottish Board of Health, on the other hand, maintain 
(Leishman, Q. 24,248-24,293) that so far as Scotland is con- 
cerned the section has been cautiously and reasonably used, and 
suggest that it should be retained in its present form. The 
Ancient Order of Foresters informed us ((). 4267) that the section 
was useful in the early days of the Act, but that in view of the 
almost universal provision of additional benefits it has outlived its 
usefulness. The National Association of Ttade Union Approved 
Societies (App. XCII, 116; Q. 22,053-22,054) contend that the 
section permits of abuse and encourages unsound competition 
between Societies. They suggest that it should be amended so 
as to make subscriptions or donations over a certain prescribed 
sum per head of the membership in any year subject to the 
consent of the Central Departments. Mr. Middleton, giving 
evidence on behalf of the National Insurance Audit Department, 
informed us (App. CI. 33-38) that °° the section, in express 
terms, confers absolute discretion upon the Society in the matter 
of amount of such subscriptions, and an auditor is therefore pre- 
cluded from criticising the amount of the payments made under 
these powers, provided always that the payments appear to be
	        
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