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

MINORITY REPORT. 
30F 
Cm y— 
responsible for the immense surpluses which Societies are now 
distributing in the form of additional benefits, and that the 
disparity in valuation results would have been the same if either 
the expenditure had been heavier in the aggregate or the actuarial 
estimate had been less generous. 
29. In either of the latter events, however, the ‘statutory or 
normal rate of benefits of the Act would have been jeopardised 
to such an extent and for so large a proportion of the population 
as to have created a problem with which Parliament must have 
been compelled to deal. 
30. So long as nearly every Society is able to maintain or 
increase the normal rates of benefit the disparities do not get the 
attention they otherwise would. 
31. The Departmental Actuarial Committee state in para. 5 of 
their First Report “It is clear . . . that Parliament 
intended the scheme to be solvent, regarded as a whole, whatever 
might follow from the grouping of risks incidental to the 
voluntary segregation of insured persons in Approved Societies,’ 
and it ig further reported that the new actuarial basis referred to 
in the Report, ‘‘ will be that which, so far as we can estimate, 
would be required if the whole system were operated through a 
common fund.’’ 
32. We think that these two quotations point to an intention 
of greater uniformity in the scale of benefits than has been in fact 
realised and we feel sure that Parliament could not have foreseen 
that over the whole insured population there would be a surplus 
of 40 to 45 million pounds, nor that the segregation of insured 
persons would produce such wide disparities. 
33. We agree that on the whole the administration by 
Approved Societies has been of a high standard and that many of 
the grounds for criticism are due to the weakness of the system 
and not to any incapacity upon the part of the officers of the 
Societies. At the same time we are compelled to say that there 
are no methods of judging the real standard of efficiency of 
Societies. A standard which passes the Treasury auditors is a 
criterion only as to accuracy in accounting and in a lesser degree 
as to the legal accuracy of the work done. There is no test, other 
than that made in individual cases in which complaint is made 
to the Minister, as to whether benefit is paid to every member 
who is properly entitled to it. An auditor may discover an 
irregular payment, but he cannot discover an irregular non- 
payment. 
34. We are led to draw attention to this by the often-repeated 
Statement that the Approved Society system provides an incentive 
to good management. If such an incentive exists we fear that its 
product must be stringent management against which no system
	        
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