asked the Secretary to the Treasury whether, under Section 15 of the National Insurance Act, 1911, and paragraphs 14 and 15 of the National Health Insurance (Administration of Medical Benefit Regulations, 1912), insurance committees have power to allow insured persons to make their own arrangements with any doctors they please without reference to the Insurance Commissioners; and whether, when such arrangements have been made, the insurance committees are bound to make to the persons who have made such arrangements the payments referred to in paragraph 15 of the said Regulations without reference to the Insurance Commissioners?

Insured persons cannot make their own arrangements for medical attendance and treatment unless they are allowed to do so by the Insurance Committees, and the, contributions contemplated by the Regulations will be paid subject to the possibility of deductions under Regulation 14 (8). These Committees, in exercising their discretion, will take into consideration the general interests of all the insured persons in their area, or any particular part of it. The Government and the Commissioners will take such measures as will prevent any attempt to break down the system contemplated by the Act as approved by Parliament either by the substitution of a general system of private arrangements outside the control of the Insurance Committees for that system or by the selection of a special class of picked lives affecting the ordinary average which a panel doctor has a right to anticipate in return for his remuneration; and when no panel has been declared adequate the Commissioners will make such other arrangements as they think fit, or allow the committee to make such arrangements as they approve for the medical attendance of insured persons.

Is it not the case that under the Act and Regulations as they stand at present the answer to both parts of my question is in the affirmative? May not the Insurance Committee allow a person to make his own arrangements, and are they not bound to make payment without any further reference to the Insurance Commissioners?

Not until we have declared that the general medical service is adequate.

May I take a specific case? Cannot the London Insurance Com- mittee now authorise persons to make arrangements with their own medical men?

That depends on how far they have made satisfactory arrangements for those who do not wish to contract out of the Act.