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Medical Benefit

Volume 47: debated on Wednesday 29 January 1913

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31.

asked the Chancellor of the Exchequer if, in view of the misapprehension as to the Government's intentions with regard to free choice of doctors by insured persons, he will, in order to prevent a similar misunderstanding in future, give some kind of official form to the pledge given by him on the 2nd January to deal with any grievances which may arise as regards the working of medical benefit?

34.

asked which, if any, insurance committees have permitted doctors to join the panel and limit, by their agreements, the number of insured persons to be treated by them to those whom they agree to treat without having others assigned to them?

The conditions under which insured persons in each area may be allotted to the doctors on the panel are laid down in Section 15 (2) (d) of the National Insurance Act, and the Regulations of the Commissioners. It is within the discretion of the insurance committee, subject to those conditions, to make such arrangements as will limit the number of insured persons for whose treatment any particular doctor will be responsible. I am not aware which insurance committee have made arrangements with doctors on the panel granting such limitations.

Will the right hon. Gentleman inquire whether any insurance committees have made these arrangements? Will he also notify insurance committees that they can act in this way?

I think my answer will be quite sufficient notification. I have no knowledge that they are in ignorance on the subject.

35.

asked whether local insurance committees are entitled to fix a limit of five days in which insured persons desirous of making their own arrangements for medical benefit have to apply for the form, thus excluding a large number of persons who had not received the medical benefit ticket, which in certain cases it has been stated must be brought when application is made, from availing themselves of the provisions of Section 16 (3) of the Act?

I am not aware of any case in 'which such a time limit has been fixed. If the hon. Member has any case in mind, and will supply me with the particulars, I will make inquiries.

37.

asked where Messrs. Morgan and Dimmock practised as doctors prior to their appointment under the National Insurance Act?

Dr. Morgan practised in London. Dr. Dimmock has held important hospital appointments in London and the provinces.

Has either of these doctors practised in the district in which he now resides?

In the districts in which they have now taken up residence? I do not think that either of them has.

38 and 39.

asked (1) upon what terms Messrs. Morgan and Dimmock have been engaged as doctors for the purpose of the National Insurance Act to work in the Isle of Ely, and whether they have been assured that they shall have a monopoly of practice among insured persons in that district; and (2) whether the insurance committee having jurisdiction in the Isle of Ely have allowed insured persons to make their own arrangements with doctors not on the panel in that district, or is the right of free choice of doctor limited to Messrs. Morgan and Dimmock?

The Insurance Commissioners, upon the application of the Isle of Ely insurance committee, and after inquiry, have satisfied themselves that the number of doctors on the list in two districts was not such as to secure an adequate medical service, and have, therefore, authorised the committee to make special arrangements for the attendance of insured persons in these districts. Under these arrangements one doctor in Chatteris and three in Wisbech have undertaken complete responsibility for all the insured persons in these districts.

Has the panel system been superseded in this district? If so, was it by the insurance committee or by the Insurance Commissioners?

The ordinary system—the list system, if I may so describe it—under Section 15 of the Act, has been suspended, and a scheme suggested by the insurance committee has been accepted by the Commissioners.

Has the panel been closed? If so, for how long? Is it true that it is closed for two years?

Will the right hon. Gentleman answer the question on the Paper—

I was asking for an answer to the question on the Paper. I submit that it has not been answered.

I really think that that is enough, considering the number of other Members who have questions on the Paper.

55.

asked the Secretary to the Treasury whether, in the interests of insured persons, he will arrange that the names of all doctors willing to serve on the panels shall be placed on the public lists immediately on receipt of the knowledge of their willingness to serve?

Names of additional doctors joining the panels are kept at the offices of the insurance committees. Revised lists are published by the insurance committees at convenient intervals, but it would not be practicable for each committee to print and distribute a new list upon the receipt of each additional name.

Would it not be possible, without much trouble, to put the names of the additional doctors down in handwriting?

The list goes round to many hundreds of places, and it would be difficult to arrange that.

56.

asked if the Insurance Commissioners have received complaints from doctors on the panels that an excessive and unnecessary amount of their time is taken up in filling up forms and returns and doing other clerical work to the detriment of their useful medical work; and if steps will be taken to diminish this clerical work and arrange for it to be carried out in some other manner?

The Insurance Commissioners are anxious to receive any suggestions from doctors on the panel for simplification or improvement of the methods of keeping records and returns which their experience may show to be desirable and inquiries are being made by officials of the Commission from doctors on the panel in various districts as to their experience of work under the Act. Such suggestions as are being obtained, either by inquiry or correspondence, are receiving the careful consideration of the Commissioners.

Why was this work which was formerly carried out by club secretaries ever put upon the doctors at all?

The work of keeping the records of illnesses when the Bill was being passed through this House was regarded by both sides as being a most important piece of work.

Is there any necessity for the doctors to take three copies of the record of illnesses?

I think there is, as at present advised, but that may be a point for consideration.