CLAUSE 8.—(Rates and Conditions of Benefits.) (Hansard, 18 July 1911)

HC Deb 18 July 1911 vol 28 cc881-93 881

§ (1) The benefits conferred by this Part of this. Act upon insured persons are—

(a) Medical treatment and attendance, including the provision of proper and sufficient medicines (in this Act called "medical benefit");
(b) Treatment in sanatoria or other institutions when suffering from tuberculosis, or such other diseases as the Local Government Board with the ap- 882 proval of the Treasury may appoint (in this Act called "sanatorium benefit");
(c) Weekly payments whilst rendered unfit to provide their own maintenance by some specific disease or by bodily or mental disablement, commencing from the fourth day after notice thereof is given, and continuing for a period not exceeding twenty-six weeks (in this Act called "sickness benefit");
(d) In the case of the disease or disablement continuing after the determination of sickness benefit, weekly payments so long as so rendered unfit by the disease or disablement (in this Act called "disablement benefit"):
(e) Payment in the case of the confinement of the wife of an insured person, who is not herself an insured person, or of a woman who is an insured person, of a sum of thirty shillings (in this Act called "maternity benefit");
(f) In the case of persons entitled under any scheme made in accordance with this Part of this Act to any of the further benefits mentioned in Part II. of the Fourth Schedule to this Act (in this Act called "additional benefits") such of those benefits as may be distributable under that scheme.

§ (2) Subject to the provisions of this Part of this Act, the rates of sickness benefit and disablement benefit to which insured persons are entitled shall be the rates specified in Part I. of the Fourth Schedule to this Act.

§ (3) The right to sickness benefit and disablement benefit shall not commence before the insured person attains the age of sixteen and shall cease on his attaining the age of seventy, but, save as aforesaid, the right to benefit (other than additional benefits) shall continue throughout life.

§ (4) Except with the consent of the society or committee administering the benefit, no insured person shall be entitled to any benefit during any period when he is resident either temporarily or permanently outside the British islands, or to medical benefit during any period when he is resident outside the United Kingdom.

§ (5) Where an insured person, having been in receipt of sickness benefit recovers from the disease or disablement in respect of which he receives such benefit, any subsequent disease or disablement, or a recurrence of the same disease or disablement, shall be deemed to be a continuation of the previous disease or disablement, unless in the meanwhile a period, continuous or discontinuous, of at least twelve months has elapsed, and at least fifty weekly contributions have been paid by or in respect of him:

§ Provided that the benefit in respect of such subsequent or recurrent disease or disablement shall not commence to be payable before the date at which it would, apart from this provision, have commenced.

§ (6) Where a woman is herself entitled to maternity benefit she shall not be entitled to sickness benefit, disablement benefit, or medical benefit at and for a period of four weeks after her confinement.

§ (7) Notwithstanding anything in this part of this Act, no insured person shall be entitled—

(a) to medical benefit during the first six months after the commencement of this Act;
(b) to sickness benefit unless and until twenty-six weeks have elapsed since his entry into insurance, and at least twenty-six contributions have been paid by or in respect of him;
(c) to disablement benefit unless and until one hundred and four weeks have elapsed since his entry into insurance, and at least one hundred and four contributions have been paid by or in respect of him;
(d) to sickness benefit in respect of any disease or disablement which commenced during the twenty-six weeks, or to disablement benefits in respect of any disease or disablement which commenced during the one hundred and four weeks, next following his entry into insurance;
(e) to sickness benefit or disablement benefit during any period when he is provided with board and lodging by his employer;
(f) to maternity benefit unless and until twenty-six, or in the case of a voluntary contributor fifty-two weeks have elapsed since his entry into insurance, and at least twenty-six, or in the case of a voluntary contributor fifty-two, contributions have been paid by or in respect of him.

§ (8) As soon as a sum has been accumulated by investment sufficient to provide interest at 3 per cent. per annum on the amounts then standing to the credit of all approved societies the benefits payable to insured persons under this part of this Act shall be extended in such manner as Parliament may determine, but in determining the distribution of such extended benefits amongst the persons who become entitled thereto regard shall be had to the claims or special considerations of persons who have entered into insurance at an early age.

§ Amendment proposed [17th July], in Subsection (7), "leave out paragraph (e)."—[Mr. Bridgeman.]

§ Question again proposed, "That the words proposed to be left out to the word 'or' ["or disablement benefit"], stand part of the Clause."

§ Mr. BRIDGEMAN
Of all the provisions in the Bill as far as we have gone, paragraph (e) is the one which has been most universally condemned as entirely unjust to those who are affected by it. I know that the Chancellor of the Exchequer has said, with reference to another subject, 885 that he intends to modify in some way the injustice which this Sub-section imposes upon domestic servants; but whatever his proposal may be, it seems absolutely necessary that this paragraph should be cut out, even if nothing is put in its place. The Bill would be far better with this paragraph omitted. In probably nine cases out of ten, certainly in three cases out of four, if domestic servants are ill their employers provide them with medical benefit, with board and lodging, and generally wages.

§ The CHANCELLOR of the EXCHEQUER (Mr. Lloyd George)
I will accept the Amendment. Owing to an Amendment which I have promised to bring forward, this paragraph is unnecessary.

§ Mr. BRIDGEMAN
We are constantly being put off with promises of what is going to be done. Does the right hon. Gentleman mean to put something in its place, or is the paragraph to go altogether? We are surely entitled at this stage to know what the policy of the Government is. They have introduced in the Bill a Clause which is unjust—in fact, is a swindle. I want to know whether the right hon. Gentleman is going to withdraw it entirely, or is he going to substitute some system of contracting out which may be suitable to Scottish agricultural labourers, but is certainly not suitable to domestic servants. Surely the question is not to be left to be decided some months hence. Those who are interested ought to know now what the policy of the Chancellor of the Exchequer is in this matter.

§ Mr. LLOYD GEORGE
The hon. Gentleman moves an Amendment. I say that I will accept it, and forthwith the hon. Gentleman talks about swindles.

§ Mr. BRIDGEMAN
Is the Amendment accepted with a view to something else being put in its place, or is the paragraph to be left out altogether?

§ Mr. LLOYD GEORGE
I have accepted the Amendment of the hon. Gentleman. Is he entitled to more than that? He moves an Amendment, and the moment I accept it he thinks there is something behind it

§ Mr. BRIDGEMAN
I said when I started that it would be better to leave out the paragraph altogether, but I understood from a previous statement of the right hon. Gentleman that instead of leaving it out altogether, he proposed to deal with servants in some other way. All I am assuming is that he should tell us now what that way is.

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§ Mr. LLOYD GEORGE
I have accepted the Amendment.

§ Mr. AUSTEN CHAMBERLAIN
I am rather sorry for the tone in which the Chancellor of the Exchequer dealt with this matter. [HON. MEMBERS: "Swindle, swindle."]

§ Mr. LLOYD GEORGE
The hon. Member talked about a "swindle."

§ Mr. AUSTEN CHAMBERLAIN
I do not want any hard language used on either side, but I do not think the Chancellor of the Exchequer has given himself time to see that there is some information which we do need on this Amendment. I will not take up much time, but I do want to put a case to him, and ask how he intends to deal with such cases. My hon. Friend proposed to strike out this Subsection, and the Chancellor of the Exchequer said: "I accept that, because at a later stage, as I have already announced, I am going to move another Amendment which will take its place, and which makes this Sub-section unnecessary." The Amendment to which the Chancellor referred is, of course, the one which he adumbrated to the Committee a little time back, and this was intended to include such cases as the Scottish agricultural labourers, domestic servants, I think hospital nurses and others. But that Amendment is not yet on the Paper. It would be a convenience if the exact form, in which the Chancellor means to put it could be given. As I understand it it does not cover, and will not cover, the whole of the cases covered by this Subsection. Take the case of the employer and his servant who might be entitled to contract themselves out of the Act under the Amendment which the right hon. Gentleman has promised, but who did not care to do so. Is the Chancellor prepared to withdraw this Sub-section, to abandon it, simply in regard to their case, and to leave the servant under such circumstances to receive the full benefit for which he or she and their employer have insured under the Act whenever the servant is in receipt of board and lodging from the employer? They have paid for these benefits. The servant should be entitled to them, and the fact that there is board and lodging given by the employer is no reason whatever for withdrawing from the servant what the servant and the employer have been forced to insure for. That is a point I wish to put to the Chancellor. So far as we know his Amendment does 887 not cover the whole of the cases included in this Sub-section. I want to know whether he will leave them to be dealt with under the general provisions of the Bill, or whether, in accepting the Amendment of my hon. Friend he reserves these cases also for some special treatment hereafter?

§ Mr. LLOYD GEORGE
Although that matter does not arise here at all, it is our intention to take these cases out altogether. In those cases which will not be covered by our Amendment, the servant or the employé will be entitled to her pay, notwithstanding the fact that she has got board and lodging.

§ Mr. AUSTEN CHAMBERLAIN
Thank you.

§ Amendment, by leave, withdrawn.

Mr. MacCALLUM SCOTT
I beg to move, in Sub-section (7), paragraph (f), to leave out the words, "unless and until twenty-six" ["maternity benefit unless and until twenty-six, or in the case of a voluntary contributor fifty-two weeks"], and to insert instead thereof the words, "during the first six months after the commencement of this Act."
I do this because I think that it makes a very small concession towards the married woman, and I am very anxious that the Bill may improve as much as possible in that direction. The Chancellor of the Exchequer has made a number of concessions. He may not have thought that they have been too graciously received, but so far as they went we were grateful for them. We were grateful for small mercies. This in itself is a small mercy, and I ask him to grant it.

§ Mr. LLOYD GEORGE
It has taken me just as long to understand my hon. Friend's Amendment as it took its author. He did not know why he put it down, and I sympathise with him. I do not think that the limit in the Clause is an unreasonable limit.

§ Question, "That those words be there added," put and negatived.

§ Sir CHARLES HENRY
I beg to move, in Sub-section (7), paragraph (f), to leave out the words, "or in the case of a voluntary contributor fifty-two."
The object of this Amendment is to put the voluntary contributor on the same basis as the other contributor as regards maternity benefit.

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§ Mr. LLOYD GEORGE
I think it must be obvious that nothing less than fifty-two weeks would be a protection in a case of this kind. Twenty-six weeks would involve a payment of 6d. or 7d., as the case may be, which would be 13s. a year. It obviously would be to the interest of every person to insure, because they get for the 13s. 30s., and in addition to that they may also get a chance of 10s. a week and medical attendance themselves if they happen to fall ill. That, of course, we could not possibly put upon the face of the Insurance Bill. It is a bad business proposition, and I think my hon. Friend will see that it is so.

§ Amendment, by leave, withdrawn.

§ 4.0 P.M.

§ Mr. GODFREY LOCKER-LAMPSON
I beg to move the omission of Sub-section (8), and I do so in order to get a little information on the subject it raises. I do not quite understand what the accumulation referred to—one and five- ninths of a penny—is. It seems to me that it ought to-come as a new Sub-section to Clause 40. The accumulations referred to are in respect to the margin which Government actuaries made calculations for, and in that case I do not see it is necessary at all because in Clause 30 the circumstances are accounted for, and we are told exactly what is to be done with these. I simply put down this Amendment in order to try and get certain information.

§ Question proposed, "That the words of the Sub-section down to the word 'determine'" ["in such manner as Parliament may determine"] stand part of the Clause.

§ Mr. LLOYD GEORGE
I think we must, have the Sub-section here. It is proposed to invest surplus in order to pay off that deficit, and it is necessary here because we must deal with benefits when they arise, and I am advised that from a drafting point of view this is the place for it, otherwise they would lose these benefits.

Mr. WORTHINGTON-EVANS
The right hon. Gentleman came to the conclusion that Sub-section (8) should be inserted here because it deals with benefits. That is the ground he gives for having it put in this part of the Bill. But it does-not deal with benefits except in the most shadowy way, and until after another Act of Parliament is passed there is no allocation of benefits from the surplus, for there-is no surplus for fifteen-and-a-half year for anybody's benefit. The Sub-section 889 does say that benefits shall be extended in such manner as Parliament may determine, but it does not attempt in this Sub-section to say how these benefits are to be expended; it leaves it to a future Parliament, and this is an endeavour to try to tie the hands of a future Parliament, because it says the benefits are to be distributed amongst the persons who become entitled thereto, and "regard shall be had to the claims or special considerations of persons who have entered into insurance at an early age." I venture to think the only reason this Clause is here at all is in order to justify the attempt to take away from those under sixteen the benefits rightly due to them. The Chancellor of the Exchequer acted the part of a strong man at one time stating he would take these benefits away and then thinking that the general public might not like that he has put in a Sub-section here as a certain indication that at some time or another these young people should get their benefits back. Strictly speaking, this Subsection does deal with Clause 40. It deals with what would happen if the reserves under Clause 40 are made good; that is if sums accumulated are sufficient to redeem the value created upon the passing of this Bill something is to happen under this Sub-section (8). If the Bill is the original and complete measure which it is claimed to be, the Chancellor of the Exchequer ought to resist the temptation of putting this in except in its proper place.

§ Mr. LLOYD GEORGE
If young persons are to receive exactly the same benefits I think it is necessary to indicate that it is desirable that young persons should get benefits from the fact that they pay for a longer period.

§ Captain CLIVE
I do not understand how it should be necessary to put restrictions upon the action of Parliament at some future time. Would it not be better to put in "approved societies with the approval of the Commissioners," and, if necessary, to add among the additional benefits the insurance of young persons.

§ Mr. JAMES HOPE
I cannot help thinking this is very unsatisfactory. You say that certain things should be done "in such manner as Parliament may determine! "You do not know what a future Parliament will do, but you put in a phrase quite irrespective of that. A great deal of unnecessary controversy arises over these things, and especially in regard to the latter part of the Sub-section. Other ob- 890 jects may be held to be more deserving of the attention of a future Parliament than those indicated in the end of the Subsection, and there is no binding force in words of that sort. I remember similar words in the Budget of 1909 in regard to the distribution of the Land Taxes. Half of these taxes were to go as Parliament might determine. There has been a new Parliament since, and it did not determine the distribution of these taxes. All this leads to a great deal of angry discussion.

§ Mr. AUSTEN CHAMBERLAIN
I think we are are really now discussing a separate question from that which was raised by the Amendment of my hon. Friend. I see there is an Amendment down in the name of the hon. Member opposite (Mr. Lees Smith) to delete the last four lines of this Sub-section. I hope the Chancellor of the Exchequer will give heed to that Amendment. I see no reason for indicating to a future Parliament or to the people that elect that Parliament the way it ought to deal with this question. A future Parliament will have absolute discretion, and will not be bound by what we do; and that discretion ought to be left unfettered by words which really cannot have any effect. That, however, is a different thing to striking out the whole Sub-section. Personally, I see nothing to be gained by that, but I should, as at present advised and unless something is said to convince me to the contrary, support the Amendment to omit the last four lines of the Sub-section.

§ Amendment, by leave, withdrawn.

§ Mr. LEES SMITH
I beg to move, in Sub-section (8), to leave out the words, "but in determining the distribution of such extended benefits amongst the persons who become entitled hereto, regard shall be had to the claims of special considerations of persons who have entered into insurance at an early age."
It seems to me it is entirely unnecessary to try to tie the hands of a Parliament sixteen years hence. I do not agree with the hon. Member for Colchester (Mr. Worthington-Evans) that the concession made last night entirely altered the situation. I quite realise the Chancellor's point of view. Those allowed into the scheme under sixteen years of age will not get the full value of the State grant for another sixteen years, and if Parliament sixteen years hence wishes on account of that to give them special treatment there is nothing to prevent it. But why decide the matter now. This may appear urgent 891 to the present Chancellor, but, after all, other things may appear more urgent to the Chancellor of the Exchequer sixteen years hence, and, as he will undoubtedly know the circumstances better than we can, I see no necessity to tie his hand.

§ Mr. LLOYD GEORGE
I agree that the words cannot possibly have any binding force. We are leaving it to Parliament to determine, and we cannot bind a future Parliament or give instructions to a future Parliament that it would regard as binding. It is rather an indication, I think, of the view at the present moment and would only count for what it is worth. Still, Parliament will take these things into account when the time comes, and, as these words would have no binding force, I 'cannot resist the Amendment.

§ The CHAIRMAN
That is the last of the Amendments to the Clause.

§ Question put, "That the Clause, as amended, stand part of the Bill."

§ Mr. AMERY
There is another very important question which I should like to bring to the attention of the Chancellor of the Exchequer. The right hon. Gentleman, with the general sympathy of the House and the country, has undertaken a great campaign dealing with the terrible scourge of tuberculosis. I submit that there is another national scourge claiming directly or indirectly a mortality almost as great, which is causing even more harm to the health of the nation, and which is even more definitely curable and more in need of State intervention. I refer to the scourge of syphilis. I need not dwell upon the extent of this disease, nor upon the reasons why it is screened in public records, nor need I dwell upon the fact that it is largely the underlying cause of other diseases. It is even more definitely curable than consumption, but it is not being cured, more especially amongst the less wealthy classes. For reasons which I need not now elaborate, the sufferers from this disease do not always have recourse to proper medical treatment, but they have recourse largely to quack doctors and quack medicines. Even when they do begin with proper treatment the expense and length of it causes most of them, especially in the poorer classes, to discontinue it as soon as the first symptoms have disappeared, with the result that they go away carrying within themselves the germs of disease and suffering, not only to themselves, but to 892 others. Experience has shown that where-ever the disease is regularly and properly treated as is the case in the Army, the most satisfactory results do occur. I am sure the Undersecretary for War would be ready to confirm my statement when I say that by curative treatment, sickness and mortality from this disease has been reduced by over 50 per cent. in the Army during the last ten years.
The proper treatment of this disease should be cheap and accessible, and such as the victims of the disease have confidence in. I do not ask the Chancellor of the Exchequer to set aside a large sum of money for dealing with this problem. I know that all the money he has at his disposal is fully pledged with the question of dealing with tuberculosis, but I think he should contemplate a serious national campaign to deal with this terrible national scourge, and in view of its importance, I think the right hon. Gentleman at an early stage should set aside a certain amount of money to make experiments in certain areas and devote a certain amount of money to certain institutions for the treatment of this disease in certain districts in order to gain experience and find out how the sufferers can best be gob at and most effectively treated. I hope the Committee will pardon me for intervening at this stage. I only ventured to raise the question at the last moment because I had hoped it would have been raised by a medical Member of the House. I feel it is highly desirable that nothing should prevent a subject of such immense importance being freely discussed. The only objection that could be urged against undertaking a system of national treatment of this question is the objection that it would be in some measure a condoning of vice. I do not think this House could possibly sustain an objection of that kind. In an enormous number of cases the real sufferer is only the victim of the misconduct of others. I thank the Committee very much for having allowed me to make these remarks, and I hope the Chancellor of the Exchequer will give the Committee a satisfactory assurance that under the heading of "other diseases" the treatment of this disease will be taken up as, part of the national scheme, and I hope that meanwhile we may set aside a sum of money, if it is only a moderate sum, to begin a series of experiments in the treatment of this disease.

§ The FIRST LORD of the ADMIRALTY (Mr. McKenna)
The Chancellor of the 893 Exchequer wishes me to express his apologies because he has been unavoidably called away. I rise to thank the hon. Member for South Birmingham for the interesting speech he has just made in calling attention to a disagreeable topic. I wish to point out to him that if he will look at Sub-clause (1) of Clause 8, paragraph (b), he will see that this subject is not barred and power is taken to deal with "such other diseases as the Local Government Board with the approval of the Treasury may appoint." Therefore I have no doubt that the views expressed by hon. Gentlemen will receive careful consideration at the hands of the Local Government Board.

§ Mr. BOOTH
I want some assurance with regard to the treatment of a small Amendment which was down in the name of several hon. Members. When the Amendment was called on I understood that if they had been in their places and had moved the Amendment it would have been accepted. It was an Amendment relating to Clause 8, Sub-section (1), paragraph (c), to leave out the words "rendered unfit to provide their own maintenance," and to insert the words, "totally unable to follow any occupation." It was a definition which the Institute of Actuaries considered to be necessary. I should like some assurance that the matter will be attended to on Report.

§ Mr. McKENNA
My right hon. Friend has undertaken to make the necessary alterations on Report.