§ (1) Every local health committee shall for the purpose of administering medical benefit make arrangements with duly qualified medical practitioners in accordance with regulations made by the Insurance Commissioners.
§ (2) The regulations made by the Insurance Commissioners shall provide for the arrangements made being subject to the approval of the Insurance Commissioners and being such as to secure that insured persons shall, save as hereinafter provided, receive adequate medical attendance and treatment from the medical practitioners with whom arrangements are so made, and shall require the adoption by every local health committee of such system as will secure—
- (a) the preparation and publication of lists of medical practitioners who have agreed to attend and treat insured persons whose medical benefit is administered by the committee within the area to which the list relates;
- (b) a right on the part of any duly qualified medical practitioner who is desirous of being included in any such list as aforesaid of being so included, but where the Insurance Commissioners, after such inquiry as may be prescribed, are satisfied that his continuance in the list would be prejudicial to the efficiency of the medical service of the insured, they may remove his name from the list;
- (c) a right on the part of any insured person of selecting, at such periods as may be prescribed, from the appropriate list the practitioner by whom he wishes to be attended and treated, and, subject to the consent
682 of the practitioner so selected, of being attended and treated by him; - (d) the distribution amongst and, so far as practicable, under arrangements made by the several practitioners whose names are on the lists of the insured persons who after due notice have failed to make any selection, or who have been refused by the practitioner whom they have selected:
§ Provided that if the Insurance Commissioners are satisfied after inquiry that the practitioners included in any list are not such as to secure an adequate medical service in any area, they may dispense with the necessity of the adoption of such system as aforesaid as respects that area, and authorise the Committee to make such other arrangements as the Commissioners may approve.
§ (3) The regulations made by the Insurance Commissioners shall authorise the local health committee by which medical benefit is administered to require any persons whose income exceeds a limit to be fixed by them, and to allow any other persons, in lieu of receiving medical benefit under such arrangements as aforesaid, to make their own arrangements for receiving medical attendance and treatment (including medicines and appliances), and in such case the committee shall, subject to the regulations, contribute from the funds out of which medical benefit is payable towards the cost of medical attendance and treatment (including medicines and appliances) for such persons sums not exceeding in the aggregate the amounts which the committee would otherwise have expended in providing medical benefit for them.
§ (4) The regulations may provide that, in the case of persons who are receiving medical attendance and treatment under any system or through any organisation existing at the time of the passing of this Act, and approved by the local health committee and the Insurance Commissioners, such medical attendance and treatment may be treated as, or as part of, their medical benefit under this Part of this Act, and may provide for the Committee contributing towards the expenses thereof the whole or any part of the sums which would be contributed in the case of persons who have made their own arrangements as aforesaid.
§ (5) Every such Committee shall also make provision for the supply of proper and sufficient drugs and medicines to 683 insured persons in accordance with regulations made by the Insurance Commissioners, which shall provide for the arrangements made being subject to the approval of the Insurance Commissioners, and being such as to enable insured persons to obtain from any person with whom arrangements have been made such drugs, medicines, and appliances as may be ordered by the medical practitioner by whom they are attended, and shall require the adoption by every local health committee of such a system as will secure—
- (a) The preparation and publication of lists of persons, firms, and bodies corporate who have agreed to supply drugs, medicines, and appliances to insured persons whose medical benefit is administered by the Committee, according to such scale of prices as may be fixed by the Committee;
- (b) A right on the part of any properly qualified person who is desirous of being included in any such list as aforesaid, of being so included, except in cases where the Insurance Commissioners after inquiry are satisfied that his inclusion or continuance in such list would be prejudicial to the efficiency of the service:
§ Provided that—
- (i) If the Insurance Commissioners are satisfied that the scale of prices fixed by the Committee is reasonable, but that the persons, firms, or bodies corporate included in any list are not such as to secure an adequate and convenient supply of drugs, medicines, and appliances in any area, they may dispense with the necessity of the adoption of such system as aforesaid as respects that area and authorise the Committee to make such other arrangements as the Commissioners may approve;
- (ii) The regulations shall prohibit an arrangement being made with a medical practitioner under which he is bound or agrees to provide drugs or medicine for any insured person without the consent of the Insurance Commissioners, which consent they shall not give unless the circumstances of any locality are such as to make it expedient to do so;
- (iii) Subject to the foregoing provision as to dispensing by a medical practitioner,
684 the regulations shall prohibit arrangements for the supply of drugs and medicines being made with persons other than persons, firms, or bodies corporate entitled to carry on the business of a chemist and druggist under the provisions of the Poisons and Pharmacy Act, 1908, who undertake that all medicines supplied by them to insured persons shall be dispensed either by a registered pharmacist or by a person who, for three years immediately prior to the passing of this Act, has acted as a dispenser to a duly qualified medical practitioner or a public institution.
§ (6) There shall in each year be paid to the local health committee for each county or county borough out of moneys credited to a society which has members resident in the county or county borough such sum in respect of the medical benefit for every such member as in default of agreement, may be determined by the Insurance Commissioners.
§ (7) If in any year the amount payable to a local health committee in respect of all persons for the administration of whose medical benefit it is responsible is insufficient to meet the estimated expenditure thereon, the Committee may, through the Insurance Commissioners, transmit to the Treasury and to the council of the county or county borough an account showing the amount so payable and the estimated expenditure, and the Treasury and the county council or the council of the county borough, may if they think fit and if satisfied that the amounts so payable and the proposed expenditure are reasonable and proper in the circumstances, sanction the expenditure.
§ (8) The Treasury and the council of the county or county borough sanctioning any such expenditure as aforesaid shall thereupon each be liable to make good, in the case of the Treasury out of moneys provided by Parliament, and in the case of the council of a county or county borough out of the county fund or borough fund or borough rate, as the case may be, one half of any sums so sanctioned by them and expended by the local health committee on medical benefit in the course of the year in excess of the amounts so payable to the local health committee as aforesaid.
§ Amendments made: In Sub-section (2), paragraph (a), leave out the words "within the area to which the list relates."
685
§
At the end of paragraph (d) insert,
(e) the provision of medical attendance and treatment, on the same terms as those arranged with respect to insured persons, to members of any friendly society which becomes an approved society who were such members at the date of the passing of this Act, and who are not entitled to medical benefit under this Part of this Act by reason either that they are of the age of sixty-five or upwards at the date of the commencement of this Act, or that being subject to permanent disablement at that date they are not qualified to become insured persons.
§
At the end of the Sub-section, insert the words,
or the Commissioners may themselves make such arrangements as they think fit, or may suspend the right to medical benefit in respect of any insured persons in the area for such period as they think fit, and pay to each such person a sum equal to the estimated cost of his medical benefit during that period, and where the Commissioners take any such action themselves they shall retain and apply for the purpose such part of the sums payable to the local health committee in respect of medical benefit as may be required.
§ In Sub-section (3), leave out the word "them" ["fixed by them"], and insert instead thereof the word "Committee."
§ In Sub-section (4), leave out the word "organisation," and insert instead thereof the word "institution."
§ At the end of Sub-section (4), insert the words "so, however, that such regulations shall secure that no person be deprived of his right, if he so elects, of selecting the duly qualified medical practitioner by whom he wishes to be attended and treated, in accordance with the foregoing provisions of this Section."
§ In Sub-section (5), after the word "medicines" ["drugs and medicines"], insert the words "prescribed appliances."
§ Leave out the word "person" ["any person"], and insert instead thereof the words "persons, firms, or bodies corporate."
§ Leave out the words "as may be" ["may be ordered"], and insert instead thereof the word "if."
§ In paragraph (a), leave out the words "properly qualified."
686§ In paragraph (b), leave out the words "who is," and insert instead thereof the words "firm or body corporate."
§ After the word "included" ["being so included"] insert the words "for the purpose of supplying such drugs, medicines, and appliances as such person, firm, or body corporate is entitled by law and authorised by the committee to supply."
§ Leave out the word "his" ["his inclusion"], and insert instead thereof the word "the."
§ After the word "continuance," insert the words "of the person, firm, or body corporate."
§
Leave out paragraph (ii) and insert instead thereof,
(ii) Except as may be provided by regulations made by the Insurance Commissioners, no arrangement shall be made by the local Health Committee with a medical practitioner under which he is bound or agrees to supply drugs or medicine to any insured persons.
§ In paragraph (iii) leave out the words "foregoing provision as to dispensing by a medical practitioner," and insert instead thereof "regulations made by the last foregoing proviso."
§ After the word "the" ["of the Poisons"] insert the words "Pharmacy Act, 1868, as amended by the."
§ After the word "by" ["either by"], insert the words "or under the direct supervision of."
§
At the end of paragraph (iii.), insert,
(iv.) Nothing in this Act shall interfere with the rights and privileges conferred by The Apothecaries Act, 1815, upon any person qualified under that Act to act as an assistant to any apothecary in compounding and dispensing medicines.
§ In Sub-section (6), leave out the words "for every such member as," and insert instead thereof the words "of such members and the cost of administration thereof as may be agreed between the society and committee or."—[Mr. Lloyd George.]