§ 35. Mr. HARRY LAWSONasked whether the case of the young blacksmith, quoted by the Chancellor of the Exchequer in his speech at the Music Hall, Aberdeen, on 29th November, is that of an out-patient of the London Hospital, admitted on 16th October, on the recommendation of Dr. Smith; whether he was suffering from tuberculous disease of the spine; whether the house surgeon suggested to him that he should claim his benefit under the National Insurance Act, and a form was duly filled in and sent to the Middlesex Insurance Committee on 29th October; whether the committee professed itself unable to deal with the case, and asked the hospital to retain the case for three weeks; if, when he made the statement, the Middlesex Committee had done and stated it could do nothing for this tuberculous case or any surgical case of tuberculosis; whether the hospital, at the request of the hon. Member for Hoxton, kept the man for a period of forty-eight hours, and then until 7th December, and afterwards sent him to its own convalescent home at Felixstowe as a matter of charity; how, under these circumstances, this patient can be said to have received any benefit under the National Insurance Act; and whether any provision is being or has been made for him except the voluntary relief afforded by the London Hospital for a short period of time?
§ Mr. LLOYD GEORGEThe answer to the first two parts of the question is in the affirmative. The patient applied to the Middlesex Insurance Committee for sanatorium benefit on 5th November. I have 1485 no information as to whether his application was made at the suggestion of the house surgeon of the London Hospital or of any other person. The insurance committee did not state that it could not deal with this tuberculous case or other surgical cases of tuberculosis; but informed the hospital that they were endeavouring to make arrangements for him to be transferred to a suitable institution. They accepted the treatment of his case, although informed that the disease might require two years' treatment for complete cure, and he was sent to a convalescent home at Felixstowe on 7th December. The statement that his treatment there is a matter of charity is untrue; the insurance committee is paying for it from the funds available under the National Insurance Act.
§ Mr. HARRY LAWSONIs the right hon. Gentleman aware that the rate which is being paid is a charity rate arranged for the nurses of the London Hospital, and that the cost of the upkeep of the patient at the Felixstowe Home, which is the Convalescent Home for the London Hospital, would be at least the 35s. allowed by the Insurance Commissioners, according to their last memorandum?
§ Mr. LLOYD GEORGEThe insurance committee are paying the fees asked for. If 35s. had been demanded, 35s. would have been paid. As a matter of fact 35s. is being paid for every other patient, and, if necessary, even more than that would have been paid.
§ Mr. HARRY LAWSONAm I to understand that the London Hospital would be entitled to the 35s., and not the charity rate which is now being paid?
§ Mr. LLOYD GEORGECertainly; if the hospital say they require a higher fee, I have not the slightest doubt that the committee will pay whatever fee is fair in the circumstances. Of course, if they discriminated against insurance patients, that would be another element in the case.
§ Dr. ADDISONIs the right hon. Gentleman aware that the statement made in this question so far as they concern myself are entirely inaccurate, the fact being that on the 6th December I was asked by my hon. Friend the Member for Stepney (Mr. Glyn-Jones)——
§ Mr. SPEAKERThe hon. Member is not now asking a question, but making a series of statements.
§ Dr. ADDISONIn view of the fact that a statement is made in a question, subjected to a second edition, and both entirely inaccurate, in respect of myself, may I be afforded the opportunity of making a statement?
§ Mr. SPEAKERAt the end of questions, if the hon. Member wishes to make any personal explanation, I am sure the House will be glad to hear him.
Mr. WORTHINGTON-EVANSWas this patient on the 29th November being attended to by the Insurance Committee?
§ Mr. GLYN-JONESIs the right hon. Gentleman aware that, on the 19th November, the Middlesex Insurance Committee did approve of this case for sanatorium benefit, and accepted the responsibility, and asked the London Hospital whether they could find a suitable institution; and whether the amount fixed was suggested by the London Hospital themselves?
§ Mr. SPEAKERThe hon. Member must really give himself the trouble of putting on the Paper a series of questions like that.
59. Mr. FRED HALLasked the Prime Minister whether his attention has been called to the fact that the difficulty in coming to a settlement with the doctors under the National Insurance Act has been their lack of confidence in the intentions of those with whom they have negotiated; if, in view of the deadlock which now exists, he will have a statement issued containing the notes of the various conferences which have taken place on the matter, and of all the corespondence; and will he give an indication of the Government's proposals to meet adequately the first claims of insured persons on 15th January?
§ The PRIME MINISTERThe answer to the first part of the question is in the negative. As regards the second part, I would refer the hon. Member to the various statements which have been made to the House and the documents which have been laid on the Table, especially Cd. Papers 6305, 6328, and 6520. These contain, I think, all matters of importance referred to in the question, except perhaps a further explanatory statement which has since been sent to every medical practitioner in Great Britain, and-a copy of which is being laid on the Table to-day. With regard to the last part of the question, I would refer the hon. Member to the 1487 answer given by my right hon. Friend the Chancellor of the Exchequer to the hon. Member for St, Albans Division on the 16th December.
Mr. FRED HALLHow is it possible for this measure to come into operation by 15th January if arrangements have not been made in the meantime with the doctors?
§ 69. Mr. DUNCAN MILLARasked the Chancellor of the Exchequer whether he will consider as to providing a further sum, beyond the amount already promised to meet the case of doctors whose patients reside in sparsely populated districts, to cover mileage in all country districts; and whether, in the event of no additional sum being at present available to meet such mileage charges, he will consider as to the allocation of 1d. of the amount per head payable in respect of medical attendance for each insured contributor under the National Insurance Act for that purpose?
§ Mr. LLOYD GEORGEThe exact amount allocated for this purpose cannot be definitely stated until estimates have been received from the insurance committees in these particular districts. Full details are given in the Memorandum laid on the Table on the 5th instant (Cd. 6520), and if, as there stated, they are not sufficiently clear, I shall be glad to discuss the matter further with the representatives of the districts concerned. As regards the second part of the question, as pointed out in the above-mentioned Memorandum, there is no reason why arrangements should not be made in any area whereby a special fund for mileage could be formed from the general amount available for medical remuneration in the area.
§ 70 Mr. HICKS BEACHasked the Chancellor of the Exchequer whether the Insurance Commissioners have issued a Memorandum, dated 6th December, to local insurance committees requiring them to issue on 12th December letters of invitation to medical practitioners asking them to enter into provisional arrangements for providing medical benefit to insured persons, and requiring the answer of the medical practitioners to be returned by 31st December; what reason is there for supposing that local insurance committees will complete in nineteen days negotiations which he himself has failed to carry out in nineteen months or 1488 more, and what powers the insurance committees have for granting better terms to the doctors than have already been offered by the Treasury?
§ Mr. LLOYD GEORGEThe answer to the first part of the question is in the affirmative. The negotiations which have already taken place have so narrowed the issue that, as pointed out in the Memorandum referred to, there is now no need for protracted negotiations between the doctors and the insurance committees.
§ Mr. HICKS BEACHWill the right hon. Gentleman answer the latter part of the question?
§ Mr. LLOYD GEORGEThe alternatives have been very fully set forth in the memorandum. I could not enter fully into them now, but there will be an opportunity to raise the question on the Motion for Adjournment on Friday. I understand that the question will probably be raised then, and I shall be able to state more fully what the proposals are.
§ Mr. HICKS BEACHIs it the intention of the Government that insurance committees should partially pay for these medical benefits out of the rates?
§ Mr. LLOYD GEORGEI am not sure that they could pay for them out of the rates. In any event, there is no suggestion of the kind. And it would be quite unnecessary, because the money provided by the Government is ample.
Mr. POINTERIs it the fact that insurance committees are empowered to offer better terms than the right hon. Gentleman has already offered?
§ Mr. LLOYD GEORGEThey can only offer within the money placed at their disposal by the Government.
40. Mr. MacCALLUM SCOTTasked the Chancellor of the Exchequer whether his attention has been drawn to the fact that threats are being issued against medical men who are asserting their right to go on the panels established under the National Insurance Act; and whether the* Government is prepared to give their support to such practitioners who are declining to participate in a boycott of the medical service required under the Act?
§ Mr. LLOYD GEORGEI have received a number of communications asserting that threats are being used, and I am inquiring into the matter. The Government will feel bound to use all means at their disposal for 1489 the protection of any practitioners who may be molested from any quarter merely because they are engaged in discharging duties connected with the public health, undertaken by them under the provisions of an Act of Parliament.