§ 21. Mr. LANSBURYasked the Secretary to the Treasury, with reference to the provisional regulations as to the administration of medical benefit made under the National Insurance Act and dated 1st October, 1912, whether it is intended that each local insurance committee shall fix each year a total sum to be paid for medical benefit, which is not to be exceeded, and out of which the payments for ordinary medical treatment, the payments for special services by the doctors, and the payments for drugs and medicines are alike to come; whether it is intended that, when a capitation fee or a rate of payment per visit has been agreed on, the medical practitioner will not necessarily get that fee or that rate, but only such a proportion thereof as the total sum arbitrarily fixed by the local insurance committee for the various items of expenditure will allow; whether he is aware that, under such circumstances, the medical practitioners will find themselves getting a smaller annual remuneration whenever the sickness of the year has necessitated a larger outlay on drugs and medicines, so that, for instance, when an influenza epidemic involves more quinine than usual, the medical practitioners will find their incomes reduced; whether he is aware that such an arrangement is in contravention of the spirit of Section 15 (5), proviso (ii), which was intended to prevent the medical practitioner from having any pecuniary interest in stinting the supply of expensive drugs; whether he is aware that the arrangement is calculated to restrict the calling in of consultants in serious cases, as the costs of their fees will, in effect, have to be borne by the ordinary medical practitioners themselves; whether he will explain on what basis the local insurance committee can, or will be instructed or advised to, fix the total sum to be paid in respect of medical benefit if, as explained, this is expected to be less than the aggregate of the sums payable to the medical practitioners for fees and extras at agreed rates and for drugs and medicines at agreed prices; and whether he will arrange that the House shall have an opportunity of discussing the terms to be made for medical benefit before these are approved by the Commissioners?
§ Mr. MASTERMANThe draft regulations now before Parliament cannot be interpreted except in connection with the general question of remuneration fur medical benefit under the Insurance Act. This question is still under the consideration of the Government, and my right hon. Friend the Chancellor of the Exchequer hopes to make an announcement on the subject in the immediate future.
§ 71. Mr. OLIVER LOCKER-LAMPSONasked the Chancellor of the Exchequer if he will state how much additional money would be required to pay the doctors under the National Insurance Act 8s. 6d. per head instead of the sum originally decided upon.
§ Mr. MASTERMANIf by the sum originally decided the hon. Member means the sum of 6s. per insured person in the original actuarial estimates as the cost of medical benefit, the additional sum required to raise the 6s. to 8s. 6d. would be approximately 1½ millions a year.