§ (1) No voluntary contributor whose total income from all sources exceeds one hundred and sixty pounds a year shall be entitled to receive medical benefit, but in 1347 that case the weekly contribution which would otherwise be payable by him shall be reduced by one penny.
§ (2) Paragraph (e) of Sub-section (2) of Section fifteen of the principal Act shall extend to members of societies other than such friendly societies as are mentioned in that paragraph who were at the date of the passing of the principal Act entitled as such members to medical attendance and treatment in like manner and subject to the like conditions as it applies to members of such friendly societies.
§ Mr. C. BATHURSTI desire to move to leave out the Clause, because in my opinion, and in the opinion of my hon. Friends, this is a breach of contract bearing in mind the provisions in Section 1 of the principal Act. That Section provided that certain persons should be entitled to enjoy the benefits of health insurance as voluntary contributors, and it provided, amongst other things, that if they were insured persons in the ordinary sense for the first five years of their insurance, although they might enjoy an income of upwards of £160 per annum they should still benefit like other insured persons as voluntary contributors. A considerable number of secondary school teachers and clerks have paid insurance upon a misunderstanding, and they have not received any value for their money. Surely, it is grossly unfair that those persons should now be deprived of any medical benefit hereafter, although under the principal Act they have paid on the footing that they would receive that benefit if they happened to fall ill. The only circumstances under which I should not press this Amendment would be if the right hon. Gentleman was able to assure me that he was prepared to accept the Amendment standing in the name of the hon. Member for Worcester (Mr. Goulding) which would confine this Clause to all persons becoming insured after the passing of this Amending Bill.
§ Mr. G. LOCKER-LAMPSONI beg to second the Amendment.
§ Mr. MASTERMANThis Clause was inserted to fulfil a pledge made by the Chancellor of the Exchequer to the medical profession under which some 18,000 doctors offered to go on to the panel, and in this matter the Government ask the House of Commons to support them. After all, what does it mean? Contributors at the present time can only enjoy this benefit if their income is less than £160 a year. 1348 There is a certain number of persons covered by Clause 1 of the Act who having been insured persons for five years and having got to a salary of over £160 a year would naturally pass out of the Act. The majority of them are persons of the middle or upper classes who have been learning trades and have passed up to positions of considerable emolument. All the alteration proposed by this Clause is that after five years if they pass upwards into those positions of emolument, they shall not get medical benefit but shall be excused the contribution which is equivalent, or otherwise it means that they can contract out as far as medical benefit is concerned. They can still remain members of their society and pay contributions and get the other benefits, but in that case they will have to provide their own medical benefit out of the money they save owing to being excused their contribution. It is not true to say that in regard to the class which the hon. Member opposite mentioned of secondary teachers they will not receive any advantage. They will, during the five years in which they pay medical benefit receive insurance against illness, and if during those five years they are ill, they will receive medical benefit. Under those circumstances I do not think it is too much to ask the House to support a compromise which was made with the medical profession, the violation of which would be a breach of faith so far as the Government is concerned.
§ Amendment negatived.
§ Mr. GOULDINGI beg to move, in Sub-section (1), after the word "contributor," to insert the words "becoming insured after the passing of this Act."
The right hon. Gentleman has just informed us that this Clause is intended to give effect to a pledge given by the Government to the doctors, but he did not deny either on the Committee or in this House that the giving of that pledge inflicts an injustice upon a certain body of persons belonging to the clerk class and secondary school teachers. The right hon. Gentleman has used the extraordinary argument that these people are to be excluded because when their salaries rise to £160 they are then considered amongst the wealthy classes. I never remember hearing any such argument in regard to the large number of mechanics and other well paid artisans who are earning £4 a week. On the contrary, full benefits were given to those classes, and the voluntary contributor was really devised so as to 1349 meet the case of clerks and people of that sort. I do not know whether the arrangement come to by the Government with the medical profession is a just one or not, but I hope this House will include under the Act those who have entered into a contract with the Government and the approved societies and secure to them the benefits which it is now suggested should be taken from them. If during five years they have entered into the insurance and their wages or salaries have been raised to £160 a year, then they have the right to become voluntary contributors. Their contributions have been received by the approved societies and the Government have entered into that arrangement by solemn contract with these people, and now, for the first time, they are proposing, because these people are not a large body possessing a great organisation, to make this Clause effective, and that is the reason why this grave act of injustice is going to be done to them. I challenge the right hon. Gentleman or any Member of the Government to name a single insurance corporation or commercial undertaking who would be able to come before this House and ask for a breach of this kind to be met, without giving them any compensation whatever.
I take a very ordinary case, that of a clerk whose salary is fixed and who has a bonus. That salary may in any year come up to the standard of £160 a year, and a year or two afterwards it may drop below that sum, and when that clerk comes back into insurance be comes under a reduced benefit. That is a case which may arise frequently because it is a class of employment which we knows exists. With regard to the class who have already entered into this insurance and, believing in the bona fides and honesty of Parliament have paid their contributions and entered into participation of what they considered the benefits secured to them for like, what is going to happen to the contributions which those people have already paid if this Amendment is made retrospective? They are all frittered away and put aside, and these people are deliberately deprived of the benefits they have insured for. The right hon. Gentleman says they are giving them ample compensation by a reduction of payment as regards their liabilities in case this Clause affects them. Their own actuary has estimated that the cost of medical benefit is 1½d. a week and not 1d. The Government in dealing with Ireland on this question took the valuation as 1½d., and why are you going to give to 1350 those in Ireland terms which you are not giving to those clerks in those in Ireland terms which you are not giving to those clerks in England? The right hon. Gentleman also said that this was a small class, but may I remind him that there are some 25,000 of them. I do not say all of them are likely to suffer under this Clause, but every one of them has entered into a contract which should be respected, but this is only to be done as from the passing of this Act. The right hon. Gentleman said their numbers were so small that they were not worthy of consideration.
§ Mr. MASTERMANI never said that.
§ Mr. GOULDINGMay I point out to the right hon. Gentleman that those representing friendly societies and approved societies have passed a resolution declaring that:
We strongly disapprove of the proposal that members with an income of over £160 should be deprived of medical benefit to which they had hitherto been entitled and for which they had paid contributions.Friendly societies passed that resolution unanimously, and if there is any difficulty about the medical profession, surely the Government are not going to make hanky-panky over it, and if there are pounds, shillings, and pence lost to the medical profession by giving this full benefit, surely the Chancellor of the Exchequer might grant that amount and act honestly towards these people.
§ Mr. HARRY LAWSONI beg to second the Amendment.
7.0 P.M
This is a pettifogging Clause. It does not so very much matter on what scale the injustice is perpetrated if it is perpetrated, and this is a case of distinct injustice, whether there be a form of contract or not. The tradition of our legislation here is not in favour of taking advantage of any small technicalities of law-making, and I submit that to rule this class of voluntary contributors, however small it may be, out of their medical benefit is quite unworthy of the House of Commons. Besides that, it is doing exactly that which we ought to be very wary of doing. It is still further complicating the financial arrangements of the approved societies. It has already been difficult enough for the great friendly societies, principally the affiliated orders, to adapt themselves to the new conditions, but here you are introducing a new exception which will make things still more difficult, however small may be the scale on which it will operate. I ask, Is it worth doing? I suppose that 1351 this is looked upon as a sop to the medical profession, but I hardly think that it is worth their while accepting this as an instalment or as making up to them to some extent what they think to be the disadvantages under which they have been placed owing to the operations of the Insurance Act. We all have our own ideas as to the extent of those disadvantages, but whatever view we take of the doctors' grievance, this goes a very little way to meet it. If that be so, is it worth while interfering with the provisions of the Act?
The policy of the great insurance companies has been exactly in an opposite direction. They have always refused to take—those of them who prosper most—advantage of legal technicalities. They have tried to conduct their business in a broad spirit, and they have found that in so doing they have won public confidence and that liberality has been the best policy from every point of view. The Government is going to act in exactly the opposite direction. They are going to stand on the legal technicality that there is no contract with voluntary contributors, and they are going to deprive them of the benefit to which they are entitled under the principal Act. The right hon. Gentleman may feel that he has done his best to redeem the pledge, if it was given, but, if it is opposed to the policy of Parliament—and I think the provision which follows will show him that it is—then he is relieved of any further responsibility. I do not fancy that he can have his heart in this Clause. It is offered as a sop, but I do not think that it is worthy of acceptance by the medical profession, and I am perfectly certain that it is opposed to the sound policy of working with the friendly societies as far as we can and of not interfering any more than we are obliged with the old lines on which they have carried on their great organisations of thrift.
§ Sir H. CRAIKI am sorry that I cannot support the Amendment, but I rather dissent from the view that this is a sop to the medical profession. I do not look upon it from that point of view in any way whatever. Let us look at it from a commonsense point of view. Is it the case, as an ordinary matter of common sense, that men in receipt of incomes above £160 measure their medical benefit by 8s. 6d. or 9s 6d. per week, or wish to measure it in that way? To suppose that a man enjoying an income of over £160 a year is likely to make use of a mere panel doctor 1352 and to be content with that without the choice he would ordinarily have is not in accordance with the real social facts of the position. Such a man resents mere contract practice. He would naturally be prepared to get his own doctor and to pay for him even if he had the right, under the strict terms of his contract with the friendly society under the Insurance Act, to get medical attendance without any charge whatever. It is not the case that these people will be content with such medical attendance as is secured for them under the Insurance Act. Who are these people? It has been pointed out that there are a number of clerks belonging to friendly societies who earn over £160 a year and who yet wished to have this medical treatment. I do not think that is the case. It is a very rare case.
The case of secondary school teachers has been quoted. Is there a single secondary school teacher earning more than £160 a year who is himself attended or whose family is attended by a doctor provided for him under the Insurance Act? [HON MEMBERS: "Certainly."] I know a large number of schools where they pay their secondary teachers something between £160 and £250 a year, and every one of them strongly resents being relegated to the Insurance Act, and they have never so far as I know made use of it. They would be very sorry to do so. They have their own medical attendants who have attended them and their families for years, and they are not prepared to use, and they are not in the habit of using, merely the medical attendance provided for them under the Act. I, therefore, object to saying that this is merely what is called a sop to the medical profession. It matters very little to the medical profession. It is in accordance with their wish to preserve those close, those confidential, and those friendly relations with their patients which had prevailed in the past and which they think are now being upset by the introduction, in a class which does not wish it and for which it is not suited, of a mechanical sort of relation between medical adviser and his patient. I am positively certain after conferring with these teachers that many of them will welcome this change. The payment is something which they considerably grudge, knowing that the last thing in the world they would think of doing would be to use this medical attendance provided for them under the Act. I am perfectly sure, if the right hon. Gentle- 1353 man sticks to the Bill as it is, that he will find he is conferring a boon not so much upon the medical profession as upon many of those very people who are brought within the range of this Clause in the Bill. They will welcome the relief of part of their contribution, and they will not feel any hardship in being deprived of a benefit which I feel perfectly certain that in nine cases out of ten they never for a moment think of accepting. I hope that the right hon. Gentleman will hold to the Bill as it now stands, and I am sorry that I cannot support my hon. Friend.
§ Mr. MASTERMANI welcome the support of the hon. Member opposite, but I cannot say that I endorse all of his arguments. I must confess that his statement about the service of a mere panel doctor was perhaps a little derogatory to 18,000 of the medical profession. My belief is that on the average you will get just as good medical attendance from doctors on the panel as from doctors off the panel. The hon. Member is dealing with some 25,000 voluntary contributors. If their income is at present over £160 per year, they cannot come into insurance, and the only question is how far, supposing some of them find their income going above that amount, medical arrangements should be made. I altogether repudiate the suggestion of the hon. Gentleman (Mr. Goulding)—I am sure that he made it in good faith—that I said because they were few we could neglect them.
§ Mr. GOULDINGIt is in the OFFICIAL REPORT of the Committee.
§ Mr. MASTERMANI said that when great confusion is caused in the friendly societies by some enormous change the possibility, after five years, of 5 per cent. of 25,000 persons having to make their own arrangements for medical attendance in return for the equivalent they pay to the societies for medical attendance can really be left altogether out of calculation. The hon. Gentleman says that we are breaking faith with these people. We are no more breaking faith with them than any insurance committee would be breaking faith with them if they laid down a limit of £160 and said that everyone with £160 a year would have to make their own arrangements for medical attendance. It is exactly similar to that, and you cannot say that is breaking faith with anybody. It is a possibility which might come to them ordinarily under the Act, and to 1354 persons who cannot at present prophesy whether they will come under it at all.
§ Mr. GOULDINGIs it not the fact with regard to these people that while their wages are under £160 per year you compel them to join and that it is only when they go up above £160 they become voluntary contributors?
§ Mr. MASTERMANWe certainly compel some to come under the Act, and as long as they are under the Act and paying for medical attendance they will receive full medical attendance. They will receive full medical attendance for all the five years during which they are paying for it. After that their condition will merely be the same as if a limit of £160 were imposed by an insurance committee, and any committee can impose such a limit at this moment. It is therefore idle to talk about some solemn pledge having been broken in the matter. We are giving them back exactly the equivalent of what it would cost the approved society. If we gave back more than the penny, we should be imposing a charge upon the approved societies in connection with these persons, and there is no reason why that charge should be imposed. I do not think that it was an unfair pledge for the Government to have given, and I do not think that it does injury to any person. It may be that in some cases the suggestion of the hon. Member for the University of London will be carried out, and that one of these gentlemen joining at the age of sixteen, and subsequently gaining an income of several thousand pounds a year, may prefer not to have the doctor but to have the money, one penny per week, to spend as he likes. Apart from that, I think the hon. Gentleman will realise that this is a not unfair thing to give the doctors, of whom 18,000 have come on the panel.
§ Mr. PRINGLEI rise to support the Amendment, and I regret to find myself in disagreement with the hon. Member for Glasgow and Aberdeen Universities, more especially as he told us he addressed himself to the question from a common-sense point of view. I wonder what effect some of the remarks he has made in the course of this Debate will have upon the large class of his constituents—mere panel doctors—who constitute 70 per cent. of the medical graduates of the Universities of Glasgow and Aberdeen. There are some people who will not forget that observa- 1355 tion. The hon. Gentleman takes an extraordinary view of the attitude of mind of those who have over £160 a year. He says that these men will have an utter contempt for the services of the "mere panel doctor." I do not think he can say that of Scotsmen, for even they with over £160 a year will consider that medical attendance represented at 8s. 6d. a year is worth consideration. Later on the hon. Member suggested that it amounted to one penny per week; but I must say that, bearing in mind the inconsistencies of his proposition, one has some difficulty in discovering the common sense of his point of view.
But I did not rise in the main to deal with the inconsistencies of the hon. Gentleman. I wish to draw attention to the main facts of the case as they stand. This is a proposal to vary a contract contained in an Act of Parliament. It may be a small variation. It may be one that affects few people; but it is a variation which is to be carried through without consulting them, and contrary to the Act, and no matter how small it is, no matter how few the number of people affected, I maintain that Parliament has no right to do it. There are other variations in relation to committees of insurance which are proposed in this Bill as it at present stands, and with which we shall have to deal later on, and I trust we may hope for the support and assistance of hon. Gentlemen opposite in our action upon them, provided we make good our case. On the general ground of principle I think there has been no answer to the speeches of the hon. Members for Worcester and Mile End. It may be that the Secretary to the Treasury has rashly and recklessly made promises to the doctors. Of course, if he has done so, we regret the fact; but the matter is one of very slight practical consideration to the medical profession as a whole, and I am sure that that profession would infinitely prefer that a promise rashly made should be broken rather than that Parliament should vary the conditions of a contract contained in an Act of Parliament. My right hon. Friend said that the insurance committees were entitled to deny medical treatment to the voluntary contributor under the conditions mentioned. But the situation in relation to the insurance committee is quite different from the action we are now asked to take. After all, in regard to insurance committees, insured persons have a voice in respect of any arrangement which may 1356 be made with medical men; but we hold that the action of the insurance committees has no analogy with the action which the Government are now calling upon us to take. I hope the House will accept the Amendment proposed by the hon. Member opposite, and that it will do so mainly on the ground that it will prevent a variation of the contract made with the doctors, and, secondly, because the arguments put forward by the Secretary to the Treasury in support of this variation have really no weight, and do not meet the situation mentioned by the hon. Gentleman opposite.
§ Sir F. BANBURYThe position, as I understand it, is a very simple one. An arrangement has been entered into between the House of Commons and certain people, and it is now proposed that that arrangement should be broken. My hon. Friend comes forward and says, "You are perfectly entitled to break that arrangement as far as new subscribers are concerned, but you are not entitled to do so as regards old subscribers." The hon. Member for Glasgow University, in order to controvert that proposition, says he knows a large number of people with an income of £160 a year or more who would not like to have a panel doctor. May I suggest that that has nothing to do with the question at issue? The question is, Are we going to alter an Act of Parliament to the detriment of the people who have come under that Act of Parliament on the understanding that certain things are going to be done? I would never be a party to an arrangement of that sort. I never particularly approved the Insurance Act, but when you have entered into a legal bargain, as long as it was understood by both parties, you have no business to break it on any consideration of any sort whatever. The argument brought forward by my hon. Friend appeared to me to be an argument which supports the contention I am taking up, because my hon. Friend says that this is not going to have any effect at all, that people with £160 a year do not want to have a panel doctor, and that, therefore, really nothing will happen if the Amendment of my hon. Friend is carried. But we shall be keeping our word, which, I venture to say, is the first thing Members of the House of Commons ought to do.
§ Sir H. CRAIKMy hon. Friend spoke of contributors being "compelled" to come under the Insurance Act. Has he read 1357 the first line of the Section, which provides that "No voluntary contributor"?
§ Sir F. BANBURYThe hon. Gentleman forgets that people under a given income were compelled to come under this Clause, and it was then understood that certain circumstances would arise if their income went above that figure. Now it is said we should not do what two years ago we promised we would do. The argument of the right hon. Gentleman, unless he can prove I am wrong, is that only about 25,0000 people are going to be affected by the proposal. That is one of the worst arguments I have ever heard advanced. What would it matter if even only one person is affected? The only question is, Did you do a certain thing? If you did, you are bound to accept the Amendment of my hon. Friend. If you did not, it is another matter altogether. I dare say it is quite true that the effect of carrying this Amendment will be very small, but there is a much greater effect which might occur, and that is that the trust of the people in the House of Commons, which is already, I think, a diminishing quantity, will certainly be further diminished if Amendments of this sort are resisted.
§ Sir P. MAGNUSI have some difficulty in dealing with this matter, because the Amendment now in the Bill ought to have formed part of the original Act. But when the hon. Member for the City of London speaks of a contract having been entered into between two parties I should like him to inform me who were the parties to this particular contract. I take it that they were the medical profession on the one hand, and the approved societies or insured persons on the other. It will be recollected that the medical profession entered into their part of the contract on the understanding that this particular Clause, which ought not to have been inserted in the original Bill, should be amended on the very first occasion, and it was under this condition that they entered into their part of the contract. Therefore, if we do not give the medical profession the advantages which they expected to receive, we shall certainly be breaking our contract with them, and I think the hon. Gentleman will realise it is quite as important not to break a contract with one party, as it is not to break it with another party. Just look at the common sense of this particular Clause, if I may use that phrase! When the Insurance Act was passing through the House 1358 of Commons it was pointed out that there was great absurdity in the arrangement then proposed. It was pointed out by myself and other Members that there were a large number of persons who were in receipt of incomes of less than £160 a year, but who, in a few years, might come into incomes ranging from £500 to £2,000 per annum, and it was never intended that persons of that class should be compulsorily insured, or, indeed, allowed to become voluntarily insured. It was said distinctly that some alteration must be made on the very first occasion.
The hon. Gentleman has referred to the teachers, and the hon. Member for Aberdeen University was quite correct when he said that secondary teachers in our schools wish to be exempted entirely from the operation of this Bill. I recognise, as everybody does, that thousands of the doctors on the panel are men of very great eminence, and what the secondary teachers desire is not so much to avoid having to be treated by panel doctors as not to be compelled to have medical attendance under the conditions imposed by the Act. That is a somewhat different proposition to the one attributed to my hon. Friend, and I am sure it is what he really intended to say. We must also remember that the medical benefits have only been in operation for about eight months; therefore, the amount contributed by insured persons who became voluntary insurers is extremely small. I quite recognise that as a matter of justice compensation ought to be given them for the fact that they may have paid eight months' insurance without being able subsequently to receive any benefit. But unless the payment proposed is sufficient to give them that amount of compensation, it is very much better they should be allowed to reduce their subscriptions for the few years they are to be allowed to claim medical benefit. Undoubtedly the Government is in a difficulty in this respect, and the sooner they get out of it by rendering it impossible that persons with large incomes, compelled actually against their will to become insured persons under this Act, shall be allowed to obtain medical benefit at the small sum now proposed the better it will be for all concerned.
§ Mr. HODGEI do not intend to deal with any of the arguments that have been advanced in favour of the Amendment, which I heartily support; but I desire to put before the House two practical points which occur to me as the secretary of an 1359 approved society. The first is, that under this Clause are approved societies to be put into the position of inquisitors? Are they to be continually asking who has got an increase in salary that brings him over the £160 limit? Secondly, the amount of clerical work connected witih this Act is great enough as it is, without imposing upon them another new task. Whenever it comes to the knowledge of an approved society that a member has secured a higher wage or salary than £160, they will have to apply to the Commissioners for a form, fill it up, and send it to them intimating that there is such a case. There will be a great number of cross entries to be made in the books as a consequence. I believe that is increasing the work of approved societies quite unnecessarily. For these two reasons I shall support the Amendment.
§ Dr. ADDISONThe hon. Member who has just sat down has not seized the point at issue. These being voluntary contributors, they will not be employed contributors who, in respect of wages earned, are compulsorily contributors. They are not referred to in the Clause at all. The point here is that under Section 1, Sub-section (3) of the principal Act, voluntary contributors who have been insured persons for a period of five years or upwards are allowed to continue in insurance. It is quite evident that no voluntary contributors can be deprived of anything referred to in Section 1 of the principal Act until July, 1917. As a matter of fact, the persons with whom we are dealing are not now entitled to take advantage of the provisions of Section 1. All that we are now doing is to say that in July, 1917, this particular provision shall not apply as originally proposed. The contributions for medical benefit are not carried forward. The hon. Member for Worcester (Mr. Goulding) seemed to think that we were depriving voluntary contributors of something, because something was carried forward. Nothing is carried forward. The amount is paid out every year towards the doctors on whose lists these persons are.
§ Mr. GOULDINGI did not mention anything about carried forward. I said that the penny was the compensation instead of the penny halfpenny.
§ Dr. ADDISONIn no case does it apply to persons who are compulsorily insured. The whole of this controversy illustrates 1360 the difficulty of attempting to impose an income limit. It will be within the recollection of the House that a good many of us on this side, myself included, from the very first strongly opposed a compulsory income limit. I remember that it was moved from the other side, but I do not recollect that the hon. Baronet the Member for the City of London (Sir F. Banbury) objected at the time it was proposed that there should be a compulsory income limit of £2 in respect of medical benefit.
§ Sir F. BANBURYI thought the Insurance Bill was a bad thing, and I never took much part in it.
§ Dr. ADDISONThat is no excuse for the ground of principle which the hon. Baronet raised. A proposal was made, after we had passed Section 1 of the Insurance Act, and had entered into this obligation, as the hon. Baronet thinks it is, that medical benefit should not apply to those with an income above £2. That broke down in argument. I never did think that these matters were worth all the argument used about them. I agree with the hon. Member for Mile End (Mr. Harry Lawson) that there is not so much in this as has been made of it, and that it amounts to substantially but very little. A good many cases were brought forward of persons in industrial districts who at one time had been apprentices and had joined a club, and were receiving medical attendance for something like 6s. a week. We had a case put before us of persons coming for medical attendance in a carriage and pair, and who were members of a club. The Government promised that in order to obviate advantage being taken of Section 1, Sub-section (3) of the principal Act, to do that kind of thing in future, they would allow a general income limit as applied to voluntary contributors, and to that class of persons in respect of medical benefit. It is in fulfilment of that promise that this Clause is introduced. Although I quite agree with the hon. Member for Mile End that there is not very much in it of any value to the medical profession, yet it is said it was a pledge. It seems to me there is no breach of faith in it, because nothing can happen under this Clause until July, 1917.
§ Mr. WHYTEThe hon. Member who has just sat down was quite right in saying that this matter emphasises the difficulty of establishing any income limit in relation to questions of this kind. I say 1361 that on the whole it was a mistaken direction to take to impose anything of the kind. The question of the violation of a contract has been raised. Whenever that question is raised we are told that Parliament is a sovereign body and can make one law one year establishing a certain contract and can, the next year, make another tearing up that contract. No doubt it is true that Parliament is a sovereign body. If we were not, the lawmaking power would be altogether a nullity. But that argument does not invalidate the argument, advanced from the other side as well as from this side, that in the case with which we are dealing, that of persons whom I can only describe as small folk in little companies all over the country, we are not entitled to rest our claim to change their condition with regard to insurance simply upon the sovereign power of Parliament. Even when the right hon. Gentleman advances the argument that this is the fulfilment of the pledge to the doctors, I must say that the form of the Amendment proposed by the hon. Member for Worcester (Mr. Goulding) seems to be a device which enables the House not only to carry out its pledge to the doctors, but also to a certain extent to safeguard the interests of the voluntary contributors. I cannot understand the position of the hon. Member for Glasgow and Aberdeen Universities (Sir H. Craik). He argues one way one moment and another way the next moment. When he refers to the major part of his constituents as "mere panel doctors," I agree with my hon. Friend (Mr. Pringle) in wondering what those constituents will have to say the next time he consults them. The hon. Member for the University of London (Sir P. Magnus) took much safer ground when he described them as "distinguished persons." I am altogether at a loss to know why so much difficulty should he made about the acceptance of an Amendment of this kind, which does not sweep the whole class away. I doubt very much if I could have voted for the proposal of the hon. Member for the Wilton Division (Mr. C. Bathurst), but I shall certainly support the proposal of the hon. Member for Worcester in the Lobby.
§ Mr. GLYN-JONESI rise because I think it is necessary to protest against the breach of contract argument which has been introduced. Let the matter be treated upon its merits. We can certainly never hear anything from the Opposition again about repealing the 1362 Insurance Act, for if to make a difference with regard to one benefit for one class is a breach of contract, then surely the repeal of the Insurance Act would be a wholesale breach of contract! That is not the view I take. I would call the attention of the House to the fact that when it passed this Act, Parliament was not so foolish as to deliver itself into the hands of the medical profession. What is the position? One has heard from the Opposition more than once that we have made a certain promise to the people, that we have agreed to provide medical benefit, and they say, "Now provide them." Then they goad us by saying, "Make your terms with the doctors." Parliament took care, when it passed the Insurance Act, to have a safeguard, which was that the Insurance Commissioners—not the insurance committees—should have power to suspend medical benefit. That is in the Act now. If they do that, they can return to the insured person this part of his contributions, which is a yearly contribution.
If Parliament has taken that power in regard to the whole of the insured persons, surely there is no breach of contract in the Commissioners year by year, if a particular class reaches an income limit of over £160—it may be £500 or £1,000—saying to the individual, "We are no longer in a position to provide medical benefit for you under the terms of the Act. The profession will not do it." The hon. Member for Worcester realised that difficulty. He said that if the medical profession is not prepared to treat these people who are comparatively well off on the terms of the Act, then you must get an extra Government Grant. If he had put that in his Amendment, it would have been out of order. What does he really mean? That we are to go to the medical profession and say that five years from now, whatever is the income of a person who remains a voluntary contributor, "You must treat him on the terms provided by the Act, namely, on the same terms that you are treating everybody else." If he wants us to do that, there is no difficulty in providing it, but he has not said that. The Opposition tell us that we have made a bargain with the insured person, that we must pay the medical profession what they ask, and come to Parliament for a fresh Grant. The Debate this afternoon has been particularly interesting from this point of view. When the Act was going through the House, hon. Members opposite goaded us as being the people who wanted 1363 to sweat the doctors. Hon. Members opposite were the people who wanted an income limit in order to protect the doctors. Now they turn round and say, "You have no right to place an income limit, even of £160, on persons who become voluntary contributors." I hope the medical profession will note the change of front which has been adopted by hon. Members opposite. Is it done to place the administrators of the Act in a new difficulty. If we were to pass this Amendment we should pledge ourselves to provide medical benefit for anyone, whatever his income might be, provided that at one time he has been a compulsorily insured person. What we are now asked to say is that whatever that person's income may be in future, we are to be under a contract with him to see that he shall get his medical benefit, and, if we cannot provide it for 8s. 6d., we must pay the medical profession what they ask for treating men with these means. It savours of putting the administrators of the Insurance Act into a difficulty in regard to the medical profession.
§ The CHANCELLOR of the EXCHEQUER (Mr. Lloyd George)I feel bound to say something about this Clause, because it is the result of very protracted negotiations which I have had with the medical profession. This is one of the points which they criticised constantly at all the conferences which I had with them, and the one which I felt the least capable of equitably persisting in. They said, "Here you have a provision for medical attendance for a class of persons who earn weekly wages and are not in a position to pay heavy doctor's bills. That is the justification for a contract practice and that is the justification for the equivalent of it which you have in this Act. A doctor's bill sometimes means ruin for life to a man who is only earning a small weekly wage; but, they said, that does not apply to that person if he ceases to be a weekly wage earner and becomes a man who is very well off, and it is rather hard on us that we should have to attend to a man who may be earning £500, £600, £700, or it may be £1,000 a year at the rate of 7s. a year, that being the class we look to in order to make up the deficiencies in our income which arise very often from the scale of charges which we impose upon the working classes. 1364 Even in districts where there is no contract practice, it is very well known that the scale of charges for the working classes is different from the scale charged to the person who is well off. I felt that there was a good deal to be said from their point of view, and I undertook that in the first Amending Bill which we introduced I would see that the Government put in a Clause to this effect and would press it upon the attention of the House and I feel in honour bound to stand by that pledge. The proposition has been put forward that the conditions of an Act of Parliament are equivalent to a contract between the subject and the State as a reason why we could not depart from this. You cannot possibly do that in an Act of Parliament. To say that you cannot alter the provisions of an Act of Parliament without involving a breach of contract with the subject is an impossible proposition, and you could not defend it under any conceivable conditions. In this case, at any rate, you have four years' notice, and at the end of the four years any person of this sort will really get outside the contract terms, and will have to make his own conditions with the doctors. I thought many of the demands put forward by the doctors were very unreasonable, but I really could not resist this. I thought it was a very reasonable demand to make, and I felt, therefore, that we were in honour bound to see to it; but if there is anything in the contract question at all my hon. Friends must remember that since this pledge was given £1,600,000, outside the Act altogether, was found in order to assist the payment of the doctors, so that, at any rate the very Act of Parliament which makes this alteration in the conditions makes another very substantial contract in favour of these persons and finds £1,600,000 for that purpose.
§ Mr. HARRY LAWSONIt cuts them out of the £1,600,000.
§ Mr. LLOYD GEORGEAt the end of the four years. I am only pointing out that you cannot alter an Act of Parliament as if it were a contract because here we had to find £1,600,000 which is not in the contract at all for the purpose of the vast majority of those who are insured persons. I do not think these are the persons who have a fair right to demand the bounty of the State, and for that reason I felt I was right in giving the pledge to introduce this Clause, and the Government must stand by it.
Mr. F. HALLI am rather surprised at the right hon. Gentleman's statement. He told us that Parliament had allocated £1,600,000 for the payment of the doctors, but he did not tell us that he was compelled to pay it in order that he might get the services of the doctors at all. It seems to me from some of the statements we have heard to-night that there is a desire to cast on one side all questions as to whether the House of Commons has made a contract or has not. The Chancellor of the Exchequer says an Act of Parliament cannot be a contract, but the fundamental principle in all business is that if you have made a contract you cannot depreciate the terms of it without both parties consulting, and if the Chancellor of the Exchequer considers that point he will see that the Amendment is the only position which can be upheld. We have heard a good many questions in regard to the price paid for the doctors. I am pleased to see that an Amendment is coming on, because I cannot see how they are going to get the equivalent by reducing the price by one penny per week. When the
§ Bill came before the House I was entirely opposed to any persons earning more than £160 a year being allowed to be insured. The whole question has been decided as to the payment to the doctors and the amount of contribution by the people whom you compelled twelve months ago to be insured, and now, because it is compulsory, you are going to say, "We are going to take away any advantages which may accrue." I cannot believe that the House of Commons is going to tear up the agreement. It is not a question of the number that you have to deal with, but a question of principle, and I hope my hon. Friend will press this to a Division, and I shall look very carefully through the Division list to see if those who have spoken to-day, and hon. Members below the Gangway, are prepared to support what, according to the assent they gave, they believe should be done.
§ Question put, "That those words be there inserted in the Bill."
§ The House divided: Ayes, 100; Noes, 228.
1367| Division No. 259] | AYES. | [7.56 p.m. |
| Agg-Gardner, James Tynte | Guinness, Hon. Rupert (Essex, S.E.) | Roberts, G. H. (Norwich) |
| Baird, J. L. | Guinness, Hon.W. E. (Bury S. Edmunds) | Roberts, S. (Sheffield, Ecclesall) |
| Baker, Sir R. L. (Dorset, N.) | Gwynne, R. S. (Sussex, Eastbourne) | Rowlands, James |
| Baldwin, Stanley | Hall, Frederick (Dulwich) | Salter, Arthur Clavell |
| Banbury, Sir Frederick George | Harris, Henry Percy | Samuel, Samuel (Wandsworth) |
| Barnes, George N. | Henderson, Major H. (Berks.) | Sanders, Robert A. |
| Barnston, Harry | Henderson, Sir A. (St. Geo., Han. Sq.) | Scott, Leslie (Liverpool, Exchange) |
| Bathurst, Charles (Wilts, Wilton) | Hewins, William Albert Samuel | Smith, Albert (Lancs., Clitheroe) |
| Beck, Arthur Cecil | Hibbert, Sir Henry F. | Snowden, Philip |
| Benn, Ion Hamilton (Greenwich) | Hills, John Waller | Spear, Sir John Ward |
| Bentinck, Lord Henry Cavendish- | Hodge, John | Stonier, Beville |
| Bird, A. | Hope, Major J. A. (Midlothian) | Stanley, Hon. G. F. (Preston) |
| Blair, Reginald | Horner, Andrew Long | Sutton, John E. |
| Boyle, William (Norfolk, Mid) | Houston, Robert Paterson | Swift, Rigby |
| Boyton, J. | Hunt, Rowland | Talbot, Lord Edmund |
| Bryce, J. Annan | Ingleby, Holcombe | Terrell, George (Wilts, N.W.) |
| Bull, Sir William James | Jowett, Frederick William | Terrell, Henry (Gloucester) |
| Burn, Colonel C. R. | Locker-Lampson, G. (Salisbury) | Thomas, James Henry |
| Cecil, Lord R. (Herts, Hitchin) | Lowe, Sir F. W. (Birm., Edgbaston) | Thompson, Robert (Belfast, North) |
| Clive, Captain Percy Archer | Macdonald, J. Ramsay (Leicester) | Thomson, W. Mitchell- (Down, North) |
| Clynes, J. R. | Mount, William Arthur | Thorne, William (West Ham) |
| Dalrymple, Viscount | Munro-Ferguson, Rt. Hon. R. C. | Ward, John (Stoke-upon-Trent) |
| Dalziel, Davison (Brixton) | Newdegate, F. A. | Wardle, George J. |
| Denison-Pender, J. C. | Newman, John R. P. | Whyte, A. F. (Perth) |
| Dickson, Rt. Hon. C. Scott | Nield, Herbert | Williams, J. (Glamorgan) |
| Duke, Henry Edward | O'Grady, James | Wills, Sir Gilbert |
| Eyres-Monsell, Belton M. | Parker, James (Halifax) | Wilson, W. T. (Westhoughton) |
| Fitzroy, Hon. E. A. | Pease, Herbert Pike (Darlington) | Wolmer, Viscount |
| Fletcher, John Samuel | Perkins, Walter F. | Yate, Colonel C. E. |
| Gill, A. H. | Pointer, Joseph | Younger, Sir George |
| Glazebrook, Captain Philip K. | Pollock, Ernest Murray | |
| Goldstone, Frank | Price, C. E. (Edinburgh, Central) | |
| Gordon, Hon. John Edward (Brighton) | Pringle, William M. R. | TELLERS FOR THE AYES.—Mr. Goulding and Mr. Harry Lawson. |
| Greene, W. R. | Randles, Sir John S. | |
| Gretton, John | Richardson, Thomas (Whitehaven) | |
| NOES. | ||
| Abraham, William (Dublin, Harbour) | Allen, Rt. Hon. Charles P. (Stroud) | Beach, Hon. Michael Hugh Hicks |
| Acland, Francis Dyke | Arnold, Sydney | Beale, Sir William Phipson |
| Addison, Dr. C. | Baker, H. T. (Accrington) | Benn W. W. (T. H'mts., St. George) |
| Alden, Percy | Baker, Joseph A. (Finsbury, E.) | Bentham, G. J. |
| Allen, Arthur A. (Dumbarton) | Balfour, Sir Robert (Lanark) | Birrell, Rt. Hon. Augustine |
| Boland, John Pius | Hayward, Evan | O'Connor, John (Kildare, N.) |
| Booth, Frederick Handel | Hazleton, Richard | O'Connor, T. P. (Liverpool) |
| Boyle, Daniel (Mayo, North) | Henderson, J. M. (Aberdeen, West) | O'Doherty, Philip |
| Brady, Patrick Joseph | Henry, Sir Charles | O'Donnell, Thomas |
| Brocklehurst, William B. | Hewart, Gordon | O'Dowd, John |
| Brunner, John F. L. | Higham, John Sharp | O'Kelly, Edward P. (Wicklow, W.) |
| Burt, Rt. Hon. Thomas | Hinds, John | O'Malley, William |
| Byles, Sir William Pollard | Hobhouse, Rt., Hon. Charles E. H. | O'Neill, Dr. Charles (Armagh, S.) |
| Cater, John | Holmes, Daniel Turner | O'Shaughnessy, P. J. |
| Cawley, Sir Frederick (Prestwich) | Holt, Richard Durning | O'Shee, James John |
| Cawley, Harold T (Heywood). | Horne, Edgar (Surrey, Guildford) | O'Sullivan, Timothy |
| Chancellor, Henry George | Howard, Hon. Geoffrey | Outhwaite, R. L. |
| Chapple, Dr. William Allen | Hughes, S. L. | Palmer, Godfrey Mark |
| Clancy, John Joseph | Illingworth, Percy H. | Pearce, Robert (Staffs, Leek) |
| Clough, William | Isaacs, Rt. Hon. Sir Rufus | Pease, Rt. Hon. Joseph A. (Rotherham) |
| Collins, Godfrey P. (Greenock) | John, Edward Thomas | Phillips, John (Longford, S.) |
| Condon, Thomas Joseph | Jones, Rt.Hon.Sir D.Brynmor (Sw'nsea) | Ponsonby, Arthur A. W. H. |
| Cornwall, Sir Edwin A. | Jones, Haydn (Merioneth) | Priestley, Sir W. E. B. (Bradford, E.) |
| Cotton, William Francis | Jones, W. S. Glyn- (T. H'mts, Stepney) | Primrose, Hon. Nell James |
| Cowan, W. H. | Joyce, Michael | Pryce-Jones, Colonel E. |
| Craig, Herbert J. (Tynemouth) | Keating, Matthew | Radford, G. H. |
| Craik, Sir Henry | Kellaway, Frederick George | Raphael, Sir Herbert Henry |
| Crumley, Patrick | Kennedy, Vincent Paul | Rawson, Colonel R. H. |
| Cullinan, John | Kilbride, Denis | Rea, Rt. Hon. Russell (South Shields) |
| Davies, David (Montgomery Co.) | King, J. | Rea, Walter Russell (Scarborough) |
| Davies, E. William (Eifion) | Lambert, Rt. Han. G. (Devon,S.Molton) | Reddy, M. |
| Davies, Timothy (Lincs., Louth) | Lambert, Richard (Wilts, Cricklade) | Redmond, John E. (Waterford) |
| Davies, Sir W. Howell (Bristol, S.) | Lardner, James C. R. | Redmond, William (Clare, E.) |
| Dawes, J. A. | Lawson, Sir W. (Cumb'rld, Cockerm'th) | Redmond, William Archer (Tyrone, E.) |
| Delany, William | Leach, Charles | Richardson, Albion (Peckham) |
| Denman, Hon. Richard Douglas | Levy, Sir Maurice | Roberts, Charles H. (Lincoln) |
| Denniss, E. R. B. | Lundon, Thomas | Roberts, Sir J. H. (Denbighs) |
| Devlin, Joseph | Lyell, Charles Henry | Robertson, John M. (Tyneside) |
| Dickinson, W. H. | Lynch, A. A. | Roche, Augustine (Louth) |
| Dillon, John | Macdonald, J. M. (Falkirk Burghs) | Roe, Sir Thomas |
| Donelan, Captain A. | McGhee, Richard | Rowntree, Arnold |
| Doris, William | Maclean, Donald | Samuel, J. (Stockton-on-Tees) |
| Duffy, William J. | Macnamara, Rt. Hon. Dr. T. J. | Scanlan, Thomas |
| Duncan, C. (Barrow-in-Furness) | MacNeill, J. G. Swift (Donegal, South) | Scott, A. MacCallum (Glas., Bridgeton) |
| Edwards, Clement (Glamorgan, E.) | Macpherson, James Ian | Seely, Col. Rt. Hon. J. E. B. |
| Edwards, John Hugh (Glamorgan, Mid) | MacVeagh, Jeremiah | Sheehy, David |
| Elverston, Sir Harold | M'Callum, Sir John M. | Shortt, Edward |
| Esmonde, Dr. John (Tipperary, N.) | Magnus, Sir Philip | Simon, Rt. Hon. Sir John Allsebrook |
| Esmonde, Sir Thomas (Wexford, N.) | Manfield, Harry | Smyth, Thomas F. |
| Essex, Sir Richard Walter | Markham, Sir Arthur Basil | Stewart, Gershom |
| Falconer, J. | Marks, Sir George Croydon | Strauss, Edward A. (Southwark, West) |
| Fell, Arthur | Marshall, Arthur Harold | Taylor, John W. (Durham) |
| Fenwick, Rt. Hon. Charles | Masterman, Rt. Hon. C. F. G. | Taylor, T. C. (Radcliffe) |
| Ferens, Rt. Hon. Thomas Robinson | Meagher, Michael | Taylor, Thomas (Balton) |
| Ffrench, Peter | Meehan, Francis E. (Leitrim) | Tennant, Harold John |
| Field, William | Meehan, Patrick J. (Queen's Co., Leix) | Thorne, G. R. (Wolverhampton) |
| Fitzgibbon, John | Middlebrook, William | Toulmin, Sir George |
| Flavin, Michael Joseph | Millar, James Duncan | Trevelyan, Charles Philips |
| France, G. A. | Molloy, M. | Ure, Rt. Hon. Alexander |
| George, Rt. Hon. D. Lloyd | Molteno, Percy Alport | Wadsworth, John |
| Ginnell, Laurence | Money, L. G. Chiozza | Walsh, Stephen (Lancs.. Ince) |
| Gladstone, W. G. C. | Mooney, J. J. | White, J. Dundas (Glasgow, Tradeston) |
| Glanville, H. J. | Morgan, George Hay | White, Patrick (Meath, North) |
| Greig, Colonel James William | Morrell, Philip | Whittaker, Rt. Hon. Sir Thomas P. |
| Griffith, Ellis J. | Morrison-Bell, Major A. C. (Honiton) | Williams, Llewelyn (Carmarthen) |
| Guest, Hon. Frederick E. (Dorset, E.) | Morison, Hector | Wilson, Hon. G. G. (Hull, W.) |
| Gulland, John William | Morton, Alpheus Cleophas | Wilson, John (Durham, Mid) |
| Gwynn, Stephen Lucius (Galway) | Muldoon, John | Wilson, Rt. Hon. J. W. (Worcs., N.) |
| Hackett, John | Munro, Robert | Wing, Thomas Edward |
| Hall, Frederick (Normanton) | Murray, Captain Hon. A. C. | Wood, Hon. E. F. L. (Yorks, Ripon) |
| Harcourt, Rt. Hon. Lewis (Rossendale) | Needham, Christopher T. | Wood, John (Stalybridge) |
| Harcourt, Robert V. (Montrose) | Neilson, Francis | Wood, Rt. Hon. T. McKinnon (Glas.) |
| Harmsworth, Cecil (Luton, Beds) | Nolan, Joseph | Young, William (Perth, East) |
| Harmsworth, R. L. (Caithness-shire) | Norton, Capt. Cecil W. | Yoxall, Sir James Henry |
| Harvey, A. G. C. (Rochdale) | Nugent, Sir Walter Richard | |
| Harvey, T. E. (Leeds, West) | Nuttall, Harry | TELLERS FOR THE NOES.—Mr. William Jones and Mr. Webb. |
| Hayden, John Patrick | O'Brien, Patrick |
Bill read the third time, and passed, with Amendments.
§ Mr. C. BATHURSTI beg to move, in Sub-section (1), after the word "penny," to insert the word "halfpenny."
I am not sure of the exact actuarial equivalent of medical benefit, but undoubtedly it is 1.51d. The right hon. Gentleman has, I believe, already explained in Committee that, in fact, this actuarial 1368 equivalent is considerably reduced by administration and other expenses, but he nevertheless admits that it is worth more than ld. I think it comes out, in any case, at something like l¼d., or a shade under. I move this Amendment because I desire to see some compensation given to the voluntary contributor who is deprived of 1369 medical benefit which he was to have enjoyed under the principal Act. I am taking into account the compensation which he deserves, and which could not be less than 1½d.—1¼d. as representing the actuarial equivalent with administration expenses deducted, and the other 1¼d. as representing the compensation due to him.
§ Sir P. MAGNUSI beg to second the Amendment. I hope it will be accepted by the Government. I said on the previous Amendment that I hoped compensation would be given to those persons who, under the conditions of the principal Act, were compelled to come into insurance, and, having since paid their insurance fees, have to lose medical benefit because their income is now over £160 a year.
§ Mr. MASTERMANWe propose that those persons who came into insurance, and who have now over £160 a year, may continue in insurance for all save medical benefit. We are giving as nearly as possible the exact equivalent of what the society would have to pay. The exact amount is 56d. a year which the society would be paying for medical benefit. The nearest figure we can get is 52d. a year—that is, 1d. per week—and I do not think a person who is fortunate enough in five years to pass out of medical insurance, because he has got very much better off, should demand, or will demand, that the members who are left should have a levy laid on their funds in respect of what he saves to the society by passing out.
§ Mr. CASSELWould the right of compensation be the same as is given when an insurance company fixes the income limit?
§ Mr. MASTERMANThat cannot be proposed here. That is a totally different proposition. I am not sure whether it was proposed and negatived upstairs, but it cannot be proposed here.
§ Mr. CASSELIf there is the same difficulty, is it not desirable to follow the precedent set in the principal Act?
§ Amendment, by leave, withdrawn.
§ Mr. G. LOCKER-LAMPSONI beg to move, at the end of Sub-section (2), to add,
(3) An insured person, on satisfying the local insurance committee that he desires the services of a medical practitioner who has not entered into arrangements with such committee under Sub-section (1) of Section fifteen of the principal Act, and that he understands 1370 the consequences of making arrangements under Sub-section (3) of that Section, shall be at liberty to take such services under that Sub-section.It is quite impossible to make a new speech on the question of the free choice of doctors. If the Chancellor of the Exchequer were here, I do not believe he would deny that over and over again, while the principal Bill was passing through this House, he promised in the country that insured persons should be able to have the doctors of their choice. Practically every speech which contained that promise has been quoted in this House, and I do not propose to quote the old speeches again. But I happen to have got a copy of the "British Medical Association Journal," which contains a statement by the right hon. Gentleman which, I think, has never been quoted in this House. When the Bill was going through the House originally the hon. Member for Hoxton (Dr. Addison) appeared to be very anxious indeed as to whether persons were really going to get their choice of doctors, and he contended that there should be provision for enabling patients to choose their own doctor. The Chancellor of the Exchequer in reply to the hon. Member, used these words:—There is nothing in the Bill to prevent the free choice of doctors.Subsequently at a special representative meeting on 1st June, the Chancellor of the Exchequer said:—Personally, I am strongly in favour of it"—That is the free choice of doctors—I think one of the essentials of cure is that the patient should have faith in his doctor, and you cannot have faith in your doctor if you have a doctor thrust upon you whom you have not chosen.I agree that there is no guarantee in the principal Act that insured persons shall have the doctors of their choice. The principal Act simply says that the insurance committees, if they think fit, shall be allowed to make their own arrangements outside the panel. Although there is no guarantee in the Act, I submit that, the Chancellor of the Exchequer over and over again, while the Bill was passing through the House, gave his personal undertaking that insured persons should have the doctor of their choice. I submit that the refusal of the free choice of doctors all over the country over and over again is having results which have probably never occurred to, or impressed themselves upon, the mind of the Chancellor of the Exchequer. In London, and I believe in Edinburgh especially, there 1371 are a great many doctors who are not on the panel. There are a great many people who have been attended by those doctors since their birth, and who were actually being attended by them for some illness or other at the time the Act came into operation, and I do not see why they should not have the right, in view of the undertaking given by the Chancellor of the Exchequer, of being treated by those doctors who are outside the panel. I quite agree that one ought not to try to break down the panel system. I do not believe any responsible person to-day in the least wishes to break down the panel system; but I do maintain that if the circumstances of a patient are exceptional—that is to say, supposing he has had a special doctor for a long series of years, or supposing that he considers a particular doctor can especially well look after his complaint—he ought to be able to go outside the panel, and have the doctor of his choice.I move this Amendment in order to give the right hon. Gentleman an opportunity of repairing what I consider a very great injustice at the moment. I have refrained from making long quotations, and if I have not quoted all that was said in the country, I hope the Financial Secretary to the Treasury will not think that I have not made out a case in favour of the Amendment. I should like to mention that the Joint Committee of Approved Societies are very strongly in favour of this Amendment, and for the benefit of hon. Members who were not in the Committee upstairs and who may not have seen the communication which was sent round by the Joint Committee, I may mention that that Committee includes representatives of the National Federation of Friendly Societies, the General Federation of Trade Unions, the National Union of Deposit Societies, the National Union of Borrowing Societies, the National Federation of Dividing Associations, and the National Federation of Approved Societies. All these societies want the Government to adopt this Amendment. They have said so quite plainly in their circular.
It being a quarter-past Eight of the clock, and there being Private Business set down by direction of the Chairman of Ways and Means, under Standing Order No. 8, further proceeding was postponed without Question put.