NEW CLAUSE.—(Fees.) (Hansard, 15 August 1913)

Mr. BATHURST
I beg to move, "That the Clause be read a second time."
This is a technical point but quite a short one. The Amendment, relates to fees under the regulations drafted under the Midwives Act of 1902. Perhaps I may refer to the proviso which I seek to amend. It is in Section 18 of the principal Act, Sub-section (1), and is to the following effect:— Provided always that the mother shall decide whether she shall be attended by a duly qualified medical practitioner or by a duly certified midwife, and shall have free choice in the selection of such practitioner or midwife"— and this is the point— but if in the case of a midwife being selected a duly qualified medical practitioner is subsequently summoned in pursuance of the rules made under the Midwives Act, 1902, the prescribed fee"— that is the fee prescribed by those rules— shall, subject to regulations made by the Insurance Commissioners, be recoverable as part of the maternity benefit. 3237 This really means in effect that the prescribed fee is now recoverable by the doctor as part of the maternity benefit, and the statutory period to which reference is made is the period of twelve days during which it is impossible to say whether the doctor will be called in and whether therefore any part of the maternity benefit, if not the whole, will be deflected to the pockets of the doctor. If anything happens during that period to necessitate the employment of a doctor then the midwife under the Midwives Act is bound to call in a doctor, and until the approved society knows whether or not a doctor has been called in it is utterly impossible for it to pay that maternity benefit either to the doctor or otherwise for the benefit of the woman—that is to say, possibly to the midwife. So it means a great delay and this Amendment is in the interest both of the midwife and of the mother because there is this delay of twelve days during which no one gets the maternity benefit at all, because it is almost impossible to say whether a doctor will have to be called in, and part at any rate of the maternity benefit be diverted to the doctor, and not pass either to the mother or to the midwife.
What I seek to do by this Amendment is to sax that, for the purpose of the Midwives Act and rules issued under that Act, the prescribed fee to which reference is made in the Act shall not be taken out of the maternity benefit at all. In other words, that the maternity benefit shall pass to the woman, or if the woman has employed her—she is entitled under the Act to employ a certified midwife—to the midwife for her remuneration, and so far as it is not so employed, if a doctor is called in, then something will be available out of it, if he chooses to send in his charge to the mother for the payment of the doctor. There is no reason why the Midwives Act should be mixed up with the National Insurance Act in this connection. I hope that the right hon. Gentleman will see the reasonableness of this, and in fairness both to the mother and to the midwife will accept the Amendment.

§ Mr. MASTERMAN
I entirely accept the principle of the new Clause. Everyone who has had anything to do with the administration of the Act knows that the original proviso, however desirable it, might have been in theory, has proved impracticable, and it has no friend. The doctors, the midwives, the approved societies, and the insured persons, dislike it. Therefore, I hope that it may be unanimously rejected by the 3238 Committee. The only point is the question of form. The form that I would like to take is the form on page 776, which says at the end that it shall be irrecoverable as part of the maternity benefit. I think that we should give a second reading to the Clause of the hon. Member for Wilton, and we could then move in as an Amendment the substance of the Clause proposed by the hon. Member for Derby. I think that that would meet the convenience of everyone.

Mr. BATHURST
I am bound to say that I have no pride of paternity, and as long as this is settled to the satisfaction of the Committee I do not mind who moves it.

§ Mr. MASTERMAN
My suggestion was to read the Clause of the hon. Gentleman a second time and by a little alteration of the Clause we can incorporate into it the Amendment which stands in the name of the, hon. Member for Derby.

§ Sir P. MAGNUS
As far as I understand this Clause provides that the doctor's fee, if called in, shall not be recoverable out of the maternity benefit. I think it is very desirable that the maternity benefit should be handed over entirely to the woman herself, but I should like to know from whom under these circumstances will the doctor's fee be recoverable. It seems to me according to this new Clause the doctor may be required to discharge an important office without receiving any fee at all. I would like to know from the right hon. Gentleman whether he has made any arrangement by which the doctor called in an emergency, a great emergency, shall have his fee?

§ Mr. MASTERMAN
The answer to that is that the doctor is in exactly the same position as before the Act was passed. He will adjust his scale of fees, as he did before the Act was passed, to the needs of the person, instead of having one prescribed fee; and he will have all his statutory rights to recover that fee without interference with the maternity benefit.

§ Dr. ADDISON
I am sure the hon. Gentleman opposite has unnecessary misgivings. Personally, I am heartily in agreement with this Amendment. It is very essential to the smooth working of the Act. In many cases the medical man recover; fees from the statutory authority, in respect of the Midwives Act, which is really the county council, and in other cases they are able to recover fees where they give attendance. There is no alteration in that respect, and I think this is a very desirable Amendment.