29. Mr. NEWDEGATEasked the Chancellor of the Exchequer whether he is aware that under the National Insurance Act doctors have issued notes for supplying appliances to patients; whether he is aware that articles scheduled as appliances are of a limited description and do not include kidney belts or appliances for relief of cases which are a source of trouble without this assistance; whether he is aware that before the National Insurance Act came into operation patients in possession of hospital notes could obtain kidney belts at 30 per cent. less cost than persons insured under the Act are able to do; and whether, as the average of insured persons requiring kidney belts would not amount to one in 1,000 insured persons, he will advise the inclusion of this article amongst appliances?
§ Mr. MASTERMANThe prescribed list of appliances is subject to such revision as may be found advisable when more experience has been gained after working of the Act. I have noted the suggestion of the hon. Member and it will receive due consideration.
33. Mr. FREDERICK HALL (Dulwich)asked if under the National Insurance Act medical benefits can be extended to Ireland except by way of additional benefits; what would be the additional cost to the United Kingdom of extending full medical benefits to Ireland; and if under the Government of Ireland Bill the payments to be made by the United Kingdom for the working of the National Insurance Act are limited to the purposes for which that Act is applied to Ireland?
§ Mr. MASTERMANThe answer to the first question is in the negative. If medical benefit were provided in Ireland upon the same terms as in Great Britain and if the contributions were adjusted accordingly, the additional cost to the Exchequer over and above the present provision on the basis of those actually insured would be approximately £40,000. The general extension of medical benefit to Ireland could not be effected without legislation. Such extension would clearly appertain to the general subject matter of the Act of 1911 within the meaning of Clause 2 Sub-section (12) of the Government of Ireland Bill. An Exchequer Grant is already made to Ireland under Section 81 (10) of the National Insurance Act of the same amount as would be paid under 692 the Act were medical benefit provided in that country.
§ Mr. MASTERMANThe extension cannot be done without legislation. The legislation would arrange as to the conditions under which the money should be given.
§ 43. Mr. G. LOCKER-LAMPSONasked whether the insurance committees in the county of Middlesex, the Isle of Ely, and Sheffield have refused free choice of doctor outside the panels unless exceptional circumstances are proved; and whether any definition of exceptional circumstances has been laid down by them?
§ Mr. MASTERMANI am not aware that the three insurance committees mentioned have acted differently from other committees. As I have frequently stated, the Act only contemplates permission being given to an insured person to make his own arrangements in exceptional circumstances. It is for the committee to decide upon each application whether the circumstances of the case are or are not exceptional.
§ Mr. G. LOCKER-LAMPSONIs it left absolutely to the discretion of the insurance committee to deny the choice of a doctor to insured persons?
§ Mr. MASTERMANIt is absolutely left by the Act to the discretion of the committee to permit or not to permit any case of what is ordinarily called "making their own arrangements."
Mr. F. HALLIs that consistent with the statement made by the Chancellor of the Exchequer in another place?
§ Mr. MASTERMANI cannot tell what the hon. Member means by "another place."
Mr. F. HALLWhitefield's Tabernacle, where he said all insured people would have the right to choose their own doctors.
§ Mr. MASTERMANIf the hon. Member studies the speech to which he referred, he will find that it is not so.
Mr. MacCALLUM SCOTTIs it not the case that every insured person has the right to choose his own doctor among those doctors who are willing to serve?
§ Mr. MASTERMANEvery insured person has the right to choose his own doctor among all the doctors willing to serve him and willing to serve under the Insurance Act.
§ Sir PHILIP MAGNUSHave arrangements yet been made by which nurses in hospitals are allowed to make their own arrangements, and have they received the forms to be filled in?
§ Mr. MASTERMANI do not know, but I believe that certainly in London those arrangements have been made.
§ 65. Sir J. D. REESasked whether an insured person is entitled to the provision of the services of a herbalist, instead of a doctor, when desired; and what benefits will be provided for Christian Scientists under the National Insurance Act?
§ Mr. MASTERMANDuly qualified medical practitioners alone have the right to be included in a panel list. It is, however, open to persons who belong to an unorthodox school of medicine to apply to their insurance committee for permission to make their own arrangements for medical attendance and treatment, and if such permission is given the committee will make a contribution towards the cost of the treatment.
76. Major HOPEasked whether an insured person who has paid all his contributions since 15th July, 1912, and has requested without success both his approved society and the Insurance Commissioners that he should be allotted to a doctor for receipt of medical benefit, is entitled, if taken ill, to call in any doctor available and recover that doctor's bill in full from the National Insurance Fund?
§ Mr. MASTERMANIf an insured person has been refused by the doctor whom he has selected, he is entitled to be allotted to some doctor on the panel. The allotment, however, is not a matter for the approved society or the Insurance Commissioners, but for the insurance committee of the area in which he resides. I am inquiring, however, concerning the special case in Midlothian which the hon. and gallant Member brought to my notice in last week's debate, and will communicate with him on the subject.
§ Mr. TOUCHEIf an insured person is not refused by a doctor, but the doctor is too busy to attend him, and if after much delay a doctor not on the panel has 694 to be called in, will the insured person be entitled to claim the fee necessary for the other doctor?
§ Mr. MASTERMANHe certainly is not entitled to claim the fee, but whether any fee could be allowed would depend on the circumstances of the particular case.