§ 21. Sir J. D. REESasked the Chancellor of the Exchequer whether he is aware that a practice for which £1,200 was offered before the National Insurance Act was in sight realised one offer of £900 soon after 341 it was passed, and is now unsaleable, and that many similar cases have occurred; that the passing of this Act has stopped the buying and selling of practices and brought ruin to medical men all over the country; and what compensation it is proposed to give to the owners of such depreciated practices?
§ The FINANCIAL SECRETARY to the TREASURY (Mr. Masterman)The answer to the first two parts of the question is in the negative. I am not aware that any scheme of compensation is required in connection with an Act which will greatly increase the remuneration of those who accept service under it.
§ Sir J. D. REESDoes the right hon. Gentleman dispute the facts put forward in the question? Does his ipsi dixit make any difference in the adopting of the Act?
§ Mr. MASTERMANThe hon. Gentleman asked me if I heard of these facts, and he said I have not. There is not the slightest doubt but after a few months' time the doctors on the panel will find their practice worth very much more than now.
§ Sir J. D. REESIs not that confined to doctors who have been strike-breakers? Are there not other doctors to be considered besides these?
§ Mr. KINGAre not the doctors themselves to blame for having been lead into the morass in which they find themselves?
§ 22. Sir J. D. REESasked what steps the Government intend to take to provide medical benefits on and after 15th January, 1913, in view of the fact that insured persons on that date have paid tax for six months on the faith of Government assurances that medical benefit will be forthcoming; and whether the Government proposes to proceed with the compulsory collection of insurance tax, notwithstanding the fact that 42 per cent. of the medical profession have formally refused service under the Act in its present form, which refusal practically makes the medical benefits of the Act impossible of attainment?
§ Mr. MASTERMANMedical benefit will be provided in accordance with the National Insurance Act as from 15th January, and insurance contributions will continue to be paid as required under the same Act. I do not know the hon. Member's authority for the figures given in the 342 last part of the question, but I would point out that if, as he suggests, only 42 per cent. of the medical profession have preferred not to undertake the provision of medical benefit under the Act, the remaining 58 per cent. would be very largely in excess of the number required to give adequate medical attendance to the insured persons.
§ Earl WINTERTONMay I ask the right hon. Gentleman whether he will make a statement to-day or to-morrow as to what is to be done in the case of counties where there are no resident doctors to work the Act? Is he aware that great anxiety is felt by the insured persons in such cases?
§ Mr. MASTERMANIf there are such cases some statement will be made.
§ 48. Mr. CASSELasked whether it is intended to obtain the sanction of the House of Commons before any arrangements are made by the insurance committees for the provision of medical benefit which involves the payment out of public funds of amounts in excess of those hitherto sanctioned by Parliament?
§ Mr. MASTERMANThe National Insurance Act does not impose any limit upon the amount which may be expended out of contributions in the provision of medical benefit. The effect of spending more than the amount allowed in the actuarial calculations upon which the scheme is based would, in the absence of a special Grant, be to reduce the amount available for other benefits. It is proposed to ask Parliament for a special Grant to defray the expenditure which may be incurred by insurance committees after the moneys actuarialy available for the present calendar year have become exhausted. The agreements now being entered into with the doctors in no case run for more than three months, and no public money will be expended without the previous sanction of Parliament.
§ Mr. CASSELIs it not the ease that binding agreements will be entered into before Parliament is consulted, and what becomes of the control of this House over finance if binding agreements are entered into before the sanction of this House is obtained when that sanction could be perfectly well asked for and obtained beforehand?
§ Mr. MASTERMANNo binding agreement with the doctors, involving the expenditure of public money outside that 343 provided by the National Insurance Act, will be entered into until Parliament has voted the money, if it does vote the money.
§ Mr. CASSELIs it not the case that unless the additional money is found out of public money there will not be enough to provide for medical benefit?
§ Mr. MASTERMANI have said that agreements with the doctors are only for three months. Those agreements can be fully honoured out of the money already provided by Parliament.
§ Mr. CASSELDoes the right hon. Gentleman think there is any special reason why this House should not be given an opportunity of considering this matter?
§ Mr. MASTERMANI hope on the earliest appropriate occasion the House will be given an opportunity, but, of course, that rests with the Prime Minister and not with myself.
§ Mr. CASSELThe question was addressed to the Prime Minister.