§ 58. Sir A. GRIFFITH-BOSCAWENasked the Secretary to the Treasury whether a doctor who joins a panel under the National Insurance Act after the official list of the panel has been published can begin to undertake work immediately he joins, or whether he will have to wait till the next publication of the names on the panel; and whether a county insurance committee can refuse to pay him for services rendered under such circumstances?
§ The FINANCIAL SECRETARY to the TREASURY (Mr. Masterman)In any district where the normal panel system is in force a doctor can join the panel at any time. His name would not be included in the published list until such time as the insurance committee issued a revised list of practitioners on the panel. He would be entitled to receive payment in respect of insured persons who elect to be treated by him, and whose treatment he undertakes as from the date on which he joins the panel. Those insured persons who do not express a wish to be attended by any particular doctor will be assigned by the insurance committee to doctors on the panel, and as far as possible under arrangements made by the practitioners on the panel at that time.
Mr. WORTHINGTON-EVANSDo I understand the right hon. Gentleman correctly, that the doctors who join the panels late will also get their share of the insured persons who do not choose their own doctors?
§ Mr. MASTERMANNot necessarily for the first three months.
§ Sir A. GRIFFITH-BOSCAWENUnder the Regulations they will receive payment for any services they undertook immediately after joining the panel?
§ Mr. MASTERMANYes. They will receive payment in respect of insured persons whose treatment they undertook as from the date of joining the panel.
§ Mr. CASSELDoes not the Act provide that every doctor shall have the right to join the panel at any time?
§ Mr. MASTERMANCertainly. My first statement was that in any district where the normal panel system is in force a doctor can join the panel at any time.
§ Mr. CASSELDid not the right hon. Gentleman state that for the first three months he would not have the full opportunity?
§ Mr. MASTERMANPerhaps the hon. Gentleman will refer to my answer.
61. Mr. WORTHINGTON-EVANSasked whether approved societies or the insurance committees will be allowed to provide medical benefit for insured persons over sixty-five at the commencement of the Act; and, if so, whether the extra grant of 2s. 6d. will be payable in respect of them?
§ Mr. MASTERMANBy Section 49 (3), persons over sixty-five at the commencement of the Act who come under the special provisions of that Section and are members of approved societies are entitled to such benefits as the society determines, and can provide out of their employers' and their own contributions, and the State 2d. As far as I am aware, however, all the approved societies have chosen that this money should be devoted to the provision of sick pay rather than of medical treatment. Insurance committees have the same powers and duties in the case of persons of this class who are deposit contributors as the societies have in the case of members of approved societies.
Mr. WORTHINGTON-EVANSDid not the right hon. Gentleman issue to societies two forms of alternative benefits, neither of which included medical benefits, directing the societies to choose one or the other?
§ Mr. MASTERMANNo. They were purely optional for the guidance of societies giving actuarial figures of what could be provided if they chose either of them.
62. Mr. WORTHINGTON-EVANSasked whether the proposed extra grant of 2s. 6d. will be allowed to provide medical benefit for existing members of friendly societies who do not become insured persons because they were over sixty-five at the commencement of the Act?
§ Mr. MASTERMANThe answer is in the negative. Societies which have decided to devote the 9d. a week (or 8d. in the case of women), under Section 49 of the Act, to sick pay rather than to medical benefit will make their own arrangements for medical treatment of their members outside the Act.
Mr. WORTHINGTON-EVANSCan the right hon. Gentleman say whether the 2s. 6d.—the £1,6.50,000—will also be available for such benefits?
§ Mr. MASTERMANNot outside the Act.
65. Mr. WORTHINGTON-EVANSasked why the Statutory Rules, No. 17 and 19, relating to the administration of medical benefit, dated 5th December, 1912, and the Forms 21 and 22, relating to persons desiring to make their own arrangements for medical treatment, were not sent to Members of Parliament until the 8th January, 1913?
§ Mr. MASTERMANThe Medical Regulations (S.R.O. 1719) were laid on 5th December as H.C. 386, and were available to all Members through the Vote Office on 7th December. The stock of forms Medical 21 and 22 (apart from some advanced copies) was only received from the printers on 6th and 7th January, and copies were immediately sent to Members.
§ 66. Mr. KINGasked whether insured workers under the National Insurance Act must expect that records of their ailments, even of a delicate nature, will pass into the hands of local and State officials, as stated widely in certain quarters; and 1669 whether the Insurance Commissioners will take measures to prevent any infringements of the reticence and secrecy which the medical profession are supposed to observe concerning their patients' cases?
§ Mr. MASTERMANThe statements to which I am very glad that my hon. Friend has called attention are absolutely incorrect. The only records which are to be kept are those which will be entered in the prescribed form of day-book. This daybook will be in the sole custody of the doctor. Nobody except the doctor can have access to it. Those leaves of the daybook which pass out of the doctor's hands are perforated, so that while the part containing the name and address of the patient and the attendances (but not the nature of the illness) is sent to the insurance committee, the other part, containing the nature of the illness and certain other particulars (but not anything by which the patient can be identified), will not go to the committee, but will be used for statistical purposes only. In this way absolute secrecy will be secured, and any danger of breach of professional confidence entirely avoided.
§ Mr. KINGIn view of the publicity given to these statements, will the right hon. Gentleman circulate these facts to the approved societies or take other steps to make them widely known?
§ Mr. MASTERMANI think the approved societies know these facts, but I have seen statements in the newspapers which seem to show that the newspapers, or some of them, do not. I will take such steps as I can to see that they shall know them.
§ Mr. MASTERMANYes.
§ 78. Mr. NEWMANasked the Secretary to the Treasury whether, on behalf of the Insurance Commissioners, he is now in a position to state that, except under certain defined and special circumstances, insured persons are not entitled, under the terms of the National Insurance Act, to make arrangements with any medical practitioners not serving on the panel in the district in which they reside?
§ Mr. MASTERMANI would refer the hon. Gentleman to an answer I gave to a similar question by the hon. Member for St. Pancras West, on the 6th January.