HC Deb 20 January 1913 vol 47 cc15-20

asked whether the right hon. Gentleman is aware that Mr. F. C. Morgan, of 95, Inverness Place, Cardiff, was examined on 21st November last by a doctor and was told that he was suffering from tuberculosis; whether he was told by the specialist to the King Edward VII. Welsh National Memorial Association, on 8th December, to await notice from the medical superintendent of the sanatorium; whether that notice has been received; and, if not, why there has been this serious delay?


No application was received in respect of this person until 4th December. He was examined by the tuberculosis officer and reported upon on 7th December, and recommended by the insurance committee for treatment in a sanatorium on 12th December. Arrangements have been made for him to enter a sanatorium this week. I am informed that the case was not an urgent one, and that the man was able to continue in employment.

26. Mr. BARNES

asked whether, in the case of an insured person who has been certified for sanatorium treatment, and for whom accommodation cannot be found, the National Insurance Commissioners have any power to render that person financial or other assistance pending his entry into a sanatorium; if not, whether it is anticipated that there will be any such cases in the normal working of the Act; and, if such cases will be possible or probable, steps can be taken to secure the power referred to?


Yes, Sir. If there should be any such cases both financial and other assistance would be provided; for during any period between an insured person becoming incapable of work, and his actual entry into a sanatorium he would receive domiciliary treatment, including both medical attendance and the provision of medicines, and also extra nourishment, etc., ancillary to the treatment; and he will also be entitled, under the ordinary conditions, to sickness benefit, normally of 10s. a week.


asked whether the right hon. Gentleman is aware that some benefit societies have issued circulars to their members urging them to select particular doctors on the panel, and have also sent canvassers to their members to inform them that they are required by the society to select certain doctors who are named; whether in the majority of cases this is being done with reference to members of these societies who only became members of any friendly society for the first time under the provisions of the National Insurance Act, and who were not patients of the particular doctors named; and whether, in view of the effect of pressure such as this or canvassing carried on with the connivance of the doctors who are favoured by the officials of these societies upon the other doctors who have gone on the local panels, and whose patients are thus interfered with, the Insurance Commissioners will have immediate steps taken to prohibit societies interfering in this manner?


Every insured person has a right to select the practitioner on the panel by whom he wishes to be attended, and the issue of any circular which conceals this fact would be unjustifiable. If my hon. Friend will inform me of any actual case in which a circular has been issued stating that members are required by the society to select certain doctors who are named, I will see if any action should be taken.


Are the panels filled throughout the country?


I think, with a few tiny exceptions, the panels are now in operation in all districts.


Where the panels are not set up, how are the insured persons going to get medical benefits?


In every case doctors are provided for insured persons.

31. Mr. HOGGE

asked what steps have been taken to acquaint insured persons with the names and addresses of doctors on the panel; and whether lists of their names and addresses have been circulated to each insured person, or, failing that, whether their names and addresses have been advertised in the local Press?


Lists of doctors on the panel have been set up in all post offices, and in offices of the Customs and Excise officers, at police stations, Labour Exchanges, and hospitals, and have also been sent to the local branches of approved societies who asked for them. Lists have not been supplied to individual insured persons, but certain newspapers have, I believe, published local lists.


Does the right hon. Gentleman not think the best plan would be to advertise all these names and addresses in the local newspapers so as to avoid the necessity of workmen going to offices, particularly Excise offices, the addresses of which they do not even know?


It depends entirely upon the local insurance committee, and they probably do not want to incur more expense than necessary.


Can they not be communicated to the approved societies?


Oh, yes; they are communicated to all the approved societies.

34. Mr. NEWMAN

asked whether, be fore admitting the name of any practitioner who may apply to have his name placed on a panel in their area, the insurance committees have been directed by the Insurance Commissioners to investigate the validity and worth of any foreign or American degree that such applicant may adduce as proof of ability to fulfil the duties required of him?


I am not aware that any medical practitioners have been included on any panel except duly qualified medical practitioners—that is, practitioners for the time being registered under the Medical Acts. No foreign or Colonial practitioner is entitled to be registered unless he possesses the qualifications prescribed by the Medical Act, 1886.

35. Mr. NEWMAN

asked the Financial Secretary to the Treasury whether his attention has been drawn to the difficulty caused to insured persons who are obliged to select a medical practitioner from their local panel owing to his status and degree being stated by means of letters of the alphabet only; whether on the Kensington panel two practitioners are described as L.K.Q.C.P.I. and L.R.F.P.S.G., respectively; and whether, in a revised or any subsequent copy of the panel that may be issued, the Insurance Commissioners will give directions that any qualifications in possession of the practitioner should be set out in more popular language?


The question of the manner in which lists of doctors on the different panels are published is entirely a matter for the insurance committees, themselves, acting in conjunction with the medical men on the panels. I believe there have been local variations in the procedure adopted, but I do not believe that these have caused any difficulties to insured persons making their choice.

36. Mr. WHYTE

asked when action will be taken upon the Report of the Highlands and Islands Medical Service Committee?


This matter is receiving very careful consideration, but I fear I am not at present in a position to make any statement with regard to it.

38. Mr. TOUCHE

asked how many of the doctors on the panel for the county of London are also on the panels of neighbouring counties?


I believe that some doctors resident near the border of the administrative county of London have arranged to continue to treat insured persons the other side of that border under the Insurance Act as formerly in private practice. A complete answer to this question would involve the separate examination and comparison of the panels of Middlesex, Surrey, Kent, Essex, West Ham, and Croydon. I will send the hon. Member, if he desires, the printed lists of doctors for all these areas.

39. Mr. TOUCHE

asked the Financial Secretary to the Treasury if his attention has been called to a letter addressed by Dr. Glaister to the Chancellor of the Exchequer, informing him that Mrs. Peppiat walked from Clerkenwell to the offices of the London Insurance Committee at. 3, Pall Mall East, to ask for an answer to a request made by her husband about ten days previously for permission to contract out of medical benefit, she being prepared to give very definite reasons for his desire to do so; that, after interviewing five clerks, Mrs. Peppiat was informed that her husband must consult a panel doctor, and that if she persisted in putting difficulties in the way they could do nothings for her; and if the office staff had authority to adopt this attitude, and why no answer had been made to Mr. Peppiat's request?


I will communicate with the London Insurance Committee in regard to the matter referred to in the hon. Member's question, but I must point out that the insurance committee is not a department of the Insurance Commission, but a public body for whose office procedure I am not directly responsible.

41. Mr. TOUCHE

asked the Financial Secretary to the Treasury if his attention has been called to a resolution passed by the London medical committee protesting against the recent formation of what is termed the London county medical committee (from among the members of which an executive committee has been formed), on the ground that in no sense consistent with reason, or in pursuance of Section 62 of the National Insurance Act, can the Insurance Commissioners be satisfied that such a committee could be regarded as representative of the 5,500 duly qualified medical practitioners resident in the county of London; and what steps are proposed to be taken by the Commissioners to secure that any body which is recognised under the Act satisfies the provisions of the Act?


The Committee referred to in the question has not yet been recognised by the Commissioners under Section 62 of the Act, The Commissioners, when considering applications made to them by a medical committee for recognition under that Section, require full information as to its composition and the procedure by which it was brought into existence.


asked whether a doctor may join the panel and by his agreement stipulate that he will give medical attendance and treatment only to patients who select him, and not to patients who may be assigned to him without their wish and without his consent lay the insurance committee?


I would refer the hon. Member to the answers already given to similar questions by the hon. Members for Stirlingshire, London University, Haggerston, Nottingham East, and Islington North, on the 6th, 9th, 13th, 14th, and 15th instant, to which I have nothing to add.


May I ask the right hon. Gentleman for a specific answer to this question? It has never really been answered before.


It has been answered three or four times.


Can the doctor stipulate by the agreement that he shall only attend his own patients and not those assigned to him?


If the insurance committee accepts that agreement, certainly.

76. Major WHITE

asked whether any doctors are entered on more than one panel under the National Insurance Act; if so, how many; and how many of these have been registered in more than two districts?


Yes, Sir. Where a doctor living near the boundary between two contiguous areas has patients in both, he has, of course, placed his name on the panel of both. It would obviously have been detrimental to the interests not only of the doctors, but of insured persons, that any such artificial divisions as arise from local government boundaries should preclude insured persons from continuing to receive the services of their own doctors. The figure of 15,000, given as the number of doctors on panels in Great Britain was arrived at after making a liberal discount for cases of this kind.


Will the right hon. Gentleman say how many duplicates are upon the panels?


That would involve an examination of all the boundaries of Great Britain.

77. Major WHITE

asked whether any doctors are entered on more than one panel in the county of London; and, if so, how many; and how many of these have been registered in more than two districts?


There is only one panel for the county of London; its division into lists for the separate boroughs is for the assistance of the insured persons in their selection of a doctor within convenient distance of their homes. Doctors were asked what districts they wished to serve, and the lists were prepared accordingly. The number of doctors on the London panel in the first list was 780; and I learn that more than a hundred new names have since been received.


Have any steps been taken to prevent a doctor from having more patients than he can attend?


I do not think any doctor has sent into us any list of the number he has already received.