NATIONAL HEALTH INSURANCE [MONEY]. (Hansard, 11 July 1919)

§ Mr. HOGGE
On this question it would be interesting to hear from my right hon. Friend what has induced the Government to extend the rate at which insured persons should be brought in from £160 to £250, when at the same time we have in the Budget Income Tax proposals to maintain the limit for Income Tax exemption at its present figure. I do not wish to anticipate the Debate on the Finance Bill next week, but it is well known that suggestions are likely to be made for the exemption from Income Tax of incomes up to £250. It is now proposed that because of a temporary rise in wages, and a temporary rise in prices, to extend the maximum sum under which a person must be brought under the National Health Insurance. It does seem rather anomalous that when you begin your Income Tax on the basis of £130 for a temporary reason you should at the same time extend the figure up to which a person must be brought under the Insurance Act. I do not know whether my right hon. Friend proposes this only as a temporary expedient which will be altered when the present rise in prices is altered, and the present equivalents in money are reduced to the basis on which the National Health 2202 Insurance Scheme was originally framed. I do not wish to argue whether £250 or £160 is a proper limit, but obviously this proposal is brought forward because of the increased rate of wages and the increased prices, and what one would like to know before agreeing to this Resolution is-whether it is the policy of the Government permanently to draw the line at £250, because if so it alters our whole conception of the National Health Insurance Act?

Mr. T. WILSON
There is a great deal in what my hon. Friend has said, but I am not sure that I agree with his suggestion, that as the rise in prices is reduced and we have progress and improvement in our general conditions, wages will come down to what they were in pre-war days. I have not had an opportunity of ascertaining what arc the views of the men directly affected. I have been told that the members of the various organisations have not had the time to consider how they are going to be affected by the new proposal. I have had communications with individuals whose wages have gone up from, say, £150 to £210 a year, and they complain that they have been excluded from the benefit of the Act owing to their wages having increased. At the same time, from the evidence I have obtained. I think there is a disposition to agree to the proposal. Those of us who have, before and since the passing of the National Insurance Act, been in close touch with the trade unions and friendly societies, have been fully aware that there was considerable opposition among the members to the Act itself. I am very much inclined to think that that opposition has to a large extent disappeared, and the fact that no protests have reached myself, or, as far as I know, any of my colleagues, regarding this new provision, makes me think that the House would be well advised to allow the proposal to go forward. If wages are considerably reduced in the future it may be necessary to consider the advisability of reducing the income limit. Speaking for myself, and my own colleagues, whom I have consulted, we are not going to raise any objection to this proposal.

§ Major HURST
I hope that before this extension is made permanent some attempt will be made to obtain the opinion of the very large classes of people who are affected by it. The effect of the in crease of the limitation from £160 to £250 will be to bring in two large classes —first 2203 of all the class which has never been under the National Health Insurance Act before, and, secondly, those whose rises in wages during the last few years have taken them beyond the present limitation. I feel certain that neither of those classes has expressed any opinion whatever as to whether they want to come under this provision or not. The proposal has never really been before the country. In the district I have the honour to represent there is certainly an intense individualism, to which those who are behind this proposal hardly do justice. Only yesterday I received a letter from one of the class who during the War 'have found their wages increased beyond the old limit. He writes: I notice the Government are going to bring the limit up to £250,so as to rope in the million odd members who have had to withdraw tin account of receiving higher salaries now than in 1912. I hope you will oppose this. They gave us no option in 1912, but now when they find they are losing such a great many of their best members they want to bring us in again by simply juggling with figures. I detest this health insurance business, and was only too glad to get out of it. Major Astor is off his horse if he thinks we are grieving about losing all we have paid in. It will certainly grieve us if we have again to subscribe to this hated tax. I do not suggest that that letter is necessarily representative of the whole of the class who passed beyond the scope of the Act during the War, but I do suggest that where you have any large number of people who do not want to come under a measure of State insurance, and who are willing, rightly or wrongly, to carve out their own salvation, this House ought not to impose upon them the obligation to come under a scheme without con-suiting their wishes in any degree. It ought to be made optional for them to come under the scheme or not. After all, in the past history of this country men who have tried to help themselves have contributed enormously to the building up of modern England. They have been provident by act of grace instead of by Act of Parliament, and they prefer to remain so. Whether they are foolish or not, I think Parliament ought to consult their views. There is no mandate to increase this limitation, and I hope that before this proposal passes into law the wishes of those whose daily lives are going to be affected by it will be consulted.

§ The MINISTER of HEALTH (Dr. Addison)
In regard to the remarks of 2204 my hon. and learned Friend, I would say that he is under considerable misapprehension as to the contents of the Bill and the history of its formulation. All the care which could be taken to consult the representative societies concerned was taken before it was submitted to the House, and although it is not, perhaps, very material to the Financial Resolution, I would remind him, in regard to the new classes which may be brought in, that they are entitled to claim exemption, so that the hardship which he forecasts for certain persons will not arise. With regard to the point raised as to Income Tax, I shall say nothing. This proposal is brought forward because, owing to the increase in wages, between 500,000 and 1,000,000 persons, who have paid regularly their contributions under the Insurance Act, would be automatically deprived of any benefit which may arise from those contributions. It is, therefore, necessary to increase the wage limit so as to secure that they do not lose any benefit to which they have contributed. As to whether the proposal is temporary or not I cannot say anything very definite. I do not know whether wages will come down or not, but I am rather inclined to agree with the hon. Member (Mr. Wilson) that there is no reason for supposing a return to the pre-war level. It is quite true that the Bill in itself reveals nothing of any temporary nature. It provides that those brought in by reason of the raising of the wage limit, but not hitherto included, shall have the right to contract out. If you look at the terms of the Bill, you will see that it is very generous, and it can be amended in Committee to cover any particular cases. I think we shall have to leave to future Parliaments and their discretion any action which may be thought necessary if the general rate of wages alters.