NATIONAL HEALTH INSURANCE (REGULATIONS).

HC Deb 30 January 1929 vol 224 cc1097-104

Mr. W. HIRST

I beg to move, That a humble Address be presented to His Majesty praying that the Regulations, dated the 26th day of November, 1928, entitled the National Health Insurance (Medical Benefit) Consolidated Regulations, 1928, be annulled. It is not my intention to take up too much time of the House in reciting the various circumstances associated with this question. It will be within the recollection of most hon. Members that on one or two occasions last year, when this question was discussed, we attempted from this side to put up a reasonable opposition against the imposition of this Regulation. The main point involved is that in April last year there was introduced a Regulation which prevents co-operative societies which may have drug departments or chemistry departments, from taking National Health Insurance prescriptions and writing divi- dends on such prescriptions as were presented by their members. To our minds, as representing the important co-operative movement—and we claim that it is of some importance to the country—an unjust imposition has been placed upon our trading activities which is not warranted by any unprejudiced examination.

In 1925, the Retail Pharmacists' Union, who became our opponents on this issue, approached our co-operative committee to discuss the question of dividend being paid on National Health Insurance prescriptions, and put for ward reasons for suggesting that the practice was an unfair one. The first was the familiar suggestion that it encouraged malingering, an indictment which, we say, ought not to be levied against our people who have to have recourse to treatment. The second point they put forward was that if the practice were allowed to continue the Ministry would come to the conclusion that the fee allowed for making up prescriptions was an extortionate one, and that probably some reduction would be enforced by the Ministry. We prefer to believe that the second reason was the more important one so far as they were concerned. That same year our people sought the opinion of the Ministry of Health, and the answer given by a very prominent official of the Ministry was, first, that the practice the co-operative societies were then engaging in was not contrary to the law of the country and was not prejudicial to the administration of the National Health Insurance Act. Further, I am informed that that important official said that by no stretch of the imagination could it be said to be an improper practice. In those circumstances, I think our people had a right to come to the conclusion that they were perfectly safe in carrying on with a policy which is adopted generally in the case of all the commodities they sell to the members of the movement.

Following upon this, in 1925, the Darlington local medical committee, knowing what was going on, and the amount of success with which our co-operative people were meeting, drew up a resolution which they submitted to the local insurance committee. In it they suggested that it was up to the local insurance com mittee to make representations to the Ministry of Health that not only was the practice encouraging malingering but that it was adding to the work of medical practitioners and increasing it beyond their capacity. The responsibility for a statement of that kind must lie with the medical practitioners. If they are carrying out a policy of renewing certificates of unfitness to work week after week, that is their fault, and not the fault of the people concerned. At the time we suggested that no evidence of malingering had been submitted, and we further submitted that the monetary benefits to be secured by malingering were so infinitesimal that they could be of no real benefit to the parties concerned.

Taking the current amount payable, which is 5d. per prescription, one can see that, with a dividend of 2s. in the £, a member would need to have 48 prescriptions before he would be able to get 2s. Not only would the financial gain be very small, but in order to secure that 2s. the treatment would have to go on for the greater part of a year, during six months of which the insured persons would be on half benefit. I would say of our people that, in the main, they are only too anxious to get back to work, because of the financial loss which they suffer while away from their occupation, and it is ridiculous to suggest that the other consideration would deter them from resuming work as quickly as possible. From 1925 up to April of last year the Retail Pharmacists' Union had been exercising all the pressure that they could upon the Ministry to introduce the imposition of which we complain. Last year they gained some success. In May we protested in this House, and the Minister took as his leading card "malingering" and sheltered behind that explanation. He suggested that chemists were in the habit of giving gifts. We say that there is no analogy between the chemists giving gifts and the members of a cooperative society going to the chemist's department of which they are the part-owners.

Immediately after the discussion in this House last May, we had a very important co-operative congress at Hartlepool, in June, and in the co-operative movement a national congress is regarded as a very important event which carries some-weight, not only in this country but throughout the whole co-operative movement everywhere. We had an attendance of not less than 1,800 delegates, and they carried a resolution of protest against the Minister of Health and his Department for the introduction of this restriction. They then complained—and it is a very vital part of our case—that the introduction of this imposition came in May or April of last year, and it is very clear that the Minister of Health must have been receiving representations from the Retail Pharmacists' Union. A conference took place between representatives of that body and the Ministry of Health, with no one present from the co-operative movement. For the Ministry of Health or any other Department to arrange a conference with a party which proposes to impose a penalty on a third party which is not asked to be present, is a most undemocratic way of dealing with affairs of State. The next point of their resolution was that they should seek an interview with the Minister of Health. One would have thought that the right hon. Gentleman would have been prepared to receive this deputation: but the first appeal from our committee to the Minister was met with a refusal. Finally, the Minister agreed that he would receive a representative from our committee. That is my information, and, if I am mistaken, I hope the right hon. Gentleman will put me right. He will not dispute these three points of the reply which he made to the deputation—first, that they were within their legal fights in the imposition of these consolidation regulations. Nobody was saying that they were not within their legal rights. But in 1925 a very important official of the Ministry of Health stated that there was nothing contrary to the law at that time in the practice which co-operative movement was pursuing. If it was good in 1925, then it holds good to-day. The right hon. Gentleman attempted to apologise for his lack of courtesy in not receiving the co-operative deputation and suggested, as an explanation that there had been no time. I believe that my colleagues would be the first to recognise that during this Parliament no Department has carried out so much work as the Ministry of Health in connection with legislation.

We all agree that the Minister of Health has been overburdened with work, but if it was easy enough for him to receive the representative of the Retail Pharmacists' Union it was just as easy for him to have received a representative from our society. The medical practitioners must carry some responsibility in this matter, and they certainly must assume responsibility for allowing those people to continue to receive benefits. Finally, we were told that they were legally advised when a purchaser was not a purchaser. We had to face that difficulty in certain instances, and out of a given total our trade has been reduced in those particular instances by a little over one-third. In two instances we have figures to prove that statement. The Retail Pharmacists Union is a very important body, and they have to deal with the Proprietary Articles Traders Association. We are up against that organisation however formidable it may be, and it stands to the credit of Canada that they will not allow in that country any such practice. That society claims to be a price fixing association. Heaven knows that at least there is to-day far too much profit making in connection with matters of this kind!

The time has come to stop that kind of thing, and we claim that the policy being carried out by our society is the right policy as far as it is attempting to dis- tribute profits amongst the whole of the people involved in the association. I received a copy recently of the "Chemist and Druggist." I have not seen that paper before, but it is singular to note that one of the leading articles is an article on co-operative trading methods. That journal speaks of the disagreeable nature of the circumstances arising between the Retail Pharmacists' Union on the one hand and the Parliamentary Committee of the Co-operative Society on the other. They say that there has been a feud created between those bodies. For my part, I welcome the establishment of that feud. Then they go on to suggest in the same article that the co-operative movement has long ceased to be what it was intended to be. It would be important for us at least to have some further explanation of that. I say to the Minister of Health that, if there is anything in what the Prime Minister said a few days ago in his speeches in the country, it is totally unfair, if not unwise in the highest development of our country, that an imposition like this should be placed on that trading agency which is making the greatest contribution towards the realisation of those virtues that any movement can make.

Mr. SPEAKER

Before I allow this Debate to continue, I should like to say that I understand from the Motion which the hon. Member has moved that his objection to these Regulations is founded on one Regulation, No. 27, relating to the supply of drugs or appliances. Am I right in that supposition?

Mr. HIRST

I think it is true to say that our main objection is against Subsection (4) of Part I of the Third Schedule, which reads: A chemist shall not give, promise or ask for any prescription any gift or reward, whether by a share of profit on present business or by way of discount, rebate or otherwise, as an inducement to or in consideration of his presenting an order for drugs or appliances on a prescription form provided by the Committee.

Mr. SPEAKER

I should like information from the Minister of Health as to whether that particular Order wa3 not made in April, 1928.

Mr. CHAMBERLAIN

Yes, Sir, that is so.

Mr. SPEAKER

If that be so, I can hardly see that this Address for which the hon. Member is moving can be in order now, because he will understand that these are not new Orders. The particular one with which we are now dealing is a consolidation of Regulations.

Mr. A. V. ALEXANDER

On that point of Order. It is understood under the Statute that the consolidation of the Regulations has to be laid on the Table in draft, and an Order has been so laid in draft. Surely, it is within the province of any hon. Member of the House to raise any objection, if he so desires, to any part of the Regulations laid on the Table in draft.

Mr. SPEAKER

I do not think that that is the case. I think that the Rule only applies when a Regulation is laid on the Table for the first time, and not to a consolidation of various Regulations.

Mr. ALEXANDER

Further on the point of Order. We have taken the only constitutional procedure open to us. A. consolidated set of Regulations has been laid on the Table, and we therefore pray, in the terms of this Motion, not against a section only, although we address an argument to that, but against the consolidation of the Regulations, because that contains it. That is the only course we can take.

Mr. SPEAKER

I have not had very long to consider this question, and perhaps the House will excuse me if I am not as explicit on it as I otherwise might be. It seems to me that, even if the House were to agree to this Motion, it would not have any effect at all in a court of law.

Mr. CHAMBERLAIN indicated assent.

Mr. BARNES

Further on the point of Order. May I ask whether the House is in a position to vote against the consolidated Regulations'! If that be so, surely we are entitled to discuss them.

Mr. SPEAKER

I have not had time to consider the matter. It was not until I heard the hon. Member's speech that I gathered that his Motion was confined to one particular Regulation among these consolidated Regulations. There are, I understand, several new Regulations among these consolidated Regulations, and against those, naturally, a Humble Address could have been moved now and would have had effect, but upon a Regulation that was ordered in April of last year I hardly see that it would be in order to protest against the whole of the Regulations in these consolidating Regulations.

Mr. ALEXANDER

I am much obliged, Sir, for the opinion which you have expressed, but are we not entitled to vote against the general consolidation which has been laid on the Table of the House, and, because there are new Regulations included in the general consolidation, surely it must have effect in a court of law.

Mr. CHAMBERLAIN

May I put this point to you, Sir. Seeing that this is a question of consolidation of existing Regulations, with which, no doubt, some new Regulations are connected, would not the effect of the Address being passed and a consolidation not taking place be to leave the Regulations which have already been passed in force, and, if so, would not that include this particular Regulation against which the Motion is directed?

Mr. SPEAKER

The right hon. Gentleman has put the point better than I could do. That is exactly the reason why I do not think the Motion is in order.

Mr. ALEXANDER

If you rule that, Sir, we must accept it.

Mr. SPEAKER

I do rule that.

The remaining Orders were read, and postponed.

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