ATIONAL INSURANCE BILL. BY J. H. WATTS. 3/= net. THE LIBRARY OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES \ THE NATIONAL INSURANCE BILL. BY THE SAME AUTHOR. THE ASSURANCE COMPANIES ACT, 1909. ANNOTA TED, WITH AN INTRODUCTION AND INDEX. 1 910. Price 6s. THE NATIONAL INSURANCE BILL. WITH AN INTRODUCTION AND NOTES. BY J^ JH. WA TTS^ OF THE INNEB TEMPLE AND THE SOUTH EASTEEN CIECUIT, Author of'^'^ The Assurance Companies Act, 1909." LONDON : STEVENS AND SONS, LIMITED, 119 & 120, CTIANCKRY LANE, 1911 CO NATIONAL INSURANCE BILL. INTRODUCTION. £^ The long expected and much talked of Sickness Insurance tu Bill has at last, after numerous jDostponements, been in- >. troduced into the House of Commons, and I do not think < it is overstating the case to say that the principle of State- E help to insurance contained in the Bill has been warmly approved and welcomed by all parties in the State. Unionists as well as Radicals have vied with each other in their welcome and appreciation of this principle of the measure, and it is on points of detail and administra- tion that criticism has been directed. The Bill is divided into tAvo parts— the first dealing I' with sickness under the comprehensive name of " National Health Insurance," and the second with "Unem- ployment Insurance." I venture to think that it is a cj pity that these two subjects, which are surely quite dis- cs tinct, should not have been dealt with in separate Bills, for their inclusion makes the Bill very long and cumber- some, and each part, moreover, is under the control of a separate minister, the Chancellor of the Exchequer being responsible for the conduct through the House of the Sickness portion, while Mr. Sydney Buxton has charge of the Unemployment section; and as the provisions of ^ the Bill in respect of each portion are so numerous and g complicated, and afYoct so many and often conflicting in- 2 tcrests, it has been impossible for members of the House of Commons to adequately discuss the Bill during the 2 NATIONAL INSURANCE BILL. second reading debate. The Bill was introduced into the House on the 4th May, and passed its second reading, without a division. The Bill will now go into Committee of the whole House early in July, and the Government are going to make every effort to get the Bill passed before the end of August. The Bill applies to the whole of the United Kingdom, and dealing first with the part relating to sickness insur- ance, the Bill is intended to effect as wide an insurance as possible of the working population against sickness and breakdown, by providing "for insurance against loss of health, and for the prevention and cure of sickness." All workers, whether married or otherwise, between the ages of sixteen and sixty-five, whose earnings do not amount to more than £160 per annum are to be compelled (with a few exceptions) to come within the provisions of the Bill by insuring against sickness. The exceptions are certain casual labourers, commission agents who work for more than one employer, municipal and civil servants who have retiring pensions, while soldiers and sailors in the army and navy and school teachers are to be provided for under special schemes. Workmen are to contribute 4:d. per week (women 3d.). Emj^loyers are to contribute 3^. per week for each Avork- man they employ, and the State 2d. Where the workman over twenty -one does not earn more than 2s. 6d. a day, and does not receive " board and lodging," he is to pay less and his employer more, as follows: — Where wages are not more than 1-s. 6d. a day — The employer is to pay 6d. (for women id.) per week . The workman is to pay Id. per week. Where wages are not more than 2s. a day — The employer is to pay 5d. (for women 4:d.) per week . The workman is to pay 2d. per week. INTRODUCTION. 6 Where wages are not more than 2s. 6d. a day — The employer is to pay 4:d. (for women 3d.) per week. The workman is to pay 3^. per week. Where the employed person receives no wages, then the employer must pay the whole amount; the State in each case contributing the 2d. — thus making the total of 9d. a week for every workman, and Sc?. for every woman worker. The above payments are all compulsory, and are to bo collected as follows: — The employer is to be responsible for the 7d. a week in respect of every workman and 6d. for every woman worker employed by him. Every work- man is to have a card, and the employer is to affix a 7d. or 6^. stamp weekly on such card, and is to deduct the 4:d. (or whatever the workman's contribution may be) from the Avorkman's wages. This is the compulsory side of the Bill; but there is also a voluntary side. Persons who are earning more than £160 per annum, provided they are engaged in some occu- pation, may join the scheme. They mil, however, have to pay, in addition to the amount payable by compulsorj^ contributors, the amount which employers have to pay, that is to say, voluntary contributors will have to pay 7d. a week, the State contributing 2d. Voluntary contribu- tors, however, to join at the above rates, must be under forty-five years of age and must join within six months of tho passing of the Act. If they are over forty-five, or allow more than six months to go by before they join, then they will have to pay on a scale wliicli will bo arranged according to their age. Tho Bill is drawn with a view to its being worked through the friendly societies, and contributors are en- couraged to join one of these societies or oIIkm- " ajiproved societies" to be formed on account ol' I lie advantages Avhich tho Bill lioMs oiil to llioni. For sncli contribulors. 4 NATIONAL INSURANCE BILL. however, who do not or cannot join a society on account of their bad state of health provision has been made with the Post Office to receive their contributions. They will be known as "deposit" or "Post Office" contributors, and they will only be entitled to draw sickness benefits up to the amount of the deposits made in their names. So much for contributions to the scheme. Now for the benefits . These are divided into minimum and additional benefits . The minimum benefits shortly are these: — (1) Medical attendance (and medicine) for life. (2) Admission into a sanatorium. (3) Sick pay of 10s. a Aveek for men and 7s. 6d. for women for the first thirteen weeks (calculated from fourth day of sickness), and 5s. in each case for remainder of illness. Members over fifty and under sixty who have not made 500 contributions will only re- ceive 7s. a week for men and 6s. for women for the first thirteen weeks, and 5s. after- wards; and if over sixty, such members will only receive 5s. in both cases. (4) A maternity benefit of 30s. Young unmarried persons under age of twenty-one will receive smaller sick benefits: 5s. for boys and 4s. for g-irls . Boys and girls under sixteen will only be entitled to medical attendance and sanatorium treatment. The sickness benefit of 5s. a week is to cease at seventy (when the old age pension becomes payable). According to the actuarial calculations which have been made, after allowing for the above benefits and cost of administration, and the liquidation of any original deficit in fifteen or sixteen years time, there should remain a margin of 10 per cent. This margin is to be made avail- able for the additional benefits. INTRODUCTION. 5 The additional benefits ^vill include such benefits as: — (1) Free medical attendance for contributor's family . (2) Benevolent fund for distressed members. (3) Extension of full sick pay to twentj^-six weeks, starting from first day of illness, increasing sick pay either in all cases or in cases of married men with large families. (4) Convalescent allowances; building and main- taining convalescent homes. (5) "Pocket-money'" for men in hospital or con- valescent homes. (6) Additional invalidity or superannuation bene- fit, or addition to old age pension. (7) An extension of the maternity benefit. The societies may grant any or either of the above additional benefits when their funds allow — and it is hoped that as these additional benefits can only become available if the funds are economically administered, that this \\i\\ prove to be a check on malingering, as members will have a common interest in seeing that the funds are not wasted. A waiting period of six months has been laid down for the temporary sickness benefit, and of two years for the permanent invalidity benefit. Sick pay will not be payable (except by way of a.d- vance) to workmen entitled to compensation for accidents. Contributions Avill cease at seventy years of age, and persons over sixty-five when the Act passes will not be taken into the scheme. Benefits arc not to be assignable. Women marrying and ceasing to be employed within tlic meaning of the Bill, will not be insurofl; but if they bf'como widows and go out to work again, then they will bo entitled to rejoin thf insurance at once, at their former rate. 6 NATIONAL INSURANCE BILL. I have given in the foregoing lines a rough idea and outline of the general effect of the Bill; but of course it is necessarily a very short one, as owing to the length of the Bill and its varied and intricate provisions, were I to attempt to fill in all or nearly all the details, this Intro- duction would have to be of inordinate length. I would, however, at this point beg to refer the reader to the "Memorandum explanatory of the Bill" relating to the insurance sections thereof which is printed in Appendix A, and would suggest a perusal of this memorandum before reading the clauses and schedules of the Bill itself. Although, as I have said, all parties have welcomed the main principle of the Bill, yet it is only natural to expect that a Bill so novel in its provisions and so far reaching in its scope should arouse criticism from all quarters, and ever since the Bill was introduced, and indeed even before then, the newspapers have been full of complaints and fears, some of them imaginary and some very real, from the many sections of the community who are espe- cially affected. Doctors, chemists, midwives, members of friendly societies and trade unions, collectors and agents for sickness and other insurance societies, have been stirred to their very depths by the introduction of the Bill, and very naturally so, for if their fears are well founded, and unless they can obtain such alterations in the Bill as are necessary to meet their particular needs and requirements, many of these classes of the community will either find their occupation gone or, at any rate, be very seriously affected. Indeed, so great has been the demand either for delay or consideration, that I suppose no Bill of recent times has aroused anything like a similar amount of interest and alarm, and amidst the chorus of qualified blessings from all these sections, there is also to be heard their clear note of determination that the Bill must be altered in this, that, and the other way, before it can possibly be allowed to become law. PART I. Insurance Commissioners, Health Committees, &c. To carry the provisions of the Bill into effect, and to till up the many blanks which are left, insurance com- missioners are to be appointed (clause 41). These com- missioners are to be appointed by the Treasury. No number is mentioned, nor is there any mention as to their qualification for the post, salary, &c. There is to be a central office in London, Avith such branch offices as the Treasury may think fit. The commissioners would seem to have unlimited powers to fill in the extraordinary number of details omitted from the Bill. Clause 42 enacts that the commissioners are to appoint an advisory committee for the purpose of giving them " advice and assistance in connection with the making and altering of regulations under this part of the Act, consisting of representatives of associations of employers and approved societies, and of such other persons as the commissioners may appoint." There is, however, no pro- vision or direction that doctors shall be included among the commissioners or on the advisory committee. It is certainly advisable that doctors should be included on both these bodies, and it is to be hoped that the clauses will be so amcndfid. Referring to the insurance commis- sioners, Mr. Lloyd George has since said, " Wo must have a medical expert on the body," and care must bn taken to see that clause 41 is so amended. Clause 43 provides that a local health committee shall be constituted in every county and county borough. One- third of the members of such local health committee is 8 NATIONAL INSURANCE BILL. to be appointed by the county councils, and must consist, at any rate in part, of members of the local sanitary au- thorities, and sub-sect. (5) provides that at least two of the members appointed by the insurance commissioners shall be duly qualified medical practitioners. The local health committee will have to consider the needs of the county with regard to all questions of public health, and to make provision for the publication of in- formation on questions of health. FRIENDLY SOCIETIES. 9 Friendly Societies. Members of the various friendly societies throughout the country are much exercised as to how they will be affected. Benefits under the Bill are to be distributed through "approved societies" and through a Post Office system, set up by the Government for the benefit of those persons who do not join a society, or are rejected. The following are the conditions which are necessary for a friendly society to conform to in order to become an ' ' approved society " : — (1) Absolute self-government. (2) Not working for a profit. (3) Election of all committees, representatives, &c. by the members in accordance with the rules approved by the Insurance Office or regulations drawn up under the Act. (4) A mininmm number of 10,000 insured persons under the Act (5,000 in the case of Ireland). (5) Local as well as central control of arrangements for medical attendance and payment of sickness benefit and appeals. For all questions arising under the Act, societies will be required to pro- vide for a final appeal to arbitrators ajipointed by the Insurance Office . (6) Giving security by the deposit of sufficient stock or in some other way to compensate the Govern- ment for any malversation by officers. (7) Keeping separate accounts lor the State schemo. (8) Complying with the provisions and rcquiromcnts of tlie Act, 10 NATIONAL INSURANCE BILL. Any society which satisfies the above conditions may become an approved society, and it will not be asked to apply any of its existing funds for the purposes of the new scheme. All the great friendly societies and trade unions will be able to comply with these conditions. They will still remain independent and will have the right to accept or reject members. If a society has not 10,000 members, it may join with another society, or societies, in order to make up the requisite numbers . The existing funds of the societies, which remain under their own control, will in time be expended in discharge of various authorized benefits— and the new accumulating funds are to be invested by the National Debt Commis- sioners, who will credit the societies with interest thereon, but taking the interest to be allowed at 3 per cent.— this is about 1 per cent, less than the so:cieties at present obtain. Members and officials of the great societies do not like this, and they and their predecessors, who have built up these societies which have done such a gTeat work in the past, naturally view with alarm the partial loss of their administration by this losing of the financial control of their funds in future, and the loss of interest will, of course, make a verv material difference in the scale of benefits %vhich would have been otherAvise available for their members. Against this, however, they must set the 2d. a week which the State is now to contribute for every member. The Manchester Unity of Oddfellows have passed a resolution asking the Cliancellor to make such amendments "as will enable the societies to continue the work of investment which in the past had so much to do with their success." Each society mil have to keep separate accounts for its dealings under the new scheme, and these accounts are to be subjected to a Treasury audit. The assets and lia- bilities of every branch are to be separately valued every third year at the instance of the insurance commissioners. When the valuation shows a surplus leave will be given FRIENDLY SOCIETIES. 11 for the distribution of one or any of the authorized " addi- tional benefits."' The cost of administration, it is feared, will be much more (possibly some 20 per cent.) than under the very economical administration and vast amount of honorary services which have been the rule in the friendly. societies. Another thing- members of the existing societies do not like is this : In the past these societies have consisted of a brotherhood of men draA\Ti together by the ties of thrift and good fellowship; they were a selected body of men consisting of the pick of their class. Now all this is to be changed, for now every one is to be compelled to insure against the rainy-day; and although the societies are free to reject any proposing member, yet the members fear that the result of the Bill will be that the societies will be swamped by new members, and new members of a lower calibre than the present ones. "Unity," the organ of the Foresters, Oddfellows, and kindred societies, makes a vigorous onslaught on some of the proposals of the Bill: — "Mr. Lloyd George is acting contrary to the spirit of the Truck Act in compelling- employers to withhold from their workmen part of the wages duo and giving in place something different. " No one has asked for compulsory insurance. " The Bill Avill mutilate, and in time annihilate the spirit of voluntary self-help, which has ever been tlie proud delight of the friendly societies. " If there is one class more than another which needs insurance it is the casual labourer. He represents the class that is outside the scope of the Bill. " If there is one class more than another which least needs outside aid it is tlie engineerinrevail.s re- garding the relative amount to be apportioned 50 NATIONAL INSURANCE BILL. to attendance and to materials, no attempt should be made to force upon medical men a service which is not sufficiently well paid to yield a jDroper remuneration for the labour entailed . " For some years past the length and costliness of the medical curriculum have made it increasingly difficult for persons to enter the medical profession. The in- comes made hj many practitioners are wholly inadequate to recompense them for all this cost and labour; and any scheme of medical insurance, therefore, which threatens to diminish these small incomes will, in the opinion of the Council, be fraught with serious conse- quenoe in the future, both to the public and to the medical profession." In communicating these resolutions to the Chancellor of the Exchequer, the Council stated that they were in accordance with the views of the great majority of the FelloAvs and members of the College, that the members of the medical profession have never been more united in f eelingr than they are in relation to the matters referred to, and that they looked forward to making a further communication upon points of importance in connexion w^ith hospitals and medical education. On the 31st May and 1st June a gi-eat special repre- sentative meeting of the British Medical Association was held in London for the consideration of the Bill. The meeting was so representative and important that the Chancellor of the Exchequer thought it wise to attend the meeting and discuss the scheme with the members. The first question discussed was that of the free choice of doctor. Mr. Lloyd George's reply was: "I have already said something with regard to that in the House of Commons. Personallj^ I am strongly in favour of it. There are difficulties. There are vested rights which have already been created whore doctors have got DOCTORS. 31 the care of clubs and patients, who are already regis- tered in those clubs or paying regularly to them. Very often it has been the matter of a bargain and sale of the practice, where the club practice has been purchased on the understanding that those patients are more or less under the care of the doctor of the club. I want you to consider, therefore, first of all, before you come to jan examination of the proposals made with regard to the free choice of doctor, the vested interests which have been created and which exist at the present moment where there arc club doctors with a club practice which they may have purchased. Subject to that, I am on all grounds in favour of a free choice of doctor. I think one of the essentials of curing is that the patient should have faith in his doctor; and you cannot have faith in your doctor if you have doctors thrust on you whom you have not chosen, who for various reasons, most of them unsatis- factory, the patient may not believe in. Therefore, I am myself strongly in favour of the system which I believe exists in two or three towns of this country of setting up a panel on which all qualified medical prac- titioners will be able to serve — not compelled to serve, no doctor will be obliged to take this work— but on which a qualified medical practitioner will be qualified to serve. " I want to make one very important qualification here. If a panel of that kind is to be a sucoass the doctors themselves must exercise disciplinary powers, otherwise it will be a failui'e. It practically means handing over to the doctors in each district the control of the medical arrangements. That involves thai lln' doctors liavo not merely the responsibility of curing llicif |);ilicnts, but they have the responsibility of suppressing touting, un- fair canvassing, and also for chocking ruthlessly the practice of malingering. U inav very well lie tliiit in a district a medical man iimy Iimvc flic r(^])ufation of being free and easy with his patients, and of not being too seveiv upon the?n wlion tlle^ ehiiiii sick pay: iiiul hr 32 NATIONAL INSURANCE BILL. may add to the number of his patients by having the reputation of not being too severe upon malingerers. The doctors ought at once to take in hand the pun- ishing of that form of encouragement of malingering. Subject to the medical profession undertaking the respon- sibility lof treating that form of touting, advertising, canvassing, and encouragement of malingering as in- famous conduct in your professional sense, I should be delighted to see a free panel of doctors set up under the care of the local doctors themselves." On the question of the abolition of the control of doctors by the friendly societies, Mr. Lloyd George said: " Your chairman has informed me that in your view it will be far better if the whole of the medical service were taken out of the hands of the friendly societies altogether. (Loud and prolonged cheers.) I am not in the least sur- prised at that demonstration, because I must say you have a very legitimate grievance in many respects. It is not merely your grievance ; it is the grievance of the patients as well. I am entirely with you in this— entirely and wholeheartedly with you in this— and if you can persuade the House of Commons to consent to the transfer of the whole of the medical attendance, including maternity, to the local health committees, you will find me an en- thusiastic supporter of that proposal. (Loud cheers.) But you must remember there are two sides to this ques- tion, and that the approved societies Avill not readily resign this power. You have brought a good deal of pres- sure upon me during the last few days, and I want you to transfer that pressure from me to the House of Commons. I am entirely of your view as to this; I do not believe you will ever get a satisfactory medical service until you do transfer it to the local committees. [Mr. Lloyd George here referred to an interview with a deputation from the Hearts of Oak Society.] I am strongly in favour of it for two reasons. One is that you will have representation on the local health committees. The Government appoints DOCTORS. 83 oue-fourth of the representatives on the local health com- mittees. We propose to appoint local practitioners, among others to represent us on the local health com- mittees, not, I warn you, merely to look after the interests of the profession, but to look after the interests and the health of the community as well. We shall want you, not as delegates of your profession — you will forgive me for speaking quite plainly — you Avill be there to see fair play to your profession, but in the main you will be there also as exijerts who understand the fundamental principles of health to guide and instruct the committees in really cleansing the land of the foulness which breeds disease at the jjresent moment. You will have to bring pressure to bear upon your members for this jjurpose, and your only hope of getting a transfer to the local health com- mittees, your only safe method of doing it, is by putting yourselves at once into communication each with his local member and getting him to pass an amendment in this sense. May I say anotlier word about the local health committees, if I am not taking up too much of your time? (No, no.) Personally, I am vovy opposed to their being committees of the County Council. I think it is far better they should be independent bodies. However, I should like to hoar your opinion later on upon that sub- ject." The Chairjnan: "There is one question on thai. Will the Chancellor of the Exchequer accept the position of the British Medical Association that the machinery of medi- cal benefits can only be adequately and successfully settled by direct arrangeiiiciil Ijotween tlu' iiicdicnl j)rofcssion and the State — that is, th:' insurance commissioners and the local hoaltii committws?" Mr. Lloyd (Jeorgc: "That is practically IIk^ same thing. I am strongly in favour of the local health com- mittees arrangement. I fold yon ih.if lln'ir wcii' two reasons why I preferred llic locil IkmIiIi (•(tminil Ices. 1 W. I) 34 NATIONAL INSURANCE BILL. do not mind admitting medical service is probably going to cost much more than I anticipated. I do not want to encourage you to ask for too much. In order to show you that I thought so even when I framed the Bill, let me refer you to a special provision here. You will find it in sub-section (5), clause 14. I propose there that where the fund for medical attendance is inadequate the Treasury and the County Council between them can make up the deficiency. The Treasury is prepared to pay half of any deficiency. That is the first time that the Treasury has come to offer to pay half of the medical charges for curing the jjeople of this countrj^. . . . I do think that it is a great mistake for the jjublic to under-pay any pro- fession, especially a profession which has got the life of the public more or less in its hands. I felt perfectly certain that it was no use making any provision for pay- ment which was not an elastic one, and an elastic one means an expanding one. That is the real elastic of this Bill. This contains all the expanding power. The rates and the Treasury will come to the rescue. You may say that the rates will not. The rates will, and I will tell you why. It is to the interest of the ratepayer to do this work through the health committees, because otherwise he will have to do it through the parish doctor : he gets the advan- tage of the Stat-e paying half if he does it througli the local health committee, and you may depend upon it that if you are well represented, and I am sure you will be, on the local health committee, this measure will put the medical profession, especially in the industrial districts and in the country districts, upon a better and a more satisfactory footing, and, what is more important for you, as I know as a professional man vrho had had to go through the same sort of struggle, on a more secure foot- ing than it ever has been. ' .The Cliairman: "Will the Chancellor support an amendment in the Bill to place the whole administration of medical benefits under the local health committees?" DOCTORS. 35 Mr. Lloyd C^eorge: " Certainiy. I said so. This is very important. It depends entirely upon the measure of support which you secure for me there. After all, the Government has to consider the interests of the whole Bill, which must not be recklessly endangered; but the Avhole of my support will be for this . The Chairman: "The next question is one which is addressed to myself: 'Why has the chairman entirely omitted to announce our absolute refusal to accept friendly society management?'" (Cheers.) Mr. Lloyd George: "If by friendly society manage- ment is meant the absolute control by the friendly societies, that is at an end for ever under this Bill. At present the medical profession arc left face to face Avith the friendly societies, there is no appeal; whereas in future the insurance commissioners stand between the medical profession and the friendly societies. The money is paid now to the friendly societies. In future the money Avill bo paid to the insurance commissioners, ajid the friendly societies simply get credit for it. We do not part with that cash except upon conditions which we re- gard as perfectly fair, not merely to the medical profes- sion, but to the patient as well; wliat is still more impor- tant is this, one great grievance against the friendly societies is that they now make a profit out of the doctor. Thoy save the money that ouglit to go to pay the doctor for the purpose of increasing their bcnciits. That we M'ill insist upon their not doing in future. In fact that is the moaning of that clause. It will be part of our responsi- bility, part of our obligation, and our duty under the statuto to see that tbc money w\\u-\\ \vc iiitcjid should go for medical benefits sliall go there and shall not go into the pockets of tlic friendly societies for dislrihiil ion or any other benefits." (Cheers.) The jK.'xt poijit was a rosolation of (ho meeting that 1)2 36 NATIONAL INSURANCE BILL. those with au income above £2 per week should be ex- cluded from the medical and maternity benefits. Mr. Lloyd George said: — " I am afraid I cannot be as satisfactory in my answer here, but I want you to listen to me. I want you first of all to realise the difficulties. Take, first of all, the industrial classes of this country. You could not impose an income limit uj)on the industrial classes, and I am certain of it." (A voice — Why?) "In the first place, the vast majority of the well-to-do workers are already in clubs — the vast majority but not all. The miners, who are highly-paid workmen, are almost entirely in clubs. I see a gentleman here who has one of the largest and most important practices of that kind in South Wales, and I have no doubt he has been very angry Avith me the last few days, although he is an old friend of mine. Are you going to cut them out? If you do, I do not believe you would get any member of the House of Commons to jjropose it, unless he were a University representative (laughter), and, if you did get a University representa- tive to propose it, I am certain you would not get a seconder. I Avant you first of all to bear in mind that this Bill has to be carried, not through the Treasury, not through the British Medical Association, not through the friendly societies, but through* the House of Commons; and the House of Commons represents, in the first place, something like half a million miners. You could not do it. The same thing applies to engineers. There you have another highly-paid class of workmen, and if you propose to cut the engineers out you could not do it. It is no use asking for a corner of the moon, and that is really what it is you are asking from the House of Commons — a thing that no man in the House of Commons dare get up to propose." Dealing with the objection to the absence of a wage limit above which no worker should be entitled to the State medical benefits, Mr. Llovd George said: — " I have DOCTORS. 37 dealt with the industrial classes, and now I come to what I regard as much more important, the voluntary insurer. When you come to the voluntary insurer — the tradesmen and those Avhose income is, say, over £160 a year — there I agree that you have a case, and I am quite preisared to consider it. I shall have, of course, to hear and take the opinion of my colleagues, and I shall also see what the opinion is in the House of Commons; because, after all, a minister is only one out of 670. I am quite prepared to consider here an income limit, so that the man who is earning his £200, £300, or £400 a year shall not be en- titled to claim medical services at 6s., 7s., or 8s. a year, or whatever it is. AVith regai'd to the industrial classes, I do not believe you ^\ill ever persuade the House of Com- mons to give an income limit. One reason is, you may get an engineer earning this year £200, but go to him in a couple of years and he is not earning £50, The fluctua- tions are enormous in certain trades. Tlie same thijia: applies even to the miners. At certain times, Avhen times are bad, they are not earning half Avhat they earn at the very best times. 1 Avould ask some of my friends in the ajUiery districts, can they get a single member for those districts who dare in the House of Commons propose to exclude the colliers earning £3 or £4 a week? Of course they could not do it. U I may say so, I am willing to meet you in all things Avhich, 1 will not say are merely reasonable, but practicable, and I am here to do it. But .... I tell you frankly that in my judgment it is abso- lutely impossible to introduce any limit for the wage- earning workers quib' impossible. You Avould not carry it out, but when you come to the vohuitary contributors to the scheme, tliere I agree with you that it is desirable tliere should Ix' an incx)me limit. I will support an income limit with regard to those. 1 think you put it too low, l)ut I am quite willing to consider, and consider favour- ably, any income limit that would exelud(; the voluntary contributors above the income tax limit. Beyond that 38 NATIONAL INSURANCE BILL. I could uot possibly at present go, and I am very sorry that we should have cx)me to a jioint ou which we are not in agreement yet." The Chairman: " Does the Chancellor of the Exchequer recognise that if the income limit is extended to £160 the average cost of medical attendance must be distinctly greater than if the limit is £100?" Mr. Lloyd George: "Yes, I do take that into account, certainly. . . . The only thing I will say is this, that Ave are also entitled to take into account that for the first time you are getting securit}' for payment from a class where you had no security before . " ( " No , no . " ) " What I say you are entitled to take into account when you make your arrangements, and are entitled to press ou the health committees and the insurance commissioners, is that you are for the first time taking into your arrangements a class of persons who up to the present have been paying you a fee for attendance; but I say it should also be taken into account that you are for the first time getting security for payment from another class, not the same class. That does not apjDly to all of you, but I am certain that the country practitioner attends to that class now. I am en- titled, on behalf of the insurance commissioners, to say that for the first time you are getting a guarantee of paj^meut for that class. . . ; I have in the last few dsijs heard of cases of that kind in London where the doctor is never called in except at the last moment, because the friends feel they must have a death certificate. I have heard from the East-end of London and from Fulham that the doctor has only been called in because the friends say, ' We cannot afford to have an inquest ' — when it is too late for the doctor to save the poor wretch. To the doctor in such circumstances the State would for the first time give something when there was nothing before. I appeal to you. You are the great healing pro- fession. Of course your first consideration is the con- DOCTORS. 39 sideration of your own homes, I agree. You must see that jou are faiih' treated. No man who is not faii'ly treated can do his duty; but for the first time we aro making an effort to come to the rescue of millions of wretched people Avho cannot afford your assistance at the present time.'" (Cheers.) The next question discussed was the objection to the proposed paj-ment of a Hat rate of 6s. per insured patient per annum, this 6s. including Is. 6d. for drugs and appli- ances . In reply to a suggestion that the conditions of remu- neration were unsatisfactory, Mr. Lloyd George said : " That is a matter of judgment. All I will say about that is, you must remember this Bill does not settle the conditions. The conditions of re- muneration are to be settled afterwards between the health committee, the advisory committee, the insur- ance commissioners, and yourselves. That is the time to fight that question out. I still say that if you attempt to put in a scale in an Act of Parliament you will make the greatest mistake of your lives. Tn the first place, you cannot have a scale whicli is applicable to each district. Each district must l)e considered according to its own conditions. There is also this to be said —if you fix a rigid sc^ale you cannot alter il. and if in times to come you think the rates ought to be put up. h't me tell you that there is only one thing more difficult than carrying an Act of Parliament, and that is to ameiid it." The Chairman said the next queslicni was of ronmnera- tioii, both as regards the method and the amount; first, as regards th(> method. They believed that the State which undertook this scheme should \;iivii to pay for good services in resj)ect of that scheme, iind Ili;i1, 1 lim'roi'e, the State should li'' prepared lo |)iiy for all services on the scheme of pavment for work done. 40 NATIONAL INSURANCE BILL. Mr. Lloyd George: " If you mean that the doctors send in a bill in each case, frankly I think that is impossible. ... If you are going to allow the patients an unlimited right to call the doctor in when the patient likes, and get his bottle of medicine, and that every bottle should be charged for and every attendance charg-ed for, that would break down the scheme so hopelessly that it would be futile to proceed with it. Therefore, I would respect- fully suggest to the meeting that it is far more important for them to fight out, not in the Bill, but afterwards M'ith the advisory committee and the insurance commis- sioners, the scale of the fee which should be allowed." The Chairman asked if Mr. Lloyd George had realised that the payment of medical men by capitation fee meant paying them in inverse ratio to the amount of work they did; and that, apart from the amount of the remuneration', under any capitation fee, the majority of the medical practitioners of this country objected strongly, and would in fact refuse, to accept work on contract terms. Mr. Lloyd George: " I have an ans\^■er in the words of a medical man; you will find it in the supplement to the Report of the British Medical Association: — * On the whole, I consider my position with regard to my clubs satisfactory; I find my members grate- ful. I unhesitatingly condemn the entire club system, as it exists at present, as unsatisfactory both for the patients and the medical men; but I would strongly deprecate any interference with it until some better scheme for universal application has been de- vised. Up to the present, I fail to see that a prac- ticable one has even been suggested. I believe con- tract practice in some form in a district like mine to be absolutely necessary.' That really represents my position in the matter. I do not think it is satisfactory. . . . ; but, up to the present, DOCTORS. 41 I have not heard a single sug-gestion of an alternative which seemed to me to be practicable.' The Chairman: "A number of our members are of opinion that if the system of payment for services rendered be not tried on a general national scale, at all events it should be tried on an experimental scale in cer- tain districts. Is it competent for the members in a locality to impress as strongly as they possibly can upon the local health committees, even to the extent of organis- ing a local medical strike, that such a system should be, in that area, tried?" Mr. Lloyd George: "There is nothing in the Bill to prevent the experiment being tried, but I must put in this Avord of caution. Supposing that you had a local health committee for a whole county, you could not have half-a-dozen favoured districts drawing an unlimited amount from the local health committee and getting a sort of Paradise for doctors and patients in that corner of the county to the detriment of the rest of the doctors in the whole of the same community. ... It would be use- ful to have an experiment tried, in order to see whether it is passible to run it; but I would like to see the experiment very carefully tried first before you apply it in a general way." The Chairman said that they had been pressed in various quarters and for various reasons to, at all events, mention a minimum capitation grant. He asked whether the duties of medical jjractitioners under the contract wouhl ho clearly defined and all extra service be paid for on an agreed scale. By exti-a he meant sucli as oj)erations, consultations, night Avork, the administratioji of anros- thetics, and mileage. Was Mr. Lloyd George willing to provide that emergencies ol' Jiil kinds should hv excluded from the medical attendance? Would ;iii insured person bo able to claim medical attendance from a doctor belong- ing to an area different from that in which the insured 42 NATIONAL INSURANCE BILL. usually resided? Then there was tlie position of the un- married; and also the very important point with regard to diseases due to misconduct in the sense in which that was usually taken. It was suggested that persons suffer- ing from such disease should be excluded from medical benefit. Mr. Lloyd George: "Some of the questions descend into details which are very important and which Aviil have to be considered, but upon which I should hesitate very much to express an opinion at this stage. Generally, I may say this : Of course the payment of a specialist would not be included in the capitation fee, and, therefore, if there were consultations, they must necessarily be outside the range of whatever capitation grant is paid. . . . That v.ould not be a burden cast upon the medical man, but the society — or the local health committee, as the case may be — would have to pay that fee. With regard ,to operations, that also I should put in the same category. Most of the serious operations . . . would be performed in institutions, and I can well understand the medical pro- fession insisting upon special arrangements being made for serious oj^erations. That is a matter which you will have to arrange with the local health committee, and with the societies, as the case may be, subject to the approval of the insurance commissioners. I can well understand your charging in these very special cases an extra fee. But there is real danger in allowing what is called 'extras.' ... So that we must very carefully scrutinise the demand for any extras, and not allow too wide a margin for demands of that kind. . . . Mileage is an important thing", but I do not think there should be a fee for emergencies. ... At the present moment, night Avork, I believe, is included in the general contract fee. That is a matter I would rather not pronounce upon . . . until I get the opinion of the medical advisers who are to advise the commissioners. . . . All I ^will say is this, DOCTORS. 43 that tlieie will be uotliing in the Act of Paiiiament to pre- vent your demauding a fee for night work. . . . With regard to curing the man who has brought on illness by his own misconduct, . . . Ave had to make provision for this, because it is not merely the health of the man him- self, but it is the health of those dependent upon him, and the health of the community. In fact, it is in the interests of the medical profession as well as the country that he should be cured at the very first possible moment, because you may depend it will come back to the medical profes- sion, and it will come back in the shape of much more serious disease, and, when it does that, the burden is upon vou.' The Chairman asked why the Government proposed to penalise the Post Office contributor, and so set up a mono- poly for the friendly societies. Mr. Lloyd George: " There is only one thing I would say about the Post Office contributor, and that is that the ().v. basis does not come in in that case. You certainly can not be expected to take people who are already ill at that rate. The reason we thought the 6s. was fair was that you will be getting it for people naIio wore well as well as those who were ill.' Replying to the Chairman on the goodwill of practices, Mr. Lloyd George said: " For the moment it will ail'ect o-oodwill; but the moment the medical profession and the Government come to an understanding and it is realised that the interests of the profession will be safeguarded, my own opinion is that the goodwill will be more valu- able, for this reason, that you are offered security for the first time for payment, in the lower ranks of life, for those whom really, at the present moment, you cannot refuse to attend although you know the payment is very precarious. ' 1 have given the details oi' (liis interview at such lencjth, because 1 imagine everyone must recognise that 44 NATIONAL INSURANCE BILL. the scheme depends to such an enormous extent on the g'oodwill and hearty co-operation of the medical pro- fession, and I have given the replies and explanations of the Chancellor of the Exchequer as fully as I possibh' could, because I am very anxious that the case should be presented quite fairly as well from the Government's as from the doctors' point of view. The effect of the meeting with Mr. Lloyd George on the minds of the doctors can best be gauged by the opinions expressed at the mass meeting of members of the medical profession which was held the same evening. Dr. J. A. Maodonald proposed the following resolution, which had been carried at the representative meeting of the British Medical Association: — " That, whilst approv- ing the main objects of the National Insurance Bill, and being desirous of co-operating for their attainment, in view of the fact that the present proposals of the Govern- ment are unsatisfactory, it is the opinion of this meeting that the Government should be asked to delay dealing with the proposed medical benefits until satisfactory terms have been arranged with the medical jarofession." He said that the following terms Avere to be placed before the Chancellor of the Exchequer as those on which the medical profession would accept service under the Bill: — " (1) An income limit of £2 a week for those entitled to medical benefit. " (2) Free choice of doctor by the patient, subject only to the consent of the doctor to attend him. " (3) Medical and maternity benefits to be ,adminis- tered by local health committees, and not in any respect by friendly societies. " (4) The method of remuneration of medical practi- tioners adopted by each local health committee to be according to the preference of the majority of the medical profession of the district of that committee. DOCTORS. 45 " (5) Medical remuneratiou to be Avhat the profession considers adequate, having due regard to the duties to be j^erformed and other conditions of service . " (6) Adequate medical representation among the in- surance commissioners, in the central advisory committee, and in the local health com- mittees; and statutory recognition of a local medical committee representative of the profes- sion in the district of each health committee." This resolution was carried unanimously, and the six points above enumerated were also accepted, although there was a very large minority who, while they voted in favour of reducing the suggested income limit of £2 for the sake of unanimity, were yet strongly of opinion that it should be much further reduced, namely, to 30s. vSir Thomas Barlow, the president of the Royal College of Physicians, who seconded the resolution, said they had the gre-atest sympathy with the general purposes of the Bill (cheers), for nobody was more alive than the doctor to the great difKcultics of industrial conditions and to the consideration thai in a healthy nation they got an efficient nation. The terms wliicli Dr. Macdonald had read appeared to him to be eminently reasonable. The real difficulty, as Mr. Lloyd George now understood, was in tiieir relation to the friendly societies. They knew too well how many of their humbler brethren had been put under the heel of tlie friendly societies, and they all intended to claim that tlr-ii- hMinl)lest practitioners, Avhen- cver work of the kind proj)os(Hl was given them to do, should hav<,' a living wage. The other point of difficulty was the voluntary participation in flie ni'^lieal benefits, iiiid in this matter he thought they \\()iil(| ji.ive lo go very warily. VVlid lici- tli"\- were lo lis ;i deliiiili' limil lie did not know, but he believed lli.it in t his diiccl ion IJic Chan- cellor (d" fill' I'lxchequer could he inllueneed. 46 NATIONAL INSURANCE BILL. Mr. Butlin, the president of the Rojal College of Surgeons, supported the resolution. He said he regarded the present crisis as the greatest he had ever known in the medical profession. He was deeply disappointed at the interview with Mr. Lloyd George. He spoke charm- ingly. (" Ah!" and laughter.) He answered some ques- tions satisfactorily, he answered others not so satisfac- torily, and on several occasions escaped. (Laughter.) His impression was that the Chancellor did not give waj^, nor give the representative meeting the least hope that he would give way, or that the House of Commons would give way one jot in regard to the rate of wages. In his opinion Mr. Lloyd Greorge w^as still bent on placing the administration of medical relief, or a great part of it, in the hands of friendly societies. ("Shame.") Mr. Lloyd George had given them to understand that the Bill was going to pass by the end of August, and he had said that upon the advisory committee there would be some medical men in general practice. Mr. Lloyd George pointed out that they would then be able to make arrange- ments, but when the Bill Avas passed the arrangements would depend upon the terms of the Bill, and the same modifications could never be made then as could be made before the Bill was passed. In his opinion a very grave crisis lay in front of the medical profession. They were anxious to do what they could to assist the Government in carrying a measure of this kind, but they must see that it did not mean ruin to a large number of men in th.e profession. 'They had suggested at the College of Sur- geons that no person with an income of over £100 a year should participate in the medical benefits. (Cheers.) Sir Victor Horsley expressed the opinion tliat the posi- tion of the profession was not one from Avhich they could not save themselves. They had allowed the friendly societies to take uj) a jjosition towards the profession, which self-respecting men ought not to have permitted. DOCTORS. 47 (Cheers.) He urged all connected with the profession to join the British Medical Association, and he also recom- mended the signing of the declaration that they Avould not assist methods which they knew to be inimical to the best interests of the nation. (Cheers.) The questions he had put to Mr. Lloyd George had been answered fully, frankly, and dii'ectly, but equally frankly and fully he declared himself against the views of the medical profes- sion on the wage limit. To the question — " Do you accept the position of the British Medical Association — nameh', that the relations of the medical profession to the Govern- ment should be direct; in other words, that the friendly societies should be totally excluded from such relations?" Mr. Lloyd George replied in the affirmative. This was not in the Bill, but it was possible for a united profession to insist that the insertion should be made during the passage of the Bill. (Cheers.) This is the position of the matter. I think the doctors are justified in thinking, as so many of them do, that Mr. Lloyd George was not quite frank with them, and that he rather evaded many of the issues. For instance, ^^•hen on the question of taking the Avhole of the medical service out of the hands of the friendly societies altogether, after saying that they had a legitimate grievance, and that he was "entirely and wholeheartedly '" with them in this, he then proceeded to invite them "to persuade the House of Commons to consent to the transfer of the Avhole of the medical attendance, including maternity, to the local health committees," and that then they would find him "an enthusiastic supporter of the proposal"! He is the responsible Minister iji charge of the Bill, and if the above protestations mean anything, surely it is his duty, as it should be his pleasure, to ;iltri' the Bill and carry it through the House. The fact remains tlmt thi,- doctoi's me not satisfied. The British Medical Association has sent onl a circular to its nil iiibers asking for an expression of (lieir views oji the 48 NATIONAL INSURANCE BILL. policy adopted by the Association towards the Bill. Some 20,000 have already replied endorsing the demands of the Association. Nor has the situation been improved by Mr. Lloyd George's speech at Birmingham. His allusion to " this wrangle in the sick-room " was hardly calculated to allay the irritation of men who for generations have been willingly attending thousands upon thousands of these sick-rooms without the slightest hope of any pay- ment or reward! I have gone at such length into the question of " Doctors," not only because I sympatliise with them, but also because everyone must see how essential it is to obtain their hearty co-operation, for unless that end is obtained, the doctors have the power to make the Act a dead letter. For amendments desired by the British Medical Asso- ciation, see Appendix D. CHEMISTS. 49 Chemists. I now come to thu criticisms and objections of chemists. At present, although many doctors make up their own prescriptions, many, of course, do not, and the chemists are naturally anxious to know how their interests will be affected. The amount paid to doctors is not to include medicine, &c., but no provision is made for the way in which medicine will be bought and provided. Viscount Wolmer asked the Chancellor of the Exchequer how small chemists could benefit under the Bill if health com- mittees were to buy drugs wholesale and give them out to doctors and patients, and liis reply was that he had no reason to believe that health committees would buy drugs wholesale and dole them out to doctors and patients. The Chancellor of the Exchequer's proposal is that Is. (id. per week for each sick person should be allowed for drugs, &c. This, however, is strongly objected to by chemists, who .sent a deputation to the Chancellor, object- ing to payment on ;i cupitiition basis, and suggesting that an oflicial schedule of prices should be drawn uj) on tlie basis of wliich medicines should be supplied (o insured patients through any chemist, and not by selected chemists. The chemists are very uneasy at Mr. Lloyd George's proposals, but, finding that the portions of the Bill Avhich deal with them arc more nebulous than those affecting the doctors, they preferred at first to adopt a non-committal attitude. Latterly, however, they have taken up a (h-mcr attitude. Ah-. J. F. Harrington, president of the Pharmaceutical W. E 50 NATIONAL INSURANCE BILL. Society, has said that the chief points to which chemists would feel bound to object would be: — The tendency that the remuneration of the chemists would be reduced. ,The way in which the individual will be unable to select the chemist whom he might prefer to em- ploy. The power apparently given to friendly societies to administer medical benefits and their control of the terms, according to Avhich chemists would be em- ployed. " The lines on which chemists Avould be inclined to criticise the Bill are very similar to those which have aroused the attention of the medical profession. " If the Bill were to go through in its present form, it would mean the loss to retail chemists of some 7,000,000 customers, for it would transfer a very large volume of business from ordinary retail trading to the kind of busi- ness which will come under the class of medical benefits . "It is very difficult to make any detailed criticism of the measure for everything at present is so nebulous. " The action we have taken is to 'wait and see' what the Bill really means to us before we make any public move. " We have appointed a sj^ecial committee to consider the whole matter." The president said he had no hesitation in saying that the Bill means ruin to retail 25harmacists if it is to be ad- ministered on the lines recently laid down by one who is a member of the Manchester Oddfellows Committee. " If we are to be put into the hands of the friendly societies, and they are to arrange terms, and so forth, the retail chemist will be unable to keep his shop oiDen. " As a responsible society, however, we have to con- sider the interests of the public as well as our own. " And if the friendly societies get the upper hand, there CHEMISTS. 51 is, I think, a very real danger that the public interests will suffer. " There is a great difficulty in getting the non-pro- fessional public to realise that a professional man has a right to sell his drugs (in this case) at more than the margin of profit which would be fair in ordinary trading. " But if this is not recognised, it is clear that in the long run it will be impossible for the public to retain the advantages which it enjoys at present of having profes- sional men to dispense drugs." In a way the position of chemists under the Bill is even more serious than that of the doctors, for whereas the doctors have it in their power, if they stand firm, to com- pel the Government to come to terms with them, the chemists are not in so good a position. It would be com- paratively easy for the friendly societies or the National Health Committees to establish large drug depots for the sujjply of medicines to insured persons, and in this way thousands of chemists would find a large proportion of their profitable business taken away from them without any redr&ss. As it would doubtless be to the advantage of the societies' funds to start these depots, the position of chemists is a very serious one, and it is absolutely neces- sary for them to bring all the influence they caoi to bear on the Government, so that they may not br injured by the Bill. For amendments desired by the rharmaccutical Society of Great Britain, see Appendix E. 52 NATIONAL INSURANCE BILL. Midwives. There are some 30,000 women on the midwives' roll, and it is said that about 50 per cent, of the total number of births in England and Wales are attended by midwives, and, of course, the percentage attending the labouring classes is therefore much higher than this. How will midwives be affected by the Bill? It is impossible to say in the form in which it is at present drawn. The maternity benefit of 30s. is for " medical attendance '' and nursing. I doubt if the words in the Bill would cover the fee charged by a midwife, and as I cannot think that the drawers of the Bill intended to take away from the woman her free choice as to whether she shall employ a doctor or a midwife, and as the Chancellor of the Ex- chequer, in answer to a question, said that the maternity benefit was " intended to cover the cost of doctor and midwife where necessary," words must be inserted making it clear that a midwife can be sent for, and paid out of the maternity benefit. CLERKS. 53 Clerks. It is very difficult to see how the position of clerks will be benefited under the Bill. Every clerk who is not earn- ing more than £160 a year will be compelled to join the scheme. But the clerk is in a different position to the ordinary workman. As a general rule, Avhen a clerk is ill his salary goes on just the same, and his work is cheer- fully divided among his fellow clerks. I am afraid there is grave danger that the application of the Bill to clerks may alter this pleasant state of things. In future, the clerk is to pay his 4:d. a week, the employer 3d., and the State 2d., to insure against a risk which, in the great majority of cases, does not at present exist! But as the employer will be compelled in future to pay at least 3d. a week for every clerk that he employs, he will scarcely continue to pay his clerks their full salary during their absence through illness. The clerk will receive 10s. a week, and free medical attendance, &c., and I am afraid the effect of the Bill in time may be that employers may treat their clerks in the same way as manual labourers, no work, no pay; so the Bill to clerks may mean this, that they may bo 4fZ. a week poorer in good health, and ]jos- sibly a sovereign or more poorer in sickness, while all the time the State will bo paying 2d. a week for every clerk to insure against a risk Avhich is practically non-existent, for whicli interference I should doubt whether the clerk would be grateful! The Chancelloi- of the Exchequer has caused the fol- lowing letter to be addressed to a correspondent who wrote to him as to the position of clerks under the provisions of tbc National Insurance Bill: — 54 NATIONAL INSURANCE BILL. "Treasury Chambers, Whitehall, May 23, 1911. " Dear sir, — In reply to your letter of the 18th instant, I am desired by the Chancellor of the Exchequer to say that he does not see how it is possible for the position of clerks to be in any way prejudiced by the proposals of the Insurance Bill. " The benefits provided by the Bill are secured by con- tributions as follows: — (1) The employer pays 3d. a week for every clerk receiving a salary not exceeding £160 a year; (2) the clerk himself pays 4J.; (3) a State grant is made of two-ninths of the total benefits. " Although it is possible that an employer may claim in future to make a deduction to the extent of the value of his 3d. from the wages he has been used to pay to his clerks during sickness, he would not be justified in making any deduction in respect of the benefits under the Insur- ance Bill so far as those benefits are secured by the con- tributions of the clerks themselves and by the State grant. The position of the clerks must, therefore, be improved by at least the amount represented by the Government grant. " The Chancellor desires me also to point out that the clerks will benefit in another way — namely, by being able to share, as members of the societies to which they belong, in the management of the sums contributed under the Bill and administered through those societies, whereas at present the conditions of payment, or the question whether there should be any payment of benefits at all, may rest entirely with the employer. " Mr. Lloyd George also wishes me to draw your atten- tion to the fact that clerks in many cases do not now receive as much from their employers in sickness as is represented by the three^^ences which the employer is re- quired under the Bill to pay. In such cases the clerks' position will be improved both by the State grant and by the additional contributions from their employers under the Bill." CLERKS. 55 The following letter addressed to The Times seems to accurately present the jaosition of clerks under the Bill: — " Sir, — I venture to write to you to draAv attention to the adverse effects the National Insurance Bill will have on the position of clerks earning salaries up to £160 per annum. Those engaged in clerical labour differ so much from those emploj^ed in the various forms of unskilled labour, not only in the conditions in which the}' work, but in habits, instincts, and aspirations, that it is impos- sible that the same system should be suitable to both classes. The main difference lies in the fact that when the unskilled labourer falls ill he usually loses his job, and the pay goes with it; when, however, the clerk falls ill, nine times out of ten he not only keeps his position but receives full pay the whole time. " The majority of clerks earning and living on any- thing up to, say, 35s. a week, do not insure. Under pre- sent conditions Avhen they fall ill they continue in their position and, as has been stated, draw full pay, their M^ork being cheerfully done all the while by their fellow-clerks. " Under the new regime, however, conditions will be very much changed. The compulsion on the employer, not only to pay '6(1. per week towards insurance, but to put himself to all the trouble and vexation of filling in cards, is bound to have the deplorable result of loosening that feeling of loyalty between employer and employe which legislation should be careful never to discourage. Apart from this consideration, which is probably the most im- portant in its effect on the body politic, the clerk will gain no actual monetary benefits by his State insurance. In time of illness the employer Avill almost certainly deduct from his clerk's salary the 10s. per week provided by the State, and wore it otherwise a prciiiiiiin would be put on sickness. Thus, in s\)\tv of the premiums paid, the chirk will draw no Ix^nofit except free medical attend- ance, and that he can now obtain for 2d. per Aveek, not only for himself, hnf for \u<- whole family, by joining any 56 NATIONAL INSURANCE BILL. parish doctor's club. The position is rather different in the case of the more highly paid clerks earning, say, from 'S5s. to £3 per week. At present if they wish to insure against sickness, 8d. per week, as is well known, will give them in many slate clubs 12s. per week during illness for eight weeks, after that 6.s. per week for eight weeks, £8 premium to the wife on death of insured, and £4 to in- sured on death of wife, and a share-out at the end of the year amounting on an average to 25s. " Deducting the bonus at the end of the year and spreading it over each week, we find that the insured can obtain for 2d. per week all the above benefits. In the registered slate clubs the subscribers run no risks of a defaulting secretary, and are as secure as they would be through the State. " It must not be forgotten that the clerk insuring in a slate club during the whole of his illness draws full salary as well as club benefits. Under the new scheme, for a payment of 4d. per week, the only certain benefit is free doctoring to the actual individual (his wife and children are excluded), and 10s. per week, which, as has already been pointed out, he will not touch. "It is true that under Mr. Lloyd George's scheme the insured will draw his sick benefit for a longer time, but the number of cases in which the full sick benefit is neces- sary for more than eight weeks is so small compared with the number of small benefits required that it does jiot seriously affect the position of the average clerk. " The importance of a choice of doctor from a medical point of view has already been treated by Dr. Roberts in The Times of the 18th inst., but there is yet another aspect to this question. Pride of independence keeps the best type of worker from applying to the Guardians for sick relief; the same independence of spirit, which is one of our greatest national assets, makes it hateful to the clerk to have his doctor chosen for him, and many clerks, CLERKS. 57 who, generally speaking, will bo citizens of the best type, will refuse to have anythi-ng to do with the State doctor. " The fate of the older clerks, and, in fact, emplai/es of all kinds, now reaching ages of sixty say, who should be drawing sick benefits will be particularly hard. In most cases their benefit societies will be dissolved, no friendly societies will take them, and they will have to work through the Post Office, where they can draw no money for a year, and all the benefits paid to their old clubs will avail them nothing. " While fully recognising how easy it always is to give destructive criticism, I venture to suggest that the above points are of sufficient interest to merit careful con- sideration." The Chancellor of the Exchequer on the second reading said that " if clerks wanted to be left out they had but to express a wish in that direction"; and as the decision apparently rests with them it is for them to now consider very carefully whether it will be to their real interest to be included in the scheme. 58 NATIONAL INSURANCE BILL. Women. The position of women under the Bill is curious. Everj woman, whether married or single, who goes out to work and who is not earning more than £160 a year must con- tribute. If a woman marries and ceases to be employed her subscrij)tion ceases and she is no longer insured, and in fact loses the benefit of the subscriptions she has paid, except for this, that if she at some subsequent period again goes out to work she is allowed to rejoin as if she were at the same age as when she married . If she becomes a widow and goes into employment, she will also be entitled at once to rejoin as if she were at the same age as at tlie time of her marriage. The proposition is that there should be two separate funds — one for men and one for women . Everything con- tributed on the women's side goes into the women's fund and they are to receive full benefits therefor. The scheme does not appear to be fair to women workers, and many women are complaining of the treat- ment meted out to them. Take an instance of a girl who works in a mill, say, from the age of 15 to 30, and then leaves her work to marry. She will then lose all the payments she has made. It is true that she has been insured during this time, but it is between these ages that there is so little sickness, and in fact she has been paying more during this period than the average amount of sickness warrants, so that she is doubly hit, unless, indeed, she becomes a widow. There is also the question as to whether the amount of WOMEN. 59 Sd. per week is not rather high for Avomen, seeing that their average earnings are so much lower than men's. There is also the national and social well-being to be considered. The economic tendency will be bad, because the scheme will doubtless have the effect of inducing women on marriag-e to continue in their employment, at the cost of comfort in the home, the effect on the popu- lation, and danger to offspring. 60 NATIONAL INSURANCE BILL. Sanatoria for Consumption. Sanatoria are to be built all over the country for the treatment of consumption. It is proposed to pay a sum of £1,500,000 into a fund, which will provide grants for building these sanatoria. Provision is made by which Is. 4:d. a head annually will be available for this preventive side of the scheme, and there is also power to use an additional grant of 1^. per head for research purposes. It is hoped by these means to stamp consumption out, as contributors will be able to avail themselves of the benefits of these sana- toria in the early stages of the disease. There is some difference of opinion among medical ex- perts as to whether the sanatorium treatment is the best means to adopt for the treatment of consumption, and therefore many people have doubted the wisdom of pro- viding such a large sum to be spent on buildings, but Mr. Astor, on the second reading, pointed out that the criticisms which have been made about spending so much money on bricks and mortar in the erection of sanatoria pre-supposed extravagance in the buildings, and also that they could not be used for other purposes. Ho maintained that it would be possible to use the buildings for other purposes should we ever be so fortunate as to stamp consumption out. HOSPITALS. 61 Hospitals. The effect on hospitals is a matter for serious considera- tion, and any opinions on what its effect on our system of voluntaril}^ supported hospitals will be must, of course.. be speculative and problematical. Doctors will naturally be inclined to send operations and bad cases to the hos- pital, and the whole question A\ill have to be very care- fully considered. Now that large employers of labour will have to contribute so largely for sick benefits it is only natural to suppose that their contributions to hospitals, which have been so generous in the past, will be curtailed; and although to counterbalance this, power is given in clause 17 for approved societies to contribute to hospitals, no such power is given to health committees. I venture to think this should be given, because very possibly the greatest need for hospitals will be felt b}' those who are not members of the societies, namely, the deposit contributors. On the effect of the scheme on hospitals, Mr. Lloyd (xeorge said: "The great curative institutions arc volun- tary institutions in every sense of the tonn, and we do not propose to exercise any control over them. We propose to leave them exactly as they are in that respect. All we propose is that the health committees and the approved Bocicties shall have the power to subscribe to those institu- tions; but what use will be made of those subscrij)tions is entirely a matter for those governing bodies of the institu- tions themselves. If we begin tcJ lay dow]i conditions of that kind, that would practical!}' mean taking over the control ourselves. We do not jtroposc (hat; Avhether it Avill ever come to that is another matter. And may I add, because it is not only ver^ interestinj?, but it is verv 62 NATIONAL INSURANCE BILL. relevant, that since the insurance came into operation in Germany, private benefactions to the hospitals have doubled. " The sanatoriums," Mr. Lloyd George explained, " are for the treatment of tuberculosis or such other diseases as the Local Government Board Avith the approval of the Treasury may appoint. It has been represented to us that we ought not to confine treatment in these sana- toriums to tuberculosis, and it ought to be possible to treat other diseases of the same kind there, and if the members of the medical profession think that these insti- tutions can be made useful for other purposes we have left it open for them to be utilised for the cure of other diseases as well." Mr. Austen Chamberlain goes so far as to think that the Bill as it stands will make almost inevitable the even- tual assumption by the State of the cost of the hospitals of the country. I venture to think that such an event would be so deplorable that every effort should be made to so alter the Bill that this will not be rendered necessary. POST OFFICE CONTKIBUTOKS. 63 Post Office Contributors. They get so far as sickness benefits are concerned what they themselves pay plus what their employer and the State pays— but no more. When they have exhausted the amount standing to their credit, there is no more for them to draw; and the obvious criticism is that this is thrift — not insurance — and seems contrary to the whole scheme of the Bill as expounded and explained by the Government themselves; and if these men owe their position mainly to their own bad health, this surely is the very class which the Bill professes to help. I would suggest that it might be possible to take from each society a contribution and apply it for the aid of deposit contributors, and if a certain ratio were taken from each society it would enable the scheme to become an "insurance" one for those poor people whose health is under par, as well as for their more fortunate brethren who on account of their good health will be accepted by the societies. 64 NATIONAL INSURANCE BILL. Collectors and Insurance Agents. This is a most deserving and hardworking body of men who have perhaps done more to encourage thrift through- out the country than any other class. What is their posi- tion under the Bill? It is very difficult to say until fur- ther particulars are given, but I very much fear they will be sadly hit! They have been promised by the Govern- ment that they shall be treated with consideration; and the Attorney-General has said that there is nothing to prevent their coming into the scheme, and that it would be to their interest to do so; that to secure their services would be an advantage to the societies, to trade unions, and everybody concerned, and the Government would have the benefit of their knowledge and experience. This is all very well, but there is at present no provision for this in the Bill. Another thing collectors and agents have to fear is this: many of them collect for sickness and death risks; sick- ness, of course, goes with the Bill, but the Attornej'- General says there is no need for the fears that have arisen in their minds that there would be any interference with their death insurance system; that there need be no apprehension of the kind, that there is nothing in the Bill to do with death payments. This is, of course, quite true, but I fear it is small comfort. The masses from whom these collectors and agents giet their living have only a certain small amount to spend on insurance, and now they have to contribute for the purposes of the Bill, thej^ will have little or nothing to spare for insurance against death risks. I cannot help thinking, therefore, that collectors and agents of the great industrial life insurance societies will be very hard hit by the Bill, and every effort should be made to recompense them by giving them adequate positions in the administration of the scheme. IRELAND. 65 Ireland. Ireland (as usual) is to be differently treated to the rest of the United Kingdom, and special clauses are in- serted in the Bill to apply to Ireland. It is claimed by Irish members that, owing to the majority of the popu- lation of Ireland living under rural conditions, the rate of sickness is much lower there than in Great Britain, there will as a consequence be a smaller demand on the insur- ance fund, and that, therefore, the contributions should be lower. I am informed that the Chancellor of the Ex- chequer has promised to consider this question, and the Irish members are confident they will get some modifica- tions in this respect — for, as an Irish member said to me, " We are generally successful, because we know what we want! " w. t)6 NATIONAL INSURANCE BILL. Distress, Execution, &c. for Rent to be Illegal while Tenant is in Receipt of Sick Pay. Clause 51 is a very drastic and novel proposal, and, I venture to think, should never have been included in a National Insurance Bill. It is not well drawn, but on the face of it it really looks as if it will bear the construc- tion that the person to whom rent is due must not take any proceedings to recover the rent while the tenant is in receipt of sickness benefit, even though such period ex- tends for the space of a whole year, under a penalty of £50. This clause, apart altogether from the equity of the thing, would prove a terrible hardship to many small holders of weekly property — they have often bought some little property out of their savings and have retired on their little rents — and why such people should be so de- prived of the fruit of their thrift and economy I entirely fail to see. Nor can I see why the tenants should have this relief at the expense of their landlords. It is a Health Insurance scheme, and not a Rent Relief Bill. If the Government really wish to give such relief and think it should be one of the provisions of the Bill, then the relief should come out of the funds of the scheme and not out of the pockets of often poor and deserving holders of weekly property. To deprive such owners of rent while at the same time they are left to pay rates and taxes, strikes me as being iniquitous! The effect of such a clause would have a very harmful effect on weekly property. Values would fall and mortgages be called in, and the condition of building societies would be rendered very precarious. Tt is not right to do one's charity at the expense of some- one else — but that is what this clause does. DISTRESS, EXECUTION, ETC. FOR RENT, ILLEGAL. 67 Two suggestions have been made to remedy this — -one laeing that any loss the landlord maj^ sustain should be refunded by the Treasury, and the other that the loss should be debited to the society of which the tenant is a member. There is also another aspect of this clause. Many people think that the clause as drawn might be held to hit others besides landlords, and that any other creditor, the little shopkeeper for instance, would bo prevented from taking any proceedings to recover a debt owing to "him by the tenant. The wording should be altered so as to make it quite clear what is intended. I venture to hope the clause will be radically altered or dropped; it is overburdening the Bill and, on account of its controversial nature, will naturally impede its progress. 68 NATIONAL INSURANCE BILL. Attitude of the Socialists and Labour Party. The Socialists and Labour Party seem to view the Bill with suspicion, even though ail do not go so far as - a member of the Fabian Society who said he viewed "with suspicion a measure which received hearty support from the Tory Party! ' One point in the Bill which is re- garded as an important defect is that there is no differ- ence in the incidence of contribution between the town and country resident. Mr. Barnes, while promising the support of the Labour members for the second reading, nevertheless made it clear that unless important alterations were made in the Bill it would not secure their full approval. In fact, the posi- tion taken up by the Labour Party will depend on what happens in Committee. They have already put down amendments to postpone the sickness part of the Bill, so as to give precedence to the unemployment section, to substi- tute voluntary for compulsory insurance, and to make the contribution of the three parties — employer, workman, and State — a uniform sum of 3d. per week. Mr. Snowden goes further than many of his fellow members on the Labour side. He says: "I think the discussion, so far as it has gone, has proved conclusively that the Bill is impossible in anything like its pres.ent form. It is not only unworkable, but it would give rise to an immense amount of irritation and opposition. Vast numbers of those Avho would be compulsorily insured under this Bill, as it is now, stand to gain nothing practi- cally from it, although they are to be compelled to pay." Mr. Ramsay Macdonald calls the Bill superficial and challenges one of the three principles involved in it — that ATTITUDE OF THE SOCIALISTS AND LABOUR PARTY. 69 of the employer's liability to eoutribute. He would prefer to leave the employer out and rest on the two other prin- ciples — compulsory thrift and State support; but he is willing, however, to accept the employers contribution temporarily as a sort of necessary evil, and like some other members of his party, he would alter the relative shares of the other two and make the State pay more and the contributor less! Members of trade unions feel that the probable effect of the Bill will be to increase the numbers and power of the friendly societies, and correspondingly to depreciate the trade unions, unless, of course, trade unions qualify as approved societies. They think that the financial pro- visions of the Bill may prejudice the lighting effective- ness of trade unions, and they want to secure that trade unions paying friendly benefits shall receive equal rights with friendly societies where the payment of these bene- fits is concerned. They object to the encouragement given to employers' sick and superannuation clubs, and would like to liave them completely taken out of the scheme, the reason they give being that the difficulty of securing democratic con- trol is almost insuperable! I very nmcli doubt if the beneficiaries wall see eye to eye with the Socialists and Labour leaders on this point, however. The Executive Council of the Social Democratic Party has passed the following resolution:^ — " While supporting the principle of national insurance, this executive cannot but regard this measure as an attempt to make the working class itself bear the burden of ameliorating some of the worst results of the capitalist system, instead of saddling the cost u])0ii the master class. With regard to the details of the monsiin! the Executive Council reserves fuller criticism for the iiioiiniit, but is opposed to any direct payments l)cing iiiadi' l)y workmen from their already scanty earnings; and even if workmen •were prepared to accept the principle of dirorl payment. 70 NATIONAL INSURANCE BILL. the scale laid down in the Bill is manifestly unjust, and must be seriously amended before the Bill can be in any way acceptable to the people." They do not want to see shop clubs multiplied, because such a course would weaken trade union organisation. Mr. Barnes has said they could not agree to clause 18 because it would prevent their funds being used in the future as they had been in the past. He also says that the scale of benefits under the Bill is lower than the scale paid at present by trade unions ; but I doubt if this is cori;ect. I suspect that what they really fear is when workmen have to subscribe for the benefits under the Bill, that then they will have less to spend on contributions to the trade unions. As the Attorney-General has pointed out, it is not possible to hand over State money or employers" money to a trade union without securing that this money should not be used as a war chest against the employers. Money under the State scheme must be kept separate from the friendly society's funds or the trade union funds, and there must, of course, be a Government audit of the appli- cation of the State monies. It is said that the insurance scheme in Germany has not hurt the trade unions there. The Executive Council of the Social Democratic Party has issued, a statement criticising the scheme, in which they state that the provision for sickness is totally in- adequate and that the contributions are excessive. THE UNIONIST PARTY. 71 The Unionist Party. The Unionist party are strongly in favour of the prin- ciple of State help to insurance contained in the Bill, and are very anxious to see a good measure passed, and, indeed, it will be largely owing to their expressed inten- tion to do all they can to improve the Bill, and not to oppose it, that the Bill is likely to become law. It is,, however, on questions of details that their criticisms are directed, and anyone who has had anything to do with insurance knows how important the details are. These details are fraught not only with the success or failure of the scheme, but their effects on the friendly societies are far-reaching. Mr. Worthington Evans (who has been appointed chairman of the large committee of Unionist Members who are collecting information as to the hardships which the Bill may entail on different classes of people) pointed out in his speech on the second reading, some of the defects which the Unionist party feels the Bill contains. He l)ointod out that although the Bill would put a large addi- tional charge on employers, whicli in big concerns would no doubt fall on contracts, yet in smaller businesses he felt confident that the Bill would make a real difference in employment. In slack times there would arise in the mind of the small employer whether it would not be better to close down instead of struggling on and hoping foj- better times. To remedy this, he suggested to the Govern- ment whetlK-r it would lie possible to arrange a method under whicli thi! contributions of (employers slioiild b(^ j)aid out of profits. Another (|ue8tion Mr. Worthington Evans raised was, 72 NATIONAL INSURANCE BILL. can the large numbers driven into the scheme be kept there? The actuarial report gave 882,000 as the number in the deposit contributors class who, from the beginning, were unable to join in any approved society owing to ill- health, and the Chancellor of the Exchequer had said that about 5 per cent, of the members of friendly societies fell out annually owing to inability to continue their con- tributions. These 882,000 persons unable to join societies would probably be swollen to about one and a half mil- lions. The extent of the increase would probably depend almost entirely on the attitude of the friendly societies. If the societies were adverse to a large number of men being suddenly driven into their ranks, a great many more would be obliged to seek refuge among the deposit contributors. Mr. Worthington Evans pointed out that no one on the Government side of tlie House has yet had the pluck or hardihood to defend the provisions of the Bill relating to deposit contributors. He jDrophesied that they would be known as the D.C.s, or downcasts! Two and a half weeks' sickness benefit at 10s. a week was all they would obtain after fifty-two weeks' contributions ! Is Parliament justified in driving some million and a half workmen — probably more — into the scheme, and then only giving them such a miserable benefit? Were not some of them better provided for by private methods of insurance which the Bill would kill? He offered to show the Govern- ment a long list of dividing societies which already in- sured some one and a half millions of people, who were getting for an average cost of 2d. or M. a week benefits four or five times as large as the Government proposed to give to deposit contributors. It was said that dividing societies were unsound, that the younger paid for the older — but that was exactly what happened under this Bill; a sum of £807,000 a year was being taken from persons under sixteen years of age and put into the insurance fund to equalise the benefits given to the older members, and probably up to thirty years of age j^eople svould pay more THE UNIONIST PARTY. 73 than the market value of the benefits to which they were entitled. Another defect of the scheme Avas the method in which, in connection with liability for medical beneht, the only risk was transferred to the medical man. The poor soldiers and sailors, as usual, were to come off second best! All the House knew was that the Govern- ment were going to deduct 2(1. a week from their pay. No benefits were laid down for them in the Bill. The Admiralty and War Office might or might not make regu- lations for some benefits. He would not be satisfied unless soldiers and sailors were treated in the same way as the best men in the approved societies. He regarded the foregoing points as only some among the many which showed how crude and incomplete the Bill was. I regard as one of the gravest defects in the Bill the fact that 80 much is left to be settled by the various bodies set up under it. Based as it is on the German system, it is far too bureaucratic in its methods to plea.so English tastes. The insurance commissioners and local health committees in my opinion are given far too mueii power and latitude. There are some twenty- nine regulations and thirty-four restrictions of import- ance to be settled and prescribed, but these main regula- tions and restrictions should hv pul Ix'fore and settled by Parliament and not left for bureaucratic and outside de- cision. But the most serious sin of this kind is clause 57, with its extraordinary provision that " the insurance com- missioners . . . may by order make any appointment and do anything wliich appears to them necessary or ex- pcdionl. . . . and any such order may modify the pro- visions ol the .Vet so far as may apj)car necessary or ex- pcdient for carrying the order into effect " ! This is legis- lation \)\ huroauoracy lun m;id! Why bt; l)()thered about having a rarli;iment at all! Tjet us appoint a few commis- sioners and give them a fre(> h:iiiil liki' Ihis, mikI good-bye to the liberties for which we have been fighting during the 74 NATIONAL INSURANCE BILL. centuries. Even the Chancellor of the Exchequer had to admit, when pressed bj Mr. Worthington Evans, that the clause was rather strong! The fact is that this clause will have to be drastically altered; the marvel is that it should ever have been allowed to appear in the Bill as drafted ! ( 75 ) PART II. Unemployment Insurance. The Unemployment portion of the Bill may be regarded as the Cinderella of the scheme, for it has been comiDletely overshadowed by its more showy sister; and while the Sickness provisions have afforded one of the chief topics of conversation since the Bill was introduced, very few people have taken very much interest in the second part of the Bill. Yet these provisions relating to unemployment are of enormous and far-reaching importance, and if they had been embodied in a separate Bill (as I venture to think they should have been) and introduced either before or after a Sickness Insurance Bill, they would have com- manded immense attention and interest. I believe this is the first time in the Iiistory of any nation that a scheme of compulsory national insurance against unemployment has been introduced. It is pro- posed to start by compelling all workmen engaged in the building and engineering trades to come into the scheme. These two trades have been chosen because it is in them that the greatest fluctuations in employment are experi- enced. Certainly these industries arc most sensitive to trade depression, and it is claimed tliat they are, therefore, the most suitable for experiment. I agree that these two trades are possibly the two most in need of a scheme for provision against unemployment, but for that very reason they may bo the worst for experimental piiiposcs. Excluding agricultural labourers, women and clerical workers, tiic workmen in tho two selected trades, con- sisting as they do of about two and a half millions, com- prise about one-third of" our industrial po|)u]ation. 76 NATIONAL INSURANCE BILL. The fund to be formed for the relief of unemployment is to be raised by contributions from workmen, employers, and the State. Employers and workmen are each to con- tribute 2^d. a week for each period of employment of a week or less, and the State is to contribute one-third of the total aznount received from employers and workmen. The State is also responsible in the first instance for the cost of administration, but 10 per cent, of the income of the unemployment fund will be apportioned towards ad- ministrative expenditure. Employers may, under clause 70, instead of paying the weekly sum of 2^d. in respect of each workman, com- pound by paying in advance the sum of 15s. for a year in respect of a particular workman, the 15s. to include the employer's as well as the Avorkman's subscription. This would work out that the employer's contribution would only amount to 4s. 2d. instead of 10s. 10^. for the year, but of course the employer is running the risk of the workman leaving during the year. The ordinary contribution is to be made by the em- ployer affixing a 5d. stamp to the book belonging to the workman, and the employer will then deduct the 2^d- from the workman's wages. When a workman is unem- ployed no subscriptions are payable. The benefits are to be 7s. a week for workmen en- gaged in the engineering, construction of vehicles, and shipbuilding trades when they are out of work, and 6s. a week for workmen engaged in the housebuilding trades. The benefits are to commence after the first week of un- employment, and are payable for a period not exceeding fifteen weeks in any twelve months. In order that a man may get this, however, he must conform to the provision that he can only draw one week's benefit for ever}' five weekly contributions paid by him. This is a very im- portant rule which, while it will not handicap the hard- working and regular labourer, will penalise the lazy and worthless . UNEMPLOYMENT INSURANCE. 77 Provision is given to the Board of Trade to vary the above benefits within limits, viz., 6.s. and 8s. per week, and should necessity arise to reduce the period below the fifteen weeks. If necessary, also, powers are given to hold a public inquiry. In order to be in a position to receive the benefits a workman must show that he has been engaged in one of the insured trades for twenty-six weeks, he must make application for benefit in the prescribed manner, and he must have been continuously out of work since the date of application. He must be capable of working and unable to get suitable employment, and, of course, he must not have exhausted his right to benefit before mentioned. In addition to the above requirements a workman will be disqualified from benefit in either of the following cases : — (1) If he has lost his work through a strike or lock-out, for the period the strike oi- lock-out lasts. (2) If he has lost liis woi-k through misconduct or has thrown up his job without a good cause, for six weeks after losing such work. (3) While he is residing outside the United Kingdom. (4) If he has been iiuprisoucd. for six weeks after leav- ing prison. (5) Wliile he is an inniale ol' ajiy public iustitul ion . Tlie scheme is to be administered priuciioally tlirough the Labour Exchanges. When a workman loses his em- ployment h(! is to take his duly stamped l)Ook to the nearest exchange, and lodge liis book witli the exchange and claim benefit. The decision as to the amount of benefit (if any) that ho is entitled to draAv, will rest with an "insurance ofiiccir," and the workman will be rs in factories, 162 NATIONAL INSURANCE BILL. § 46. workshops, mines, quarries, or other industries, or relating to public health, or the housing of the working classes, or any regulations made under any such Act, or to observe or enforce any public health precautions, the society or com- mittee making such allegation may apply to the Secretarj- of State or the Local Government Board, as the case may require, for an inquiry, and thereupon the Secretary of State or Local Government Board may appoint a loom- pet«nt jDerson to hold an inquiry. This clause seems to open up a vista of costly litigation and inquiries. The remedy for many of the evils here aimed at is already in existence, and the result of this clause may be endless friction between established bodies and the Secretary of State or the Local Government Board. The provisions of this clause must in any event add very largely to the administration of the scheme. (2) If upon such inquiry' being held it appears to the person holding the inquiry that the amount of such sick- ness has (i) during a period of not less than three years before the date of the inquiry; or (ii) if there has been an outbreak of any epidemic, endemic or infectious disease, during any less period; been in excess of the average expectation of sickness by more than ten per cent., and that such excess was in whole or in part due to any such cause as aforesaid, the amount of any extra expenditure found by the person holding- the inquiry to have been incurred under this Part of this Act by the society or committee in question by reason of such cause shall be ordered by him to be made good in accordance with the following provisions: — (a) Where the excess or such part thereof as aforesaid is due to the conditions or nature of the employ- ment or to any neglect on the part of any em- jDloyer to observe or enforce any such Act or NATIONAL INSUEANCE BILL. resulation as aforesaid, it shall be made good § 46 153 by the employer: (b) Where such excess or such part thereof as aforesaid is due to bad housing or insanitary conditions in the locality, or to any neglect on the part of any local authority to observe or enforce any such Act or regulation as aforesaid, it shall be made good by such local authority as appears to the person holding the inquiry to have been in default: Where the excess or such part thereof as afore- said is due to an insufhcient or contaminated water supply, it shall be made good by the local authority or company by -which the water is supplied, or which having imposed upon it the duty of affording a water supply has refused or neglected to do so. \^/ '•ten per cent."— This seems rather a low increase above the "average expectation of sickness" (in itself rather a vague quantity !) on which to base these penalties. (3) Where any such inquiry as aforesaid is held in respect of bad housing or insanitary conditions in any locality, it shall be lawful for the local authority to serve notice upon the owner or occupier of any premises which are the subject-matter of the inquiry, and where it is proved thai such a notice has been served and that any such extra expense as aforesaid, or any part thereof, has been caused by the act or default of such owner or occu- pier, the person holding the inquiry may order the owner or occupier to repay to the local authority tlie amount of the extra expenditure or part thereof which has been so caused . (4) For the puipose of this section the average ex- pectation of 8ickne.ss shall be calculated in accordance with the tabh?s prepared by the Insurance Commissioners for 154 NATIONAL INSURANCE BILL. •§ 46. the purpose of valuations under this Part of this Act, but " any excessive sickness attributable to any disease or dis- ablement which is or is due to any disease or injury in respect of which damages or compensation are payable under the Employers' Liability Act, 1880, or the Work- men's Compensation Act, 1906, or at common law, shall not be taken into account. (5) A person holding an inquiry under this section shall have all such powers as an inspector of the Local CTOvernment Board has for the purposes of an inquiry under the Public Health Acts, and shall have power to order ho\\- and by what parties costs, including such ex- penses as the Secretary of State or Local Government Board may certify to have been incurred by them, are to be paid, and an order made by such person under this section may by leave of the High Court be enforced in. the same manner as a judgment or order of the Court to the same effect: Provided that a society or committee shall not be ordered to pay the costs of the other party to the inquiry if the person holding the inquiry certifies that the demand for an inquiry was reasonable under the circumstances, and when he so certifies the Treasury may repay to the society or committee the whole or any part of the costs incurred by it. The " person holding an inquiry " is given very large powers, and there is no provision for any appeal against his award. Words giving leave to appeal against his decisions should certainly be inserted in the Bill. (6) Without prejudice to any other method of recovery, any sum ordered under this section to be paid by a local authority may, in accordance with the regulations of the Local Government Board with the approval of the Treasury, be paid out of the Local Taxation Account and {deducted from any sums payable either directly or indirectly out of that account to the local authority. NATIONAL INSURANCE BILL. 155 (7 , For the purposes of this section any expenditure § 46- on any benefit administered by a local Health Committee shall be deemed to be expenditure of that committee, liut any sums ordered to be paid to any such committee under this section to meet extra expenditure on sickness l>euefit or disablement benefit shall be dealt with for the benefit of deposit contributors in accordance with regu- lations made by the Insurance Commissioners. Supplementary Provisions. 47. Erection of mnatoria, do.']— {I) If under any other Act of the present session any sum is made avail- able for the purposes of the provision of sanatoria and other institutions for the treatment of tuberculosis or such other diseases as the Local Government Board with tlie approval of the Treasury may appoint, such sumshall be distributed by the Local Government Board with the consent of the Treasury in making grants for those pur- poses. (2^ If an^- such grant is made to a county council, the Local Government ^Board may authorise the county council to provide any sueli institution, and where so authorised the county council shall have power to erect such buildings and to do all such things as may be neces- sary for the purpose, and any expenses of the county council, so far as not defrayed out of the grant, shall bo defrayed out of the county fund. (3) For the purpose of facilitating co-operation amongst county councils, county borough councils, and other local authorities for the provision of such sanatoria and other institutions as aforesaid, the Local Govern- meiil Board may by order make such provisions as appear to them necessary or expedient b} the con- stitution oT joint coiiiiiiitteos, joint boards, or otherwise, I'or the joint e.xercise by such councils and authorities of their po^ei-s in relation thereto, and any such order 156 NATIONAL INSURANCE BILL. § 47. may provide how, in Avhat jDroportioiis, and out of what funds or rates the expenses of providing such institu- tions, so far as they are not defrayed out of grants under this section, are to be defrayed, and may contain such consequential, incidental, and supplemental provisions as may appear necessary for the purposes of the order, and an order so made shall be binding and conclusive in respect of the matters to which it relates. In the gi-ouping under (3) it has been suggested that Wales should be made the unit for purposes of administration, on the ground that such an arrangement would make for efficiency and economy. It would be well to make provision for making use of the existing sanatoria throughout the country which are already actively engaged in tighting consumption. 48. Power to Insurance Office to make regukdiom, dc.'] — The Insurance Commissioners may make regula- tions for any of the purposes for which regulations may be made under this Part of this Act or the schedules therein referred to, and for jJrescribing anything which under this Act or any such schedules is to be prescribed, and generally for carrying this Act into effect, and any regulations so made shall have effect as if enacted in this Act. Yery wide powers are here given to the Commissioners, and there seems to be no check, even by the Treasury, much less by Parliament. 49. Determination of questions by Insurance Office.] — If any question arises — (a) as to whether a person is liable to become in- sured under this Part of this Act as being a person employed within the meaning of this Act; or (b) as to the rate of contributions payable by or in resj^ect of any insured person; or NATIONAL INSURANCE BILL. l^'?' (o) as to the rates of contributions payable in respect § 49. of an employed contributor by the employer and the contributor respectively; the question shall b© determined by the Insurance Com- missioners, in accordance with regulations made by them for the purpose. Provided that — (i) if any person feels aggrieved by the decision of the Insurance Commissioners on any question arising under paragrajDh (a), he may appeal therefrom to the county court, with a further right of appeal upon any question of law to such judge of the High Court as may be selected for the jDurpose by the Lord Chan- cellor and the decision of that judge shall be final; (ii) the regulations of the Insurance Commissioners may provide for questions under paragraph (b) being determined, in the case of any person \\ho is or is about to become a member of an approved society, by the society. "by the society." — It seems curious that the society may be the only judge as to the reasonableness of the rate fixed by itself. 50. Disputes.] — (1) Every dispute between — (a) An approved society or a branch thereof and an insured person who is a member of such society or branch or any person claiming through him; (b) An approved society or branch thereof, and any person who has for not more llian six months ceased to bo a member for the jDurposes of tliis Part of this Act of such society or braiicli, or any person claiming through him; (c) An approved society and any br.infh tlicrcof; (d) Any twoor more branches of an nppioved society, relating to ;iii\ lliiiiu' doin' oi- niiiiffod by such insured 158 NATIONAL INSURANCE BILL. § 50. person, society, or bra,ncli (as the case may be) under this ' Part of this Act or any regulation made thereunder, shall be decided in the first instance in accordance with the rules of the society, but any party to such dispute ma,y appeal from such decision in the prescribed manner to the Insurance Commissioners. (2) Every dispute between a deposit contributor and the local Health Committee, relating to anything done or omitted by such contributor or the local Health Com- mittee under this Act, or any regulation made hereunder, shall be decided in the prescribed manner by the Insur- ance Commissioners. (3) The Insurance Commissioners may authorise referees appointed by it to decide any appeal or dispute submitted to tlie Insurance Commissioners under this section . (4) The Insurance Commissioners may make regula- tions as to the procedure on any such appeal or dispute, and such regulations may apply any of the provisions of the Arbitration Act, 1889, but, except so far as it may be so applied, the Arbitration Act, 1889, shall not apply to proceedings under this section, and any decision given by the Insurance Commissioners or a referee under this section shajl be final and conclusive. 51. Distress, execution, dc. to he illegal in certain ooS'es.]— (1) It shall not be lawful during any period when an insured person is in receipt of sickness benefit, or during the fourteen days immediately following that period, for any person to levy any distress or execution upon any goods or chattels belonging- to such insured person and being on premises occupied by him, or to take any proceedings in ejectment or for the recovery of any rent or to enforce any judgment or ejectment against such insured person; and any person levying or attempting to levy any such distress or execution or en- forcing or attempting to enforce any such judgment. NATIONAL INSURANCE BILL. 159 shall be liable on summary conviction to a fine not ex- § 51- ceeding fifty founds. This claus-e has natui'ally aroused the resentment of lantUords and others. Under it a landlord may not take any steps to recover the rent duo to him if his tenant is in receipt of sickness benefit for so long a period in extreme cases of over a year — and after then his chance of recovering all these arrears would most probably be very remote. If it is felt by Parliament that such an " additional benefit " (in addition to the money and medical benefits which contiibutors are entitled to under the Bill) is desirable, siirely such relief should be given out of the funds created by the scheme, and not out of the pocket of a landlord, who himself may be a poor man, and who, moreover, all this time would himself be liable for ground rent, rates, taxes, and repairs. "or execution upon any goods."— It is not only landlords who are to be hit by this clause. These words will prevent any other creditor from enforcing a judgment he may have against the person who is in i-eceipt of sickness benefit. (2) It shall 1)0 hnvful for the judge of tlie county court upon application made on behalf of the insured pei-son ex parte for that purpose, from time to time to extend the poi-iod (hiring- which the provisions of the last preceding subsection are to he applicable, upon heing satisfied that the levying of any such distress or execu- tion or tlie taking of any such proceedings or the en- forcement of any such judgment would endanger the life of tlie insured person, and any order granting such ex- tension shall not be subject to appeal: Provided that such period shall not bo extended for moro than twelve montlis from the date when the right to levy the distress or execution or to take the proceed- ings or enforce the judgment arose, unless proper security l>c given for payment of the i-ent ihoi'oafter to become du/,' from the insured person, oi' the amount of the judg- ment debt, as the case may be. 52. Offences.^ — (1) If for the purpose ol' f)l)fiiining 160 NATIONAL INSURANCE BILL. § 52. any benefit or ijayment under this Part of this Act, either for himself or for any other person, any person knowingly makes any false statement or false representation, he shall be liable on summary conviction to imprisonment for a term not exceeding three months with or without hard labour. See clause oo, by which, if a per.sun obtains anypayments or benefits under the Act without being lawfully entitled thereto, he is made liable to repay the amount of such benefit. Are these two clauses to be read together ? If so, words accordingly should be inserted. (2) If any employer has failed to pay any contribu- tions which under this Part of this Act he is liable to pay in respect of an employed contributor, or if any such employer or insured jjerson, or any other person is guilty of any other contravention of or non-compliance with any of the requirements of this Act or the regulations made thereunder in respect of which no special penalty is provided, he shall for each offence be liable on summary conviction to a fine not exceeding ten pounds, and where the offence is failure or neglect on the part of the em- ployer to make any such contributions, to pay to the Insurance Commissioners a sum equal to the amount of the contributions which he has so failed or neglected to j)ay, which sum when paid shall be treated as a payment in satisfactioii of such contributions: Provided that no person shall be liable to any penalty in respect ,of any matter if he has acted in conformity with any decision in respect thereto by the Insurance Commissioners . 53. Civil proceedings against emploi/er for neglecting to pay contribidions Jj — (1) Where an employer has failed or neglected to pay any contributions which under this Part of this Act he is liable to pay in respect of a person being a member of an approved society in his employ- NATIONAL INSURANCE BILL. ment, and by reason thereof that person has been deprived § 53. in whole or in part of his right to any benefits which would otherwise have been payable to him, he shall be entitled to take proceeding-s against the emi^lpyer for the value of the right of which he has been so deprived, and in any such proceedings the employer may be ordered to pay to the Insurance Commissioners a sum ecjual to the value so ascertained, which sum when paid shall be carried to the credit of the society of which such person is a member, and thereupon such person sliall thencefortji be entitled to receive from the society benefits at the same rate as he would have been entitled to had the con- tributions been properly paid, together with the difference l>6tAveen the amount of the benefits (if any) he has actually received and the benefits he would have received had the contributions been properly paid. (2) Proceedings may bo taken under either this or the last preceding section notwithstanding that proceedings have also been taken under the other section in respect of the same failure or neglect to pay contributions. 54. Repayment of benefits hnproperly paid.] — If it is found at any time that a person has been in receipt of any payment or benefit under this Part of this Act without being lawfully entitled thereto he, or in the case of his death his pei'sonal representatives, shall bo liable to repay to the Insurance Commissioners the amount of such payment or benefit, and any such amount may bo recovered as a debt due to the Crown and when so recovered shall bo carried to the credit of the society of which sucli person was a member, or if he was not a member of any approved society, of the Post OfHce Fund. 161 See clause .32, by which any person guilty of making false rei^re- sentiitions for tho purpose of obtaining any benefit under the Act is I'en'lercd liable to three months' imprisonment. W. M 162 NATIONAL INSURANCE BILL. § 55. 55. Provisions as to application of existing funds of friendly societies.'] — (1) Any registered friendly society or branch which provides benefits similar to those con- ferred by this Act shall submit to the Registrar of Friendly Societies a scheme for abolisliing, reducing, or altering such benefits as respects members who become insured persons under this Part of this Act, and for the apJ)lication of the funds accumulated in respect of such members for the purposes of such benefits in any one or more of the following ways: — (a) in the payment of other benefits; (b) in the reduction of the contributions of members in respect of benefits jjayable by the society in- dependently of this Part of this Act ; (c) in the payment of contributions under this Part of this Act payable by its members; and any such scheme when confirmed by the registrar shall have effect as if enacted in this Act. (2) This section shall come into operation on the passing of this Act. Mr. Claaiies Bathurst asked the Chancellor of the Exchequer whether uuder clause 55 any existing member of a registered friendly society will under any circumstances be compelled to pay in respect of sickness and invalidity insurance to the Government and in respect of death and funeral insurance to his society a larger aggregate amount than he has now to pay for the same benefits to his society ? Mr. Lloyd George : I fear it is impossible to say whether this will be so in particular cases. It depends entirely on the amount of the benefits they are insured for. If it occurs it will be clear evidence that the member was inadequately insured against sickness and disablement. 56. Provisions as to existing superannuation funds.]^ — Where at the passing of this Act a superannuation fund or any similar fund has been established by an employer for the benefit of the workmen employed by him, and under the Act or deed establishing the fund NATIONAL INSURANCE BILL. any sum is payable by the employer towards benefits § 56. secured by the Act or deed, and those benefits include benefits similar to those conferred by this Act, the em- ployer may at anj- time before the commencement of this Act submit to the registrar a scheme allowing him to deduct from any contributions payable by him under the Act or deed towards benefits of a nature similar to those under this Act the an^ount of the employer's contribu- tions payable by him under this Part of this Act. 57. Potver to remove diffimlties.] — If any difiiculty arises with respect to the constitution of local Health Committees, or the advisory committee, or otherwise in bringing into operation this Part of this Act, the In- surance Commissioners, with the consent of the Treasury, may by order make any appointment and do anything Avhich appears to them necessary or expedient for the establishment of such committees and for bringing this Part of tliis Act into operation, and any such order may modify the provisions of this Act so fa,r as may appear necessary or expedient for carrying the order into effect. This is one of the most extraordinary clauses ever inserted in any Uill ! It actually gives to the Insurance Commissioners power to override an Act of Parliament ! They " may modify the provisions of this Act." And the only check on them is that they may only do this " with tlie consent of the Treasury," by whom they were appointed I If the framers of this Bill really meant to give the Commissioners tlieso powers, it seems rather a pitj^ to waste the time of Parliament in discussing and passing all the many clauses in the Bill ! It would have been so much simi>ler to have appointed the Commissioners in the first instance, and then by Act of Parliament give them and the Treasury power to frame and carry out the provisions of u National Insurance P.ill I 58. Appliailion to Scotland.] — This Part of this Act in its application to Scotland shall be subject to the fol- lowing modifications: — (1) The expression "Local Government Board" M 2 163 164 NATIONAL INSURANCE BILL. § 58. means the Local Government Board for Scot- land: Provided that as regards the making of riegulations respecting sums payable out of the Local Taxation (Scotland) Account the said ex- pression means the Secretary for Scotland; the expression "Local Taxation Account" means the Local Taxation (Scotland) Account; and the expression " inspector of the Local Government Board " includes a person acting under section seven or section eight of the Public Health (Scotland) Act, 1897: (2) The expression "county borough" means a burgh or police burgh within the meaning of the Local Government (Scotland) Act, 1889 (in this section referred to as the Act of 1889), con- taining within the police boundaries thereof ac- cording to the census of nineteen hundred and eleven a pojDulation of twenty thousand or up- wards, and all other burghs and police burghs shall, for the purposes of this Part of this Act, be hold to be within the county, and unless already represented on the county council shall, foir the purposes of this Part of this Act, be represented thereon as may be determined by the Secretary for Scotland on a representation in terms of section fifty-one of the Act of 1889: (3) Except in this section, references to a county and the county council thereof shall, a,s regards — (a) the counties of Kinross and Clack- mannan ; (b) the counties of Elgin and Nairn; and (c) the counties of Peebles and Selkirk; be construed in each case as references respec- tively to a combination of the two recited counties and to a joint committee of the county councils thereof which shall from time to time NATIONAL INSURANCE BILL. 165 be appointed subject to the provisions of section § 58. seventy-sis of the Act of 1889: (4) Expenses incurred by a county council under this Part of this Act shall be defrayed out of the general purposes rate; provided that notwith- standing anything contained in the Act of 1889, the ratepayers of a police burgh shall not be assessed by the county council for any such ex- penses unless the police burgh is, for the pur- poses of this Part of this Act, held to be within the county; and provided further that with respect to every burgh within the meaning pf the Act of 1889, which is, for the purposes of this Act, held to be within the county subsection three and subsection four of section sixty, and section sixty-six, of the Act of 1889, shall, so far as applicable, have effect as if such expenses were expenditure therein mentioned: (5) Expenses incurred by a town council under this Act (whether under requisition from the county council or otherwise) shall be defrayed out lol' the public health general assessment, but shall not be reckoned in any calculation as to the statutory limit of that assessment; and refer- ences to the borough fund or borough rate shall be construed accordingly: (0; The expression " borough or urban district " means a burgh or police burgh within the meaning of the Act of 1889, and the expression "rural dis- trict" moans any part of a county outwith a burgh or police burgh: (7) The expression " Lord Chief Justice," in reference to questions or disputes arising between the Insurance Ollico and a society whose head office or principal place of business is in Scotland, means the Lord President of the Court of Session : 166 NATIONAL INSURANCE BILL. § 58, (8) Tho expression "county court" means the sheriff; and in lieu of an appeal from the county court upon any question of law there shall be sub- stituted an appeal from the sheriff upon any question of law in terms of subsection (17) (b) of the Second Schedule to the Workmen's Com- pensation Act, 1906; provided that the decision of either division of the Court of Session on such appeal shall be final: (9) The expression "workhouse" means j)oorhouse; " coverture " means marriage; " levy any distress or execution upon " means use any diligence in respect of; "ejectment" means removing; "amount of judgment debt" means amount decerned for; "Public Health Acts" means the Public Health (Scotland) Acts; and "High Court" means Court of Session: 59. Application to Ireland.] — This Part of this Act, in its application to Ireland, shall be subject to the fol- lowing modifications: — (1) Tho reference to the Lord Chancellor shall be con- strued as a reference to the Lord Chancellor of Ireland. The reference to the Lord Chief Justice shall, as respects disputes or questions arising between the Insurance Commissioners and any approved society having its head office or principal place of business in Ireland, be construed as a refer- ence to the Lord Chief Justice of Ireland. References to the Local Government Board shall be construed as references to the Local Government Board for L'eland, and the refer- ence to the Local Taxation Account shall be construed as a reference to the Local Taxation (Ireland) Account. (2) A reference to the Housing of the Working Classes NATIONAL INSURANCE BILL. 16^ (Ireland) Acts, 1890 to 1908, shall be substi- §59. tuted for the reference to the Housing of the Working Classes Acts, 1890 to 1909, and a refer- ence to the Public Health (Ireland) Acts, 1878 to 1907, shall be substituted for the reference to the Public Health Acts. (3) Where the number of members of any society being insured persons exceeds five thousand, the society may receive the approval of the Insurance Com- missioners notwithstanding that the number of such members is less than ten thousand, and in the provisions of this Part of this Act with respect to the approval of societies "five thousand" shall be substituted for "ten thousand ' ' accordinglv . " At least ten thousand members " are necessary in the case of England, Scotland and Wales [clause 18 (2) (i)]. (4) (a) If it appears to any county council that, having regard to the number of employed contributors resident in the county who are not members of any society approved under the foregoing pro- visions of this Act it is desirable that steps should bo taken by the council for the estab- lishment of an approved society for the county under the council (in this section referred to as a county society), the council may at any time before the expiration of one year from the commencement of this Act submit to the Insur- ance Commissioners a scheme for the establish- ment of a county society ; (b; The scheme may provide for — (i) the representation of the council on the committee of management of the society; (ii) the appointment of ofFicors and district and other comniittoes by the council; NATIONAL INSURANCE BILL. §69. (5) (iii) the delegation of powers to com- mittees ; (iv) the giving of security by means of a charge upon the county fund or otherwise; (v) the restriction of membership to in- sured persons resident in the county not being- members of any other approved society; (vi) the reduction of benefits below the minimum rates fixed bj^ this Part of this Act; and (vii) such other matters as may appear necessary and in particular such further modi- fications of the provisions of this Part of this Act with respect to approved societies as may be required for the purpose of adapting those provisions to the case of a county society; (c) The scheme may be approved notwithstanding that the number of members or prospective members of the society is less than five thousand; (d) Where such a scheme has been approved by the Insurance Commissioners, the provisions of the scheme shall have effect notwithstanding anything to the contrary in this Part of this Act; and, subject to those provisions, the county society shall be an approved society for all the. purposes of this Part of this Act; (e) A county council desirous of submitting a scheme under this section may at any time after the passing of this Act take such steps as appear necessary with a view to ascertaining what in- sured persons resident in the county are eligible and willing to become members of the proposed county society, and generally for the formation of the society; The local health committee of a county shall consist of such number of members as may be deter- mined by the Insurance Commissioners, and of NATIONAL INSURANCE BILL. 169 that number not more than one-fourth shall bo § 59. persons appointed by the Insurance Commis- sioners, and the remainder shall be appointed by the county council. (6) Subject to the provisions of this section the rules of a local health committee of a county may pro- vide for the performance of duties by officers of local authorities in connection with the administration of benefits administered by the committee, and those officers shall perform the duties so assigned to them, and shall in respect thereof be entitled to the remuneration fixed by the rules. (7) The following provisions shall have effect with respect to the administration of medical benefit by a local healtli committee of a county in the case of deposit contributors resident in the county : — (a) It shall be the duty of the medical officer of health of each dispensary district in the countj^, Avithout the production of any medical relief ticket, to attend and treat every deposit contributor resident in his district and rec|uiring medical attendance or treatment, and at the expense of the guardians to supply proper and sufficient drugs and medicine to the contributor; (b) There shall be paid to the medical officer in respect of his services under the last preceding paragraph such yearly sum as may be prescribed in respect of each deposit con- tributor resident in his district; (c) There shall be paid to the guardians of the poor Jaw i in ion in respect of medicine and drugs supplied to deposit contributors resideni in the union, or the part of the union 170 NATIONAL INSURANCE BILL. § 69. within the county as tlie case may be, a sum calculated at such rate as may be prescribed; (d) Any sums so payable to a medical officer or board of guardians shall be paid in the prescribed manner and at the prescribed time by the local health committee out of the amount paid -or credited to the committee on account of sums payable in respect of deposit contributors resident in the county for the purposes of the cost of medical benefit. (8) If a grant is made to a county councilor county borough council out of any sum made available under any other Act of the present session for the purposes of the provision of sanatoria and other institutions for the treatment of tuber- culosis or such other diseases as the Local Gov- ernment Board may with the approval of the Treasury appoint, the council may, subject to the sanction of the Local Government Board, exercise for all or any of those purposes the powers given to them hj Part II. of the Tuber- culosis Prevention (Ireland) Act, 1908, in like manner as if those purposes were purposes au- thorised by that Part of that Act, and any ex- penses of the council so far as not defraj^ed out of the grant shall be defrayed in manner provided by that Part of that Act. (9) If on a representation made by an approved society the Insurance Commissioners are satis- fied that the society is unable to make arrange- ments upon reasonable terms for the administra- tion of medical benefit in the case of members resident in any specified locality, the Com- missioners may authorise the society in the case of members resident in that locality to suspend medical benefit and out of the moneys otherwise payable for the cost of that benefit to distribute NATIONAL INSURANCE BILL. 171 any one or more additional benefits among those § 59. members in accordance -with a scheme approved b}' the Commissioners. Mr. Lloyd George seems to recognize that very different con- ditions prevail in Ireland ; he said : — " As far as I am concerned, I would rather that the problems of Irish doctors be settled by the Irish doctors themselves. ... I am told there are very different considerations applying. At any rate, the money would be there for them. As to how it is dis- tributed, they will have to fight that out themselves, but the medical profession will be i"ep resented." He has also promised that the medical profession shall have representation on the Advisory Committee in Ireland in the same manner as that which he had referred to as regarded Great Britain. (10) For the purposes of proceedings in Ireland under the provisions of this Part of this Act relative to disputes regulations of the Insurance Com- missioners may apply all or any of the provi- sions of the Common Law Procedure (Ireland) Act, 1856, with respect to arbitration. Part II. UNEMPLOYMENT INSURANCE . 60. Right of workmen in inst&ed trades to uwemploy- ment benefit.^ — Every workman who, having been em- })loyed in a trade mentioned in the Sixth Schedule to this Act (in this Act referred to as " an insured trade "), is un- oraploycd, and in whose case the conditions laid down by this Part of this Act (in this Act referred to as " statu- tory conditions") are fuKIUod, shall be entitled, subject to the provisions of this Part of this Act, to receive pay- ments (in this Act referred to as " unemployment benc- ht") at weekly or other prescribed intervals at such rates and for such periods as arc authorised by or under the 1'^- NATIONAL INSURANCE BILL. § 60. Seventh Schedule to this Act, so long as those conditions continue to be fulfilled, and so long as he is not disquali- fied under this Act for the receijDt of unemj^loyment benefit. "Every workman," — For definition of workman see clause 81 (1). " Sixth. Schedule." — The Act is comimlsoiy in regard to work- men emploj'cd in tlie trade set forth in the Sixth Schedule. " statutory conditions."— See clause 62. " not disq^ualified." — For disqualification see clause 63. 61. Contributions hy workmen, employers, and the Treasury -I — (1) The sums required for the payment of unemployment benefit under this Act shall be derived partly from contributions by workmen in the insured trades and partly from contributions from employers of such workmen and 'partly from moneys provided hy Parliament . (2) Subject to the provisions of this Part of this Act, every workman employed within the United Kingdom in an insured trade, and every employer of any such work- man, shall be liable to pay contributions at the rates specified in Part I. of the Eighth Schedule to this Act. (3) Excei^t where the regulations under this Part of this Act otherwise prescribe, the employer shall, in the first instance be liable to pay both the contribution pay- able by himself, and also on behalf of and to the exclusion of the workman, the contribution payable by such work- man, and subject to such regulations shall be entitled notwithstanding the provisions of any Act relating to truck or any contract to the contrary, to recover from the workman by deductions from his wages or otherwise the amount of the contributions so paid by him on behalf of the workman. (4) Notwithstanding any contract to the contrary the employer shall not be entitled to deduct from the wages of, or otherwise recover from, the workman the contribu- tions jDayable by the employer himself. NATIONAL INSURANCE BILL. 173 (5) Subject to the provisions of this Part of this Act, § 61. the Board of Trade may make regulations providing ' for any matters incidental to the payment and collection of contributions payable under this Part of this Act, and in particular for — (a) payment of contributions by means of adhesive or other stamps affixed to or impressed upon books or cards, and for regulating the manner, times and conditions in, at and under which such stamps are to be affixed and impressed; (b) the issue sale custody or delivery up of books or cards and the replacement of books or cards which have been lost destroyed or defaced. (6) A cmtrihution shall he made in each year out of moneys pravided by Parliament equal to one-third of the total contributions received from employers and v}orT<:men during that year, and the sums to he contri- huted in any year shall be paid in such manner and at such times as the Treasury may determine. 62. Statutory cwiditions for receipt of unemployment benefit.']— Tlh.Q statutory conditions for the receipt of un- employment benefit by any workman are — (1) that he proves that ho has, since the commence- ment of this Act, been employed in an insured trade during each of not less than twenty-six separate calendar weeks; This is the same provision for the waiting period of six months as in the case of sickness benefit. (2) that ho has made application for unemployment benefit in the prescribed manner, and proves that since the date of tho application ho has been continuously unemplo3^cd; (3) tliat ho is capable of work but unable to obtain suitable employment; I'^-i NATIONAL INSURANCE BILL. § 62. (4) that he has not exhausted his right to unemploy- ^ ^" ment benefit under this Part of this Act: Provided that a workman shall not be deemed to have failed to fulfil the statutory conditions by reason only that he has declined an offer of employment in a situa- tion vacant in consequence of a trade dispute involving a strike or lock-out, or an offer of employment at a rate of wage lower than the rate which he habitually earns Avhen in employment, or, in the case of an offer of em- ployment in a district other than that in which he resides, at a rate of wage lower than the rate current in the dis- trict in which the employment is offered. 63. Disqualifications for unemployment benefit. '\ — (1) A workman who loses employment by reason of a trade dispute involving a strike or lock-out by which he is directly affected shall be disqualified for receiving un- employment benefit so long as the strike or lock-out con- tinues . (2) A workman who loses employment through mis- conduct or who voluntarily leaves his employment with- out just cause shall be disqualified for receiving unem- ployment benefit for a period of six weeks from the date when he so lost employment. (3) A workman who has been convicted of an offence and ordered to be imprisoned without the option of a fine or to suffer any greater punishment shall be disqualified for receiving unemployment benefit for a period of six weeks after his release from prison. (4) A workman shall be disqualified for receiving un- employment benefit whilst he is an inmate of any work- house or other institution suiaported wholly or partly out of public funds, and whilst he is resident temporarily or permanently outside the United Kingdom. 64. Determination of claims.'] — (1) All claims for un- employment benefit under this Part of this Act, and all NATIONAL INSURANCE BILL. 17-"> questions whether the statutory conditions are fulfilled § 64. in the case of any workman claiming such benefit, or whether those conditions continue to be fulfilled in the case of a workman in receipt of such benefit, or whether a workman is disqualified for receiving or continuing to receive such benefit, or otherwise arising in connexion with such claims, shall be determined by one of the offi- cers appointed under this Part of this Act for deter- mining such claims for benefit (in this Act referred to as "insurance officers"): For appointment of " insurance ofiScers " see clause 65. Provided that — (a) in any case where unemployment benefit is refused or is stopped, the workman may require the insurance officer to report the matter to a court of referees constituted in accordance with this Part of this Act, and the referees after considering the circum- stances may make to the insurance officer such recommendations Cn the case as they may think proper. If the insurance officer dis- agrees wdth anv such recommendation he shall, if so requested by the referees, refer the recommendation, with his resaons for dis- agreement, to an umpire appointed under this Part of this Act, whose decision shall be final and conclusive; limpil'e. ' — For appointment of "nmpives " yee clause 65. (b) the insurance officer in any case in which he con- siders it expedient to do so may, instead of himself determining the claim or question, refer it to a court of referees, who shall in such case determine the question, and the de- 176 NATIONAL INSURANCE BILL. § 64- cision of the court shall be final and con- clusive. " court of referees." — For con&titution see clause 66. (2) Nothing in this section shall be construed as pre- venting an insurance officer or umpire, or a court of referees, on new facts being brought to his or their know- ledge, revising a decision or recommendation given in any particular case, but where any such revision is made, the revised decision or recommendation shall have effect as if it had been an original decision or recommenda- tion, and the foregoing provisions of this section shall apply accordingly. (3) The Arbitration Act, 1889, shall not apply to pro- ceedings under this section except so far as it may be applied by regulations under this Part of this Act. (4) For the purposes of proceedings under this section in Ireland regulations may apply all or any of the pro- visions of the Common Law Procedure (Ireland) Act, 1856, with respect to arbitration. 65. Appointment of um.pires, insurance officers, in- spectors, dc] — (1) For the purjjoses of this Part of this Act umpires and insurance officers shall be appointed by the Board of Trade, subject to the consent of the Treasury as to number, and the insurance officers shall be ap- pointed to act for such areas as the Board direct. (2) The Board of Trade may appoint such other offi- cers, inspectors, and servants for the jDurposes of this Part of this Act as the Board may, with the sanction of the Treasury, determine, and there shall he paid out of monkeys provided by Parliament to the umpires and in- surmice officers and to such other officers, inspectors, and servants such salaries or remuneration as the Treasury may determine; and any expenses incurred by the Board of Trade in carrying this Part of this Act into effect NATIONAL INSUKANCK BILL. 177 to such mnoimt as may be scmctioned by the Treasury § 65. shall be defrayed, out of moneys provided by Parliament : Provided that one-tenth of the receipts, other than advances by the Treasury, paid into the unemployment fund on income account shall, in accordance with regu- lations made by the Treasury, be applied as an appro- priation in aid of money provided by Parliament for the purpose of such salaries, remuneration, and expenses. 66. Courts of referees.]— (!) A court of referees for the purposes of this Part of this Act shall consist of one or more members chosen to repi-esent employers, with an equal nuiidxr of members chosen to represent workmen, and a chairman appointed by the Board of Trade. (2) Panels of persons chosen to represent employers and workmen respectively shall be constituted by the Board of Trade for such districts and such trades or groups of trades as the Board may think fit, and the members of a court of referees to be chosen to represent employers and workmen shall be selected from those panels in the prescribed manner. (3) Subject as aforesaid, the constitution of courts of referees shall be determined by regulations made by the Board of Trade. (4) The regulations of the Board oT Trade may further [novidc Tor ihc referenc*^; to referees chosen from the panels const if uImI und<'r lliis section, for consi(UH'ation and advice, of (juestioiis bearing ujion the administra- tion of this Part of this Act, and foi' the holding of tne< tings of referees for the purpiose. (o) The Board of Trade may pay such remuneration to the chainmm and other members of a court of referees (tn/i svch trarrlllnfj and other allowances {includinc) com- pensation for loss of tim.e) to persons required to attend before any such court, and such other expenses in con- nexion irith any referees^ (ts tin Ihnird, irilh the sane- lion of the Treasury d' h rniiuc, and (u/// such paynients \\. N 178 NATIONAL INSURANCE BILL. § 66. shall he treated as expenses incurred by the Board of Trade in carrying this Part of this Act into effect. 67. Regulations.] — (1) The Board of Trade may make regulations for any of the purposes for which regu- lations may be made under this Part of this Act and the schedules therein referred to and for prescribing anything which under this Part of this Act or any such schedules is to be prescribed and — (a) for prescribing what occupations are to be deemed employment in an insured trade for the purposes of this Part of this Act; and for excluding - (i) any occupations which are common to insured and uninsured trades alike, and are ancillary only to the purposes of an insured trade; and (ii) any occupations which are ancillary only to the trade carried on by the employer Avhere that trade is not an insured trade; and (iii) any occupations in businesses which, though concerned with the making of parts or the preparation of materials for use in an insured trade, are mainly carried on as separate businesses or in conjunction with trades other than insured trades; (b) as to the determination, on application being juade for the pui'pose, of questions whether contri- butions under this Part of this Act are pay- able in respect of any workman or claiss of work- men; (c) for prescribing the evidence to be required as to the fulfilment of the conditions and qualifica- tions for receiving or continuing to receive un- employment benefit, and for that purpose re- quiring the attendance of workmen at such NATIONAL INSURANCE BILL. 179 offices or places and at such times as may be § 67. prescribed ; (d) for prescribing- the manner in which claims for unemployment benefit ma}' be made and the procedure to be followed on the consideration and examination of claims and questions to be considered and determined by the insurance officei-s, courts of referees, and umpires, and the mode in Avhich any question may be raised as to the continuance, in the case of a workman in receipt of unemploj-inent benefit, of such benefit, and iJ-ciK rally for carrying this Pai't of tliis Act into effect, and any regulations so made shall have effect as if enacted in this Act. (2) The regulations ma}', with the concurrence of the Postmaster General, provide for enabling claimants of unemployment benefit to make their claims for unem- ployment benefit under this Act through the Post Office, and for the payment of unemployment benefit through the Post Olfice. 68. inempk/yment fund.} — (1) For thi' purposes of this Part of this Act there shall be established undei- llie control and management of the Board of Trade a fund called the unemployment fund, into which shall be paid all contributions payable under this Part of this Act by employers and workmen and out of moneys pro- vided by Parliament, and out of A\liich shall be paid all claims for unemployment benefit and any other payments which under this Part of this Act are payable out of the fund. (2) The accounts of the uncnipluN'ineiil fiiiid shall be audited in such manner as the Treasur} ma\ direct. (3) Any moneys forming j)art of the unemplo\'ment fund may from time to time bo paid over to the National Debt Commissioners aiul In- them iincsted in accord- n2 18U NATIONAL INSURANCE BILL. § 68. ance with regulations made by the Treasury in any " ' securities which are for the time being authorised by Par- liament as investments for savings banks moneys. (4) The National Debt Commissioners shall present to Parliament annually an account of the securities in which moneys forming part of the sai'd fund are for the tirr^e beirig invested. 69, Treasury advances.] — (1) The Treasury may out of the Consolidated Fund Or the growing produce thereof adftcmce on the security of the unemploipnent fund any sums required for the purpose of discharging the liabili- ties of that fund under this Part of this Act : Prodded that the total amount of advances outstanding at any time shall not exceed three million pounds or such larger sum m the Treasury may fix. "The Treasury may." — The benefits receivable under the Bill are not guaranteed by tlie State, but the provision in this clause is naade for the Treasnry to advance moneys to the fund to meet times of great depression of trade whereby the trade had become exhausted. (2) // whilst any part of any such advance is out- standing it appears to the Treasury that the unemploy- ment fund is insolvent, the Board of Trade shall, if the Treaswy so direct, by order, make' such temporary modi- fications in any of the rates of contribution, or the rates or periods of miemployment benefit, (md during such pWiod, as the Treasury ma if consider necessary to seeure the solvency of the unemployment fund : Provided that no order made under this siibsection shall reduce the weekly rate of unemployynent benefit below the sum of fitm shillings, or shall increfise the rates of con- tribution from employers or ivorkmen by more than one penny per toorkinan per week, and no such order shall remain in force more than three months after all the advances and, interest thereon have been repaid. NATIONAL INSURANCE IMIJ-. ' 'make such temporary modifications."— 1 he powers given §69. seem scarcely wide enuuyh. The whule scheme is a leap in the dark, and there is really no sufficient data at present on which to formu- late the contributions and benefits. Hence, if the Board of Trade find the financial basis is wrong, it seems only right that as they may not reduce the weekly benefit below os. they should be able to enforce their order for a longer period than the three months. (3) The Treamiry may for the purpose of providing fw the issue of sums out of the Consolidated Fund under this section, or for the repay meni fo that fund of aJJ or any part of the stffns so issued, or for paying off any ."teeurity issued under this seetion, so far a^' that payment i>i nut (dherivise provided for, horrou^ money by means of the issue of Exchequer hoyids or Treasury bills, and (dl sums so borrowed sliall be paid into the Exchequer . i'4 The principal of and interest on any Exchequer bonds issued under this section shall be charged on and payable out of Hie Consolidated Fund of tJie Fnited Kingdom or the growing produce thereof. ("5) Notrvithstanding anything in any other Act, money in the hands of the National Debt Commusioners for the reduction of the National Debt shall not be applied to purchasing, reducing, or paying off any Exchequer bonds or Treasury bills issued binder this section. 70. Power of em,ployers to compound at reduced 7'ates. - Any employer may in lioii of paying as they Ix'f'ome due the eonti'ibutions to which h(> is liable under this Part of this Aot in respect oi' any workman, on his own aeeount and on behalf of th<' workman, pay in advance a contribution in respect of that workman at such )v- (liHcd rat<' as is speciHcd in I*;irt II. of th(_' Eighth Schedule to this .Act or at such other Jiitc as the Board of Ti-adc. with the approviil <>{' tlir Tn'nsiii'y. iii;i\ pi'c- scribe; and wlxic sufli a. contribution has been paid by an cm|)h)y<'r. he shall be cnl it led to I'ccovci' fVoin I lie w ork- niaii III respoct of wiioiii th'' cunl n Inil ion Iims been [ciid. 1.^1 182 NATIONAL INSURANCE BILL. § 70. and to deduct from his wages, the same sums as he woukl have been entitled to recover and deduct if he had made the ordinary weekly or other periodical contributions on behalf of the workman, and the sums which he is so en- titled to deduct shall for the purposes of this Part of this Act be treated as contributions made by the workman: Provided that if in the course of the period in respect of which the contribution in advance was paid the work- man becomes entitled, or would, had he taken the neces- sary steps, have become entitled, to unemployment benefit, and is subsequently re-employed by the same employer, the contribution so paid in advance shall not cover any part of the j^eriod of such re -employment. The rebate here allowed to the employer is a very substantial one. The weekly contributions of employer and workman would amount to 1/. Is. 8(/. in the year— and as the employer is given the option of paying 15s. in respect of both, he clearly saves 6s. 8d. — in other words, his own contribution only amounts to 4s. 2rl. — but of course he runs the risk of the workman leaving his employ during the year. The rebate, of course, is given to encourage employers to keep their workmen. 71. Return of part of contributions l)y workmen in certain cases.'] — {\) Any workman who satisfies the Board of Trade that he has paid contributions in accordance with the provisions of this Part of this Act in respect of five hundred weeks or upwards shall be entitled at any time after reaching the age of sixty to be repaid the amount, if any, by which the total amount of such con- tributions have exceeded the total amount received by him out of the unemployment fund under this Act, together with compound interest at the rate of two-and- a-half per cent, per annum calculated in the prescribed manner, and such repayment may, in accordance with regulations made by the Board of Trade, be made by way of a lumjD sum payment or by way of annuity, or in lauch other manner as may be jjrescribed. NATIONAL INSURANCE HILL. 1^3 In other wordt:, the workman will get back all the money he has 8 71. paid himself, minus anj' unemployment benefits he has received, together with 2i per cent, compound interest. (2) The Board of Trade may, if they think lit, by regulations reduce the age of sixty mentioned in the fore- going' subsection to an age not less than fifty-five in the case of workmen who prove that they have finally ceased to follow any insured trade. 72. Refund of contributions paid in respect of trork- men irorking short time.] — If any employer satisfies tlve Board of Trade that during any period of depression in his trade ^^orkmen employed by him have been systemati- cally -working short time, and that during such period he lias ijaid contributions under this Part of this Act on behalf of such workmen, as well as on his own behalf, without recovering such contributions from such ANork- men either by way of deductions from wages or otherwise, there may be refunded to him out of tho unemployment fund in accordance with regulations made by the Board of Trade tho contributions so paid by him in respect of those workmen for the period or such part thereof as in tho circumstances may seem just: Provided that no such refund shall be made in respect of any workmen for any week in which the hours of work have exceeded five-sixths of the number usually recog- nised as constituting a full week's work at that time in tho trade and district. The explanatory memorandum of this Part of tlie Bill states that tho clause is to give an advantage to omploj ers who adopt the plan of working short tiiiio in times of depression instead of dis- missing some men and keeping the rest on full time, and tliat to ffiicoixrage employers to adopt this course " the contributions botli of employers and of workmen may be remitted altogether." To cany out this object words should be inserted saying what is to be remitted in tlie case of employers who have paid tho reduced contributions of ],')». for the year in respect of particnil.ii- workmen. 184 NATIONAL INSURANCE BILL. § 73. 73. Prmnsions with resp&ct to workmen engaged through labour exchanges.] — (1) The Board of Trade tnay in such cases and on such conditions as the Board may j^rescribe, make an arrangement with any employer liable to pay contributions under this Act whereby in respect of workmen engaged by him through a labour exchange, the performance of all or any of the duties required under this Act to be performed by the employer in respect of those workmen, whether on his own behalf or on belialf of the workmen, shall be undertaken on behalf of tbe employer by the labour exchange, and whereby successive periods of employment, whether of the same workmen or different workmen, may for the purposes of the employer's contributions be treated as a continuous employment of a single workman. (2; Where any such arrangement has been made, all the periods of employment during which a workman en- gaged through a labour exchange is employed by one or more employers with whom such an arrangement has been made may, on the application of the workman, be treated for the purposes of ihis contributions as a continuous period of employment under one employer. This clause is, of course, framed to encourage employers to make greater use of the Labour Exchanges. 74. Subsidiary provisions.] — (1) If the repeated failure of any insured workman to obtain or retain em- ployment appears to the insurance officer to be wholly or partly due to defects in skill or knowledge, the insur- ance officer may, if he thinks fit, offer to arrange for the attendance of the Avorkman at a suitable course of technical instruction, and may out of the unemployment fund pay all or any of the expenses incidental to such attendance. If the workman fails or refuses either to avail himself of the offer, or to produce satisfactory evidence of his competence, or if the person in charge of the course NATIONAL INSURANCE BILL. 1S5 attended by the workman reports that there is no reason- § 74. able prospect of such defects being remedied, such facts shall be taken into consideration in determining what is suitable employment for the workman. This clause, if properly worked, should be of great value iu improving the status and value of workmen who have not been properly trained. (2) The regulations of the Board of Trade made under this Part of this Act may provide for the return to a Asorkman ^\'ho is not a workman in an insured trade and to his employer of any contributions paid by them respec- tively under the belief that the workman was a workman in an insured trade. ^3) Where under reguiat ions made by the Board of Trade any sum has been paid out of the uii(mu[)Ioviiu'ii1 Fund by way of reward for the retui'n of a book or card which has been lost, the ])erson responsible for thi^ custody of the book or card at the time of its loss shall be liable to repay the sum .so paid, not exceeding one shilJinfj in lespect of any one occasion. 75. Offences.] — (1) If for the purpose of obtaining any beneHts or payment under this Part of this Act either for himself or for any other person, any person know- ingly makas any false statement or false representation, be shall be liable on summary conviction to imprisonment lor a term not exceeding three months, with or without hard laboui-. (2 ft' any emjjloy<'r or workman has faiic*! to pay any contributions wbicb he is liable undei' fin's Part of this .\(l to j)ay. oi- if any employer or workman or any other person refuses oi' neglects to comply with an\ of llic j-c- "jiiirements of this Part of tliis .\(l. oi- llif regulations madf: tlK'reunder, he shall I'oi- ciich olTcncc be liable on summary convicfir)n to a line not exceeding /en pounds, and also, when; t.lie onencc is t'adure or neylocf to make 1^^ NATIONAL INSURANCE BILL. § 75. auy contribution under this Part of this Act, to pay to the unemployment fund a sum equal to three times the amount which he has refused or neglected to pay, which sum, when paid, shall be treated as a payment in satis- faction of the contributions which he has so refused or neglected to pay. (3) Proceedings under the foregoing provisions of this section shall not be instituted except by, or with the con- sent of, the Board of Trade, and may be commenced at any time within three months of the date at which the offence comes to the knowledge of the Board of Trade. (4) Nothing in this section shall be construed as j)re- venting the Board of Trade from recovering any sums due to the unemployment fund by means of civil jn-o- ceedings, and all such sums shall be recoverable in such proceedings as debts due to the Crown. (5) If it is found at any time tliat a person has been in receipt of unemployment benefit under this Part of this Act whilst the statutory conditions were not fulfilled in his case or Avhilst he was disqualified for receiving un- employment benefit, he, or in case of his death his per- sonal representatives, shall be liable to repay to the unemployment fund any sums paid to him in respect of unemployment benefit whilst the statutory conditions were not fulfilled or whilst he was disqualified for receiving the benefit, and the amount of such sums may be recovered as a debt due to the Crown. 76. Feriodical revision of rates of contribution.] — If at any time after the expiration of five years from the commencement of this Act it appears to the Board of Trade that the unemployment fund is insufficient or more than sufficient to discharge the liabilities imposed upon the fund under this Part of this Act, or that the rates of contribution are excessive or deficient as respects any par- ticular insured trade, or any particular branch of any such trade, the Board may, with the sanction of the NATIONAL INSURANCE BILL. 187 Treasury, by special order made in manner herein-after § 76. provided revise the rates of contribution of employers and workmen under this Part of this Act, and any such order may, if the Board think fit, prescribe different rates of contribution for different insured trades or branches thereof, and where any such order is made the rates pre- scribed b}^ the order shall as from such date as may be specified in the order be substituted as respects trades or branches thereof to which it relates for the rates pre- scribed by this Act: Provided that Avhere such a revision has bet^i made no further revision under this section shall bo madie before the expiration of Rxe years from the last revision, and that no order under this section shall increase the rates of contribution from employers or workin(Mi by more than ryne penny per workman per week. 77. Powder to extend lo other lrade.9.}-Ij it appears to the Board that it is desinible to extend the proinsiom of this Part of this Act to workmen in any trade other than an insured trade the Bom'd may, ivith the consent of tJie Treasury, make, in manner hereiyi-after pro- rided, a special order extending thi^s Part of this Act /(/ such irorkmen cither without modification or subject lo such viodificatkms as may he contained in the order, and on any such order being made this Part of this . let shall, suhfect to the modifications {if any) contained in the order, apply as if the trade mentioned in the order were an insured trade and a>s if the rates and periods of benefit mentioned in the order were the rates and periods of benefit ptovidpd hi/ this Pari of IJiis Ad In respect of fiuch trade : Provided that noswjh order shall he made whk-h would, in the opini/m of the Treasury, increme the contribution to the unemphyyment fund oul of moneys provided by Parliament to n xujn exceeding one in it lion pounds a 188 NATIONAL INSURANCE BILL. § 77. year before, the expiration oj l)hme yews fro-m the making of the order. 78. Procedure for making special orders.^} — (1) Sec- tions piglity and eighty-one of the Factory and "Workshop Act, 1901, relating- to the making of regulations under that Act, as set out and adapted in the Ninth Schedule to this Act, shall apply to special orders made under this Part of this Act. (2) Before a special order comes into force it shall be laid before both Houses of Parliament for a period of not less than thirty days during the session of Parlia- ment, and if either of those Houses before the expiration of those thirty days presents an address to His Ma;jesty ajgiainst the order or any pari thereof, no further pi'o- ceedings shall be taken thereon, without prejudice to the making of any new order. 79. Arrangements ivith associations of workmen in insured trade waking pm/ments to members tvhilst un- employed.] — (1) The Board of Trade may, on the appli- cation of any association of workmen the rules of which p'rovide for payments to its members, being workmen in an insured trade, or any class thereof, whilst unemployed, make an aiTangement with such association that, in lieu of paying unemployment benefit under this Part of this Act to w'orkmeii who prove that they are members of the association, there sliall be repaid periodically to the asso- ciation out of the unemployment fund such sum as ap- pears to be, as nearly as may be, equivalent to the aggre- gate amount which such workmen would have received during that period by way of unemployment benefit under this Part of this Act if no such arrangement had been made, but in no case exceeding two-thirds of the amount of the payments mad© during that period by the associa- tion to such workmen as aforesaid whilst unemployed. (2) The council or other governing body of any asso- NATIONAL INSURANCE BILL. 1^9 elation of workmen which has made such an arrangement § 79. as aforesaid shall be entitled to tv(>at the contributions due from any of its members to the unemployment fund under this Part of this Act, or any part thereof, as if such contributions formed part of the subscriptions pay- able by those members to the association, and, notwith- standing anything in the rules of the association to the contrary, may reduce the rates of subscription of those membei"s accordingly. (3) For the purpose of determining whether a work- man has exhausted his right to unemployment benefit under this Part of this Act, the amount of any sum which, but for this section, would have been paid to liiin by way of unemployment benefit shall be deemed to have been 60 paid. (4) The Board of Trade may make regulations for giving effect to this sectioii, and for determining the mode in which (juestions arising under this section shall be settled . 80. Repayments to associations making paymenh /<> P'ersons, whether workmen in insured trade, or not, whilsi imemployed.\—{l) The Board of Trade may with the consent of the Treasury, and on such conditions and cither annuatty or at such other intervals as the Hoard may prescrihe, repa// oat of moneys provided f)y Parlia- ment to any assori/ition of persons not trading for profit the rul.es of /rhich provide for paym,ents to persons whilst unemptoyed, whether mjrkynen in an insured trade or not, such part [in no case exceeding one-sixth) as they think fit, of the aggregate amount which the association has expendcA on such payments during the preceding year or other prescribed period, exclusive of the sum {if any) repaid to the association in respect of such period in pur- suance of an (nrang.ement under the tast foregoing section, an'/ crrlusivr in the case of i)(/i/inr}its whirh exceed I leeJvc l^'O NATIONAL INSURANCE BILL. § 80. shillings a week of so much of those payments as exceeds that mm. (2) No repayment shall be made under this section in respect of any jjeriod before the commencement of this Act. (3) The Board of Trade may make regulations fo]" giving effect to this section, and for determining the mode in which questions arising under this section shall be settled . So far the clauses in this Part of the Bill have aU related to compulsory insurance against unemployment in the insured trades ; but this clause encourages voluntary insurance in any trade. 81. Interpretation and application ?j — (1) For the pur- poses of this Part of this Act — The expression " workman " means any person of the age of eighteen or upwards employed wholly or mainly by way of manual labour, who has entered into or works under a contract of service or ap23i'enticeship with an employer, whether the con- tract is expressed or implied, is oral or in writing, and in relation to a person whilst unemployed means a i^erson who, when employed, fulfilled the conditions aforesaid ; Contributions made by an employer on behalf of a workman shall be deemed to be contributions by the workman; Two periods of unemployment of not less than two days each, separated by a period of not more than two days, or two jjeriods of unemplojanent of not less than one week each, separated by an interval of not more than six weeks, shall be treated as a continuous period, and the expression " con- tinuously unemj^loyed " shall have a corresponding meaning; Temporary work provided b}' a central bod}' or dis- NATIONAL INSUKANCE BILL. 191 tress committee under the Unemployed Workmen § 81. Act, 1905, or towards the provision of which any such central bodv or distress committee has con- tributed under that Act, shall not be deemed to be employment in an insured trade. (2) This Part of this Act shall apply to workmen em- plojed by or under the Crown to whom this Act would apply if the employer were a private person, except to such of those workmen as are serving in an established capacity in the permanent service of the Crown, subject, however, to such modifications as may be made therein by Order in Council for the purpose of adapting the [H'd- visions of this Part of this Act to the case of such workmen . Part III. GENERAL. 82. Provisiom as to stamps.] — Stamps required for the purposes of this Act shall be prepared and issued in such manner as the Commissioners of Inland Revenue with the consent of the Treasury may direct, w ho may pvox ide for applying, witli the necessary adaptations, as respects sucli stamps, all or any of tiie pi'ovisions (including penal ])rovisions^ of the vStamp Duties Management .\(t, 1891, ns amended by any subsequent Act. and section sixfy-fivc of the Post Ollice Act, 1908, and ujuv with the eonsentor th(! Postmaster-General provide for the s;ih' of such st^amps through the Post Office. 83. Outdoor relief.] — In granting outdoor relief lo a person in receipt of or entitled to nu-eive any himlii under this Act, a board of guardians in England shall not take into considcmtion any such benefit, except so far as auch l)cnefit oxcocds five shillings a week. 193 NATIONAL INSURANCE BILL. § 84. 84. Priority of claims for contributions due by banlc- nipt employers. \ — (1 ) There shall be included among the debts which, under section one of the Preferential Pay- ments in Bankruptcy Act, 1888, and section two hundred and nine of the Companies (Consolidation) Act, 1908, are, in the distribution of the property of a bankrupt and in the distribution of the assets of a company being- wound up, to be paid in priority to all other debts, all contributions payable under this Act by the bankrupt or the company in respect of employed contributors, work- men in an insured trade during the four months before the date of the receiving order, or as the case may be, the commencement of the winding up, and those Acts shall have effect accordingly. (2) In the case of the winding up of a company within the meaning of the Stannaries Act, 1887, such contribu- tions as aforesaid shall, if payable in respect of a min,er, have the like priority as is conferred on wages of miners by section nine of that Act, and that section shall have effect accordingly. (3) This section shall not apply where a company is wound up voluntarily merely for the purposes of recon- struction or of amalgamation with another company. (4) In the application of this section to Scotland a reference to section three of the Bankruptcy (Scotland) Act, 1875, shall be substituted for the reference to section one of the Preferential Payments in Bankruptcy Act, 1888. (5) In the application of this section to Ireland a refer- ence to section four of the Preferential Payments in Bankruptcy (Ireland) Act, 1889, shall be substituted for the reference to section one of the Preferential Payments in Bankruptcy Act, 1888; and any reference to a bank- rupt shall include a reference to an arranging debtor; and the reference to the receiving order shall be construed as a reference to the order of adjudication in the case NATIONAL INSUKANCE BILL. 193 of a bankru23t, or to the filing of tlie petition for arrange- § 84. ment in the case of an arranging debtor. 85. Benefits to he inaUenable.] — Every assignment of, or charge on, and every agreement to assign or charge, any of the benefits conferred by this Act shall be void and on the bankrujjtcy of any pci-son entitled to any such benefit, the benefit shall not pass to any trustee or other person acting on behalf of his creditors. 86. Poivers of inspectors.] — (1) An inspector ap- pointed under this Act shall, for the purposes of the execution of this Act have power to do all or any of the following things, namely: — (a) to enter at all reasonable times any premises or place where he has reasonable grounds for sup- posing that any emj)loyed contributors or work- men in an insured trade are employed; (b) to make such examination and inquiry as may be necessary for ascertaining Avhether the provi- sions of this Act are complied Avith in any such premises or place; (c) to examine, either alone or in the presence of any other person, as he thinks fit, with respect to any matters under this Act, every person whom he finds in any such premises or place, or whom he has reasonable cause ix> believe to be or to have been an employed contributor or workman in an insured trade, and to require every such person to bo so examined, and to sign a de- claration of the truth of the matters in respect of which he is so examined; (d) to exercise such other powers as may be necessary for carrying this Act into effect. (2) The occupier of any such premises or place and any otlier p^'rson employing any om ployed contributor or workman in an insured trade, and the servants and W. 194 NATIONAL INSURANCE BILL. § 86. agents of any such occupier or otlier person, and any cmijloyed contributor or workman in an insured trade shall furnish to any insijector all such information and shall produce for inspection all such registers, books, cards, and other documents as the inspector may reason- ably require. (3) If any person wilfully delays or obstructs an in- spector in the exercise of any power under this section or fails to give such information or to produce such docu- ments as aforesaid, or conceals or prevents or attempts to conceal or prevent any person from appearing before or being examined by an inspector, he shall be liable on summary conviction to a fine not exceeding five pounds : Provided that no one shall be required under this section to answer any question or give any evidence tending to incriminate himself. (4) Where any such premises or j)lace are liable to be inspected by inspectors or other officers, or are under the coritrol, of some other Government department, the In- surance Commissioners or Board of Trade may make arrangements with that other Government department for any of the powers and duties of inspectors under this section being carried out by inspectors or other officers of such other Government department, and where such an arrangement is made such inspectors and officers shall have all the powers of an inspector under this section. 87. Short title and commencement.^ — This Act may be cited as the National Insurance Act, 1911, and shall, save as otherwise expressly provided by this Act, come into operation on the first day of May nineteen hundred and twelve. NATIONAL INSURANCE BILL. 195 SCHEDULES. FIRST SCHEDULE. Sc hedules. Part I. EMPLOYMENTS WITHIN THE MEANING OF PART I. OF THIS ACT RELATING TO HEALTH INSURANCE. (a) Employment in the United Kingdom, or on auj' ship registered in the United Kingdom, or on any other British ship or vassel of which the owner, or (if there is more than one owner) the managing owner or manager, resides or has his principal place of business in the United Kingdom, under any contract of service or apprentice- ship, written or oral, whether expressed or implied, and whether paid by the employer or some other person, and Avhether under one or more employers, and whether paid by time or by the piece or without any money payment. (b) Employment as an outworker in such classes of work as may for the time being be specified in any special order made under Part VI. of the Factory and Workshop Act, 1901. (c) Employment in llie United Kingdom in plviug for hire with any vehicle or vessel the use of which is obtained Troin the owner thereof under any contract of bailment (or in Scotland any contract of lotting to hire) in coji- sidcration of the payment of a fixed sum or a share in the earnings or otherwise, in whicli case the owner shall for the purposes of Part I. of this .Vet be deemed to be the employer. o 2 196 NATIONAL INSURANCE BILL. Schedules. Part II. EXCEPTIONS. (a) Employment in the naval or military service of the Crown, including service in Officers' Training Corps, but excluding service in the Naval Reserves, the Army Reserve, and the Territorial Force excejjt when called out on actual service or on ijermanent service or on embodiment. (b) Employment under the Crown or any local or other public authority where the Insurance Commissioners certify that the terms of the employment are such as to secure provision in respect of sickness and disablement on the whole not less favourable than the corresponding benefits conferred by Part I. of this Act. (c) Employment as a teacher to whom the Elementary School Teachers Superannuation Act, 1898, or a scheme under section fourteen of the Education (Scotland) Act, 1908, or the National School Teachers (Ireland) Act, 1878, ajjplies. (d) Employment as an agent not ordinarily engaged in any other regular employment jDaid by commission or fees or a share in the profits, or partly in one and partly in another such ways, and not being ordinarily employed by one employer onlj^ (e) Employment in respect of which no wages or other money payment is made where the employer is the occu- pier of an agricultural holding the annual value of which as assessed for the purposes of Schedule A. of the Income Tax Acts is less than tiventy pounds or where the em- ployer is the parent of, or person liable to maintain, the person employed and that person is under the age of sixteen . (f) Employment otherwise than by way of manual labour and at a regular salary or other fixed rate of re- NATIONAL INSURANCE BILL. 197 muneration exoeeclino- onr hnndred and sirf// ponnd.'^ a Schedules, year. (g) Employment of a casual nature otherwise than for the purposes of the employer's trade or business, and otherwise than for the purposes of anj^ game or recrea- tion where the persons employed are engaged or paid through a club, and in such case the club shall be deemed to be the employer. SECOND SCHEDULE. RATES OF CONTRIBUTION UNDER PART T. OF THIS ACT RELATING TO HEALTH INSURANCE. Employed Rate. In the case of men: 7d. a week. In the case of women: 6d. a week. Contributions hy Employers and Employed Contributors. To be paid by the contributor: Men, Ad. a week; women, 3c?. a week. To be paid by the employer: 3c?. a week. In the case of employed contributors of cither sex over the age of 21 wliose wages or other remuneration do not exceed 2.?. i^d. a day and wiio are not provided with board and lodging by their employer, the following shall be the rates of contribution: — Wliorc the wages oi' oilier iciiiiiiicr;il ion ihj not cxccvid Is-. 6c/. a day — To bo j)aid h\ tiii' i'iiij>l(jy<'r : For iim'ii, (i^/. ;i wi.'ck; for women, Ad. a week. To lio jKiid by tlif contributor: id. a week. 198 NATIONAL INSURANCE BILL. Schedules. Where the \vage.s or other remuneration do not exceed 2s. a day — To be paid by the employer: For men, 6d. a week; for women, 4:d. a week. To be paid by the contributor: 2d. a week. Where the wages or other remuneration do not exceed 2s. (id. a day — To be paid by the employer: For men, 4d week; for women, 3d. a week. To be paid by the contributor: 3r7. a week. a THIRD SCHEDULE. RULES AS TO PAYMENT AND RECOVEBY OF CONTRIBUTIONS PAID BY EMPLOY'ERS ON BEHALF OF EMPLOYED CON- TRIBUTORS UNDER PART I. OF THIS ACT RELATING TO HEALTH INSURANCE. (1) The employer shall, except as herein-after pro- vided, be entitled to recover from the employed contri- butor the amount of any contributions paid by him on behalf of the employed contributor. (2) Except where the employed contributor does not receive any wages ,or other remuneration from the em- ployer, the amounts so recoverable shall, notwithstanding the provisions of any Act relating to truck or any con- tract to the contrary, be recoverable by means of deduc- tions from the wages or other remuneration, and not otherwise; but no such deductions may be made from any wages or remuneration other than such as are paid in respect of the period or part of the period in respect of which the contribution is payable, or in excess of the sum which represents the amount of the contributions for the period in respect of which the wages or other re- muneration are paid. NATIONAL INSURANCE BILL. 199 (3) Where a contribution paid by the employer on Schedules, behalf of an employed contributor is not recoverable by means of deductions as aforesaid, it shall (without pre- judice to. any other means of recovery) be recoverable summarily as a civil debt, but no such contribution shall be recoverable unless proceedings for the purpose are in- stituted within three months from the date when the con- tribution was payable. (4) Where the contributor is employed by more than one employer in any calendar week, the first person em- ploying him in that week or such other employer as may be prescribed shall be deemed to be the employer for the purposes of the provisions of Part I. of this Act relating to the payment of contributions and of this schedule. ' ' the first person .... or such other employer as may be prescribed." — In my opiniou this section requires careful con- sideration. As drawn, it may prove very harmful to the casual and other labourers. Employers will not be anxious to be the first person in the week to employ such labourers, and the effect may be to force down the wages of the workman. "as may be prescribed." — Surely it would be better to thoroughly discuss this question in Parliament instead of leaving the decision to be made elsewhere. (5) Regulations of the Insurance Commissioners may provide that in any cases or any classes of cases where employed contributors work under the general control and management of some person other than their immediate employer, such person shall, for the purposes of the pro- visions of Part I. of this Act relating to the payment, of contributions and of this schedule, be treated as the employer, and may provide for allowing liini to deduct the amount of any contributions which he may become liable to pay from any sums payable hy him to the imme- diate employer, and for enabling tlie immediate em- ployer to recover from the employed contributors the like sums and in the like manner as if he were liable to pay the contributions. 200 NATIONAL INSURANCE BILL. Schedules. (6) Where the contributor is not paid wages or other money payments by his employer or any other person, the employer shall be liable to pay the contributions pay- able both by himself and the contributor, and shall not be entitled to recover any part thereof from the con- tributor. (7) Notwithstanding any contract to the contrary, the employer shall not be entitled to deduct from the w^ages of lOr otherwise to recover from the contributor the em- ployers' contribution . (8) Any sum deducted by any employer from wages or other remuneration under this schedule shall be deemed to have been entrusted to him for the purpose of paying the contribution in respect of which it was deducted. FOURTH SCHEDULE. BENEFITS UNDER PART I. OF THIS ACT RELATING TO HEALTH INSURANCE. Part I. Rates of Benefits. Table A. — Ordinary Mates. Sickness benefit: during the first thirteen weeks the sum of 10s. a week for men, and the sum of 7^. Qd. for women: for the second thirteen weeks, 5s. a week for men and women alike. Disablement benefit — the sum of O.s. a week for men and women alike. NATIONAL INSURANCE BILL. Table B.— Reduced Rates in the case of Young Persons. Sickness benefit — for males, the sum of 5s. a week throughout the whole period of twenty-six Aveeks. for females, the sum of 4.s. a week throughout the whole period of twenty-six weeks. Disablement benefit — for females, the sum of 45-. a week. Table C. — Reduced Rates for Persons over Fifty in certain cases. Where the insured person is over 50 and under 60 — For men, the sum of Is. a week during the first thirteen weeks, and o.s. a week during the second thirteen weeks. For women, the sum of 6.?. a week during the first thirteen weeks and 6s. a week during the second thirteen weeks. Where the insured person is over 60 — For both men and women the sum of 6s. a week throughout the whole period of twenty-six weeks. See clause 9 (3). This reduction only applies to sickness benefit. Tt does not modify the right of those persons to disablement l)enpfit : that will still bo jiayable at the full i-nte. Part 11. Addit ional Bene fits . (1) Medical treatment .mhI attendance for any persons dependent upon thf^ labour of a. member. (2) An increase of sickness benefit or (lisablcnicnl 201 Schedules. 202 NATIONAL INSURANCE BILL. Schedules, benefit in tlie case either of all members of the society or of such of them as have any children or any specified number of children wholly or in part dependent upon them. (3) Payment of sickness benefit during the second thirteen weeks of disease or disablement at the same rate as during the first thirteen weeks thereof, or from the first, second, or third day after notice of disease or dis- ablement. (4) An increase of maternity benefit. (5) Allowances to a member during convalescence from some disease or disablement in respect of which sickness benefit or disablement benefit has been payable. (6) The building or leasing of premises suitable for convalescent homes and the maintenance of such homes. (7) An addition to old age pensions payable under the Old Age Pensions Act, 1908; or the payment of old age pensions at an earlier age than seventy years with an option to the person entitled to take in lieu of such earlier payment a proportionately increased pension at a later age. (8) Payments to members v/ho are in want or distress. (9) Payments for the personal use of a member who, by reason of being an inmate of a hospital or other in- stitution, is not in receipt of sickness benefit or disable- ment benefit. NATIONAL INSURANCE BILL. 208 Schedules.. FIFTH SCHEDULE. REDUCTION OR POSTPONEMENT OF SICKNESS BENEFIT AND WHERE CONTRIBUTIONS ARE IN ARREAR. Table . (1) (2) Where the ArrearB amount to Rates of Sickness Benefit during first Thirteen Weeks. Men. Women. 4 contributions a year on average .. .. G 7 8 9 10 II 12 18 s. (1. 9 6 9 8 6 8 ■V 6 7 6 6 6 5 6 5 V 6 9 6 6 6 8 6 5 9 5 6 5 3 r> I) )> 5s. , commenciu g 5th day after notice 'T3 6th „ § 7th „ a • 8th ,. 21 9th „ ll'th ,, 11th „ b 12th ,, ^ 13th „ \ 14th ,, Notes. Where tho insured j)ersoii is by virtue of any of tli(> provisions of Part F. of this Act, other than those rc- hiting to arrears, entitled to sickness benefif mI a rate lower than thf full rate, this table shall ha\e elloct as if the entries in the first column were so shifted down that tho first entry therein wa.s set opposite the entry in 204 NATIONAL INSURANCE BILL. Schedules, the second coluuiii next below the entry specifying the rate of sickness benefit to which the insured person is entitled . When the rate of sickness benefit during the first thirteen weeks to which the insured person is entitled is by virtue of any of the provisions of this Act, other than those relating to arrears, less than 5s. a week, this table shall have effect as if such lower rate were therein sub- stituted for the rate of 5s. a week. See clause 10. This schedule is only in respect of an employed contributor. The reductions in the case of voluntary contributors have not yet been prescribed. SIXTH SCHEDULE. LIST OF INSURED TRADES FOR THE PURPOSES OF PART II. OF THIS ACT RELATING TO UNEMPLOYMENT INSUR- ANCE. (1) Building; that is to say, the construction, altera- tion, repair, decoration, or demolition of any building or any part thereof. (2) Construction of works; that is to say, the con- struction, reconstruction, or alteration of railroads, docks, harbours, canals, embankments, bridges, piers or other works of construction. (3) Shipbuilding; that is to say. the construction, alteration, repair oi- decoration of ships, boats or other craft or any parts thereof, and of the tackle thereof, by persons not being members of a ship's crew. (4) Mechanical engineering, including the manufacture of ordnance and firearms. (5) Construction of vehicles; that is to say, the con- struction and decoration of vehicles or any parts thereof. NATIONAL INSURANCE BILL. 205 Schedules. SEVENTH SCHEDULE. RATES AND PERIODS OF UNEMPLOYMENT BENEFIT. In respect of each week following tlie first week of unemployment: — in the case of a workman engaged in building or con- struction of works: 6s. in the case of a workman engaged in mechanical en- gineering, shipbuilding, or construction of vehi- cles: 7s. or such other rates as may be prescribed either generally or for any particuLar trade or any branch thereof. No workman shall receive unemployment benefit for more than fifteen or such other number of weeks as may be prescribed either generally or for any particular trade or branch thereof within any period of twelve months, or in respect of any period less than one day. No workman shall receive more unemployment benefit than in the proportion of one week's benefit for every five contributions paid by him under this Act, or in such other proportion as may be prescribed either generally or for any particular trade or branch thereof. Provided that for the purpose of the foregoing para- graph — (a) in the case of a workman who satisfies the Board of Trade that he has habitually worked at an insured trade before the passing of this Act, there shall be deemed to be added to the number of contributions which he has actually paid five contributions for each period of three months or part of such period during which he has so worked before the passing of this Act, up to a maximum of twenty-five contributions; and (b) where contributions are paid under Part II. of this Act in respect of any workman at intervals 206 NATIONAL INSURANCE BILL. Schedules. greater than a week, that workman shall be en- titled to treat each contribution as so many con- tributions as there are weeks in the intervening period. Any time during which a workman is under Part II. of this Act disqualified for receiving unemployment bene- ht shall be excluded in the computation of time under this schedule. A period of unemployment shall not be deemed to oam- mence till the workman has made application for un- employment benefit in such manner and fulfilled such other conditions as may be prescribed. The power conferred by this schedule on the Board of Trade to prescribe rates and periods of unemployment benefit shall not be exercised so as to increase the rate of benefit above eight shillings per week or reduce it below six shillings per week, or to increase the period of un- employment benefit above fifteen weeks, or to alter the proportion which the period of benefit bears to the number of contributions paid, except by rules confirmed by an order made in accordance with the provisions of Part II. of this Act relating to special orders. EIGHTH SCHEDULE. OONTRIBUTIONS FOR THE PURPOSES OF PART II. OF THIS ACT RELATING TO UNEMPLOYMENT INSURANCE. Part I. RATES OF CONTRIBUTION FROM WORKMEN AND EMPLOYERS. From every workman employed in an insured trade for every week he is so employed,. 2^d. NATIONAL INSURANCE BILL. 207 From every employer by whom one or more work- Schedules, men are employed in an insured trade, in respect of each workman, for every week he is so em- ployed, 2hd. Every such period of employment of less than a week shall for the puq>oses of this part of this schedule be treated as if it were employment for a whole week. Part II. RATE OF REDUCED CONTRIBUTION BY EMPLOYER. For the calendar year or any part thereof, 15s. NINTH SCHEDULE. PROVISIONS OF THE FACTORY AND WORKSHOP ACT, 1901, APPLIED TO SPECIAL ORDERS MADE UNDER PART II. OF THIS ACT RELATING TO UNEMPLOYMENT INSUR- ANCE , 80. — (1) Before the Board of Trade make any special order under this Act, they shall publish, in such manner as they may think best adapted for informing- persons affected, notice of the proposal to make the order, and of the place where copies of the draft order may be ob- tained, and of the time (which shall be not less than twenty-oue days) within which any objection made with respect to the draft order by or on behalf of persons affected mu.st be sent to the Board of Trade. (2) Every objection um.^t be in writing and state — (a) the draft order or portions of draft order ob- jected to; (b) the spc^cific grounds of objection; and (c) the omissions, additions, or modifications asked for. 208 NATIONAL INSURANCE BILL. Schedules. (3) The Board of Trade shall consider any objection made bj or on behalf of any persons apjj earing to them to be affected which is sent to them within the required time, and they may, if they think fit, amend the draft order, and shall then cause the amended draft to be dealt with in like manner as an original draft. (4) Where the Board of Trade does not amend or with- draw ,any draft order to which any objection has been made, then (unless the objection either is witlidrawn or appears to them to be frivolous) they shall, before making the order, direct an inquiry to be held in the manner herein-after provided. 81. — (1) The Board of Trade may appoint a com- petent person to hold an inquiry with regard to any draft order, and to report to them thereon. (2) The inquiry shall be held in public, and any ob- jector :and any other person who, in the opinion of the person holding the inquiry, is affected by the draft order, may appear at the inquiry either in person or by counsel, solicitor, or agent. (3) The witnesses on the inquiry may, if the person holding it thinks fit, be examined on oath. (4) Subject as aforesaid, the inquiry and all proceed- ings preliminary and incidental thereto shall be conducted in accordance with rules made by the Board of Trade. (5) The fee to be paid to the person holding the in- quiry shall be such as the Board of Trade may direct and shall be deemed to be part of the expenses of the Board of Trade in carrying this Act into effect. 209 APPENDIX A. NATIONAL INSURANCE BILL. App. A. Explanatory Memorandum. Health Insurance Scheme. 1. Objects. The Bill is intended to effect as wide au insurance as possible of the working- population ag-ainst sickness and breakdown. It is also intended to make the Bill as ^'ar as possible a preventive measure operating to reduce the amount of sickness. Both the Majority and Minoi'ity Reports of the Poor Law Conuuission call special aitention to the utter inadequacy of our methods for preventing- and curing- sickness amongst the industrial classes. This Bill contains several provisions designed to amend this unsatisfactory state of things. In other words, it is, as described in the title, a Bill for "National Iloulth Insurance and the Pre- vention of Sickness,"' the title " Invalidity Insurance" being- by no means a suitable one for English purposes. The plan differs from the German scheme of sickness and invalidity insurances in the following respects:— (1.) It is proposed that uiuhn- ])roper sai'eguai'ds the administration of the fund should bo handed over to the jgi'eat friendly societies either already estab- lished in this country or hereafter to be founded under the Act. As all deficits due to raalino-ering will have to be borne either in levies or loss of benefits l)y the members of a defaulting- society, and nol by the Slate or the emj)loyor, (hero is every inducement to economy. Bad manageniont will be promptly and effectively penalised. Good management will bo rewarded. In Germany the .system is much more bureaucratic in its management, and does not nearly to the same oxfont adopt the principle (jf self-govornrnont . W. P 210 NATIONAL INSURANCE BILL. App. A. (2) 111 starting- a universal scheme there must neces- — sarily be a very heavy burden during the earlier years of its operation, owing to a large number of persons entering it at an age when their con- tributions are actuarially inadequate to ensure the benefits guaranteed by the Bill. Unless financial arrangements are made to liquidate the loss so arising it will fall on future generations of in- surers. The finance of the present scheme will be so arranged that the deficiency inevitable in starting a scheme which includes all ages shall in fifteen to sixteen years be completely wiped out. At the end of that period the administrators of the funds Avill be in a position to declare increased benefits, e.g., the reduction of the pension age. (3.) The fact that the superannuation of all persons over 70 is undertaken by the Government in this country, whereas in Germany it is a burden on the contributory scheme, makes an enormous difference in the rates of weekh' payments, which suffice -under the proposed scheme to produce higher benefits than those conferred by the German scheme. Moreover, the German Government makes no contribution to the cost of sickness as distinguished from invalidity, whereas the present scheme proposes to pay one-quarter of such cost in the case of women and two-ninths in the case of men. (^4.) There are sev^eral other points of difference between this scheme and the German .system, e.g., it is not [)roposed to adopt the German plan of dividing the industrial population into four classes accord- ing to the rate of wages earned — and not, as in Gerniau}^ to set up separate machinery for sick- ness and invalidity. By raking this course, and by the macliinorv Avhicii has been adopted for the collection of contributions, the inconvenience and trotible likely to be caused to employers will be greatly diminished. There are other points of variation, notably in the measure of control given to the workmen, which will appear later on. Another paper is being circulated to give particulars of the Gorman insurance. APPENDIX A. 2^11 App. A. 2. Scope of Scheme. The Bill will extend to the whole of the United Kiugdom. The Bill will jjartly rest upou compulsiou. It is pro- posed that the insurance moneys should in part be collected at the source bv deductions from wao-es. It is therefore necessary to decide how far this compulsion should go, that is, what classes of persons should be compulsorily included and what shoidd be the position of persons who choose to join the scheme voluntarily. The following proposals are made : — The compulsory deduction ftom wages will extend to all persons of whatever nationality^ under contract of service, whether paid by the hoiu", day, week, month, or year, to include artisans, mechanics, miners, clerks, shop assistants, servants, sailors in the mercantile marine, uupensionable employees of local authorities, railway employees, golf caddies, &c., &c. The compulsor}- deduction will also extend to otit-workers in such classes of work as may be covered by order of the Home Office imder the Factory- and Workshop Act, 1901. It will also include cases of joint emplojnient, e.g., em- ployment in a mine through gangers, the mine-owner being* made responsible. It will not extend to — (1.; Agents paid by commission or fees, and employed by more than one employer. {2.) Such persons as washerwomen, sempstresses, &c., executing small orders on their own account. (3.; Wives eniphned by husbands. (4.) Extremely precarious personal employments, e.g., luggage carriers, not connected with a trade or business. (.3:j Casual domestic emj)loyment. (6. J Jobbing occupations, e.g.. gardeners, if working (jn their own acctnml . I 7.) Persons receiving- more than JfiO/. a year I'roni their em|»loyers by way of salary. (8.) Soldiers and .sailoi-s, who will be dealt with se])a- rately. A reduced deduclioit from wages will be made \n these cases Tthe soldier, saihn", &c. being cared for while in (he service of the Crown j (o proviPration the special machinery necessary for APPENDIX A. 215 dealiug with such deficiencies, viz., levies upon members App. A, or reduction of benefits belo^\■ the standard schedule. : — -^ The additional benefits Avill include such benefits as the following: — (1.) Free medical attendance for dependants. (2.'') Benevolent fund for distressed members. (3.) Extension of period of full sick pay to 26 weeks; granting- sick pay from first or second day of sickness; increasing sick pay either in all cases or in the case of man-ied men Avitli largo families . (4.) Convalescent allowances in selected or necessary cases. Building and maintaining convalescent homes . (5.) "Pocket money" for men in hospital or conva- lescent homes, who are being paid for. (6.) Additional invalidity or superannuation benefit, or addition to old ag-e pension. For instance, the societies might (^\hen their funds permit) begin to gi'ant a j^ension before 70, Avith an option to the i-ecipient of taking an increase to his old age pension if he prefers to wait till 70. (7.) An extension of the maternity benefit. The Bill will require the societies to grant a reduced bene- fit under (c) and (d) in cases where those benefits are more thati two-thirds of the Avages earned bv the iiisiirod person — compensation for the reduction being made l)y the grant of one or more additional lienefits of a vakic equivalent to the reduction. The insurance office's consent would be necessary to any such adjustment of benefits. The poAver so granted may also lie used in nflior cases with the consent of the insurance office. The Bill Avill specify some of the conditions under which the benefits Avill 1)C payable, the remainder of the conditions for the minimum benefits and all condififins for (ho grant of additional liem.'fifs being left to regulations to be drawn uj) with the hclj) of the committee to be appointed under the Bill (nee later under tlio liciuliMg " ATiscollancdUs," p. 2.'),'5i. All societies in aflminisicring the l^enefils will be required to conform to tliose conditions Avhich arc embodied in the Bill or regulations. Tliose of them Avhich are not so ])re- scribed will be left to the rules of tlie sofioties: (a,) Medical attendance. — This will commence on entry into insurance ^except for the first six months of flic operation of the Act), and run throughout life. (h) The rules as to sanatoria Avill be made by the "' Local Health Committee," as to Avhicli see later. 216 NATIONAL INSURANCE BILL. App. A. (c) and (d) Temporary and permanent sickness.— The — ^- _™ folloAving rules or regulations will apply:— (i.) That notice of sickness must be given to the society. (ii.) That sick pay will only commence as from the fourth day after such notice has been de- livered ; no payment being in fact made for the first three days. (iii.) That the member must prove that he has been rendered unfit to provide his maintenance by some specified sickness or physical or mental dis- ablement. (iv.) Hules will be sanctioned to ])rescribe the periods for which a doctor's certificate will be re- quired, i.e., whether a certificate must he produced once a week, or once a fortnight; and to deal with the ease of members resident at some distance from the offices of their society. (v.) Rules will be sanctioned for the behaviour of members during- sickness, but strict compliance Avitli the directions of the doctor will be required. Societies will have to arrange for women visitors to visit women. (vi.) A waiting jjeriod of six months has been laid doAvn for the temporary sickness benefit, and of two years for the permanent invalidity benefit. (vii.) Societies will be allowed to follow their own rules for refusing- sick pay in the case of sick- ness brought on by the member's own misconduct. They will, however, be required to g-ive medical attendance in such cases, even if sick pay is re- fused. (viii.) If a member has received temporary sick pay and recovered from his sickness and falls sick a second time, such second sickness will be reckoned as continuous with the first, unless a period of 12 months has elapsed and the member has followed his usual occupation and paid his contribiitions. (ix.) The societies will be given power to im- pose fines not exceeding 20 shillings for repeated offences and to suspend payment of benefit for a period of not more than one year for any violation of the above conditions, or for imi^osing on the funds, or for refusing to obey the rules of the society. They will also be given power of expul- sion as indicated later. (x.) Sick pay (temporary and permanent) will not be paid except by way of advance to persons APPENDIX A. 217 entitled to coinpeusatiou under Act of Parliament App. A. or the connuon la^v, unless the amount of such compensation is less than the benefit to which the member is entitled, when the difference will be made up. Advances will be recoverable by legal process or deducted from future benefits. Alternatives have been inserted giving- the societies power (1) to take legal action in support of a member's claim, and (2) to refuse payment of benefit if the person injured does not take action. The societies will of course be liable to costs if they take action and lose the case. If they win the ca.se they Avill be made trustees of any sum awarded. Also, the consent of the society has been made necessary for the acceptance of any lump sum in voluntary commuta- tion of a weekly payment, and it has been left to the societies, subject to ap])eal, to determine the amount of the set-off from benefits under this Act Avhen a lump sum is paid. Where a lump sum is awarded by the Court, the award will be communicated to the approved society con- cerned . (e) Maternity benefit. — Societies will not be allowed to [)ay tliis benefit in ca.sh to tlie insured person or her husband, l)ut will be reqiiired to pay expenses incurred up to the sum of 30.S. imder prescrilied conditions. Non-assignment of Benefits. A clause has been inserted prohibiting the sale, transfer, pledging, or assignment of benefits. A clause is also inserted to the effect that when a member becomes an inmate of a hospital, asylum, infirmary, or work- house under the charge of any public authority, or of any charity, no money benefit shall be allowed unless he has a wife or children or other relatives dependent upon him for support, Avhen the amount duo shall be paid for their relief iijid maintenance. Societies will be giv(Mi [)ower to make agreements to pav the mojiey benefit towards the maintcziancc of members who ai'o taken into convalescent homes whose rules require the payment of at least one-half of the cost of maintenance; and also, they Avill 1)0 autlioriso<^l to grant subserij)tions, at tlieir discretion, to ho8[)itals anrocity with colonies and foreign countries having state schemes (jf insurance. Persons iji receipt of permanent sick alhnvances going abrijad without the consent (if llicir societies will forfeit l)enelit,s. I iiccsLmciils. Any sums staniiig Acts. 224 App. A. NATIONAL INSURANCE BILL. Equalising Clause as between Societies accepting Members of Different Ages. Inasmuch as societies will be allowed to retain their own indepeiidence and carry on business in the method to which they are accustomed, some arrangements must be made to equalise the position as between societies consisting of old or of young members. If there were only one fund and one society no difficulty would arise. The age distribution of such a society would be normal at the commencement, and as it would get its full and proper proportion of new entrants it would remain normal throughout. But as it is, there are over 20,000 societies and branches with the greatest pos- sible variety in age distribution. It is not proposed to break up and reconstitute these societies, nor is it desirable or necessary to do so. But it is necessary to put every society on exactly the same footing: — (1.) For the pui'pose of the State valuation. (2.) As regards its financial position if it takes the older lives into insurance. This has been effected in the following way: — Inasmuch as the State is covenanting to pay two-ninths of the benefits for men (one-fourth for women), every society will necessarily be in a solvent condition if it has seven- ninths for men (three-fourths for womenj of the contri- bution necessary as regards members joining it at the age of sixteen — the age when the insurance commences, and as from which all calculations for the purpose of the insurance have been made. For members joining at any age over 16, societies in order to be solvent should also hold seven- ninths for men, and three-fourths for women, of the reserves appropriate to the members' ages. These reserves they will not, of course, hold at the commencement of the scheme, and it is therefore necessary to create them in the form of a paper debt, at the cost of the whole insurance. This debt will be credited to the various societies, and will carry interest in the accounts at 3 per cent. Debt and interest will be redeemed by the investment of two-ninths for men (one-fourth for women) of the contributions paid by in- sured persons. In this way every society is put upon an equal footing of solvency as regards the acceptance of members. If a society has an age distribution of members Avhicli is exactly normal in accordance with the calculation of the Government's actuaries, the reserves credited to it in the form of the paper debt would be paid off by the investment of the two-ninths (and one-fourth) of the con- APPENDIX A. 225 tributioiis. If a .society admits youuger members, the ex- App. A. cess of their contxibutious is available to pay the debt credited to a neighboiu'ing societ3' which admits older members. No one society, therefore, can get an advantage over another society by admitting members at the youuger or older ages. The proportion of the contribution which societies have to surrender is the proportion repre.sented by the Govern- ment grant of two-ninths (or one-fourth) of the benefits. It is true, therefore, at the commencement that young per- sons of 16 years of age in fact get no value from the Government grant — for the Government pay.s two-ninths (or one-foui'th) of the benefits and takes two-ninths (or one-fourth) of the contribution. But for every age over 16 the society to which every insured person belongs from the commencement receives in the insurance a credit appro- priate to his age-risk carrying interest at 3 per cent., and this credit represents the value to him and his employer of the Government insurance. The credit is of course greater at the hig-her ages, and it is for this reason that a somewhat reduced insurance is g-iven to persons over 50 years of age and that persons over 6.5 are excluded. It is impossible without great complications under a universal scheme of insurance with a uniform rate of pre- mium to devise a scheme under which every insured person from (he commencement would receive exactly equal treat- ment. Equality of treatment can only be reached when the original deficit due to the inclusion of the older lives has been wiped off. Meanwhile, under the provisions of the Bill the younger generation will receive the full value of their own and the employers' contribution, and it is proposed in the Bill that when tlie deficit has been wiped off, and it becomes possible to extend the benefits conferred by the insurance, regard in tlie extension should be had to their ages when they joiited the insurance. The value of the promise thus made to the younger generation is shown in the financial statement which will be circidated. It should be added heie that the Bill proposes (hat (he insurance fund should l)e rolled u]) by the operation of the provisions above explained until it is sufficient to provide interest at 3 per cent, on all nmounts then s'^anding to the credit of societies. The adviinlages of this proposal are that i( enables all valuations meanwhile to be conducted on a 3 pel' r-ent. basis, and (hat it m;ikes ii capital valiintion of the fund unnecossai-y. Wlicu (he scheme is extended. Parliament will be able to make such arrangements as may be reasonable for dealinir with the capital account or r-hanging the rate of interest ado]i!ed for valuation puryiosos. W. Q 226 NATIONAL INSURANCE BILL. App. A. ^' Valuation of Sgcieties. (A.; Surpluses. If a surplus is found upon a valuation of a society, which is not a member of an association of societies, the society will be entitled to prepare a scheme for granting one or more of the additional benefits specified in the Act. The consent of the insurance office will be necessary before such a scheme can be brought into operation. If a society showing a surplus is a member of an asso- ciation of societies, it will be required to transfer one-half of any surplus to the central fund of the association, and with the approval of the association and of the insurance office it will be entitled to introduce one or more of the additional benefits. An association of societies will be entitled to introduce additional benefits for all its branches, when its central fund is sufficient for the purpose, subject to the consent of the insurance office. (B.) Deficits. If a deficiency is found, the society Avill be required to prepare a scheme for extinguishing the deficiency. Such a scheme may provide for — (a) A levy upon all members of the society. (b) A reduction of the temporary sickness benefit. (c) A postponement of sickness benefit, or an extension of the period of twelve months mentioned above between payment of full sickness benefit. All such schemes must receive the approval of the insur- ance office. If a society with a deficit is a member of an association, the deficiency must in the first instance be made good from any surplus in the liands of the association; but the govern- ing body of the association, if it alleges maladministration on the part of the branch society, will be entitled, subject to an appeal to the insurance office, to refuse to make any grant from surpluses. If within six months after the declaration of a deficit no such action should be taken as may be reasonably ex- pected to make good the deficiency in the affairs of the society within a period of three years, the insurance office is empowered and required to take over the administration of the statutory powers and funds of the society and to take steps to recover as quickly as possible the amount of APPENDIX A. 227 the deficiency by auy or all of the methods above indicated. App. A. For the purpose of these clauses further contributions will be enforced if necessary by a deduction from wagevS as indi- cated below. Member.s joining a society in which a defi- ciency has been declared after the declaration of the deficit will not be required in any way to make good such deficit. Members leaving a society in similar circumstances will be charged with their proper proportion of the deficit. Any dispute as to the amoimt of the deficit or as to the adequacy of the provision proposed for extinguishing it ^dll be de- cided by an independent referee to be appointed by the Lord Chief Justice in England and Ireland, and the Lord President in Scotland. If a society is found to be in defi- ciency at any time after the approval of a scheme for granting additional benefits, payment of such additional benefits will be suspended. Excessive Sie'kn^ss in Certain Trades, dc If one or more societies allege that excessive sickness has been caused among their members by the conditions or nature of employment in some trade or trades, or in certain shops or factories in which their members are em- ployed, they will be entitled to demand an enquiry into the conditions of the trade, shop, or factory. If it is found on such enquiry that there has been among members of the societies engaged in the particular trade, shop, or factory concerned during a period of not less than three years an amount of sickness exceeding by ten per cent, the average expectation of sickness, as shown by the table which the Treasury will publish for the use of persons making valuations under the Act, the employer will be required to make good the extra expense incurred by the -jocietie.s through such excessive .sickness. This provision will of coiir.so e.\-clndo any sickness or disease which is a subject of com])ensntinn undei' the Work- men '.s Compensation Act. Excessive Sickness in any Locality. The ]K»wers of societio-t as regards .': Add: "If a member is (ner i;i weeks in arrears no transfer value shall l)e paid in regard to him by the society or branch of which he was formerly a member." Clause 26. Hetirts of 0(d,- Benefit Society : Clause 26: Amend so as to reipiiro that transfer values •^iuill nol -1)0 made Avhoro the home society retains the mom- ^62 National insurance bill. App. C. bership and continues its benefits to members residing out _ q£ l^j^g United Kingdom. Clause 27. Improved Independent Order of Oddfelloivs (London TJniUj): (1) Clause 27: Be amended to enable members of ap- proved societies to insure to 50 per cent, over their wages, providing his wages does not exceed 21. per week. Royal Oak Benefit Society : (2) Clause 27, par. 2: That this paragraph provides that no insured person shall be insured for more than his average weekly wages in any friendly society, shop club, insurance society, or any other body, corporate or unincorporate, pro- viding benefits during sickness. Ancient Noble Order of United OddfeUoivs (Bolton Unity): I 3) Clause 27, page 22, line 26: After the word "remu- neration" insert "by more than 15 per cent." Independent Order of Reohabites: I 4) Clause 27: Amend so that the amount of any excess benefit should be divided equally between the approved society and the State. Clause 28. Ancient Order of Foresters; Grand United Order of Odd- fellows; Order of Druids; Independent Order of Rechabites ; Natio(n.(il United Order of Free Gardeners; Loyal Order of Ancient Shepherds (Ashton Unity); In'dependent Order of Oddfellows (Kent Unity): Clause 28: (a) "That this conference presses for supply by the State of account and other books for the scheme at the cost of the State, and (b) That the provisions as to State audit be more definitely stated; also whether State audit is at the cost of the State; and whether an approved scheme of audit of branches by or through the society would be acceptable." APPENDIX C. Clause 29. 263 App. C. Loyal Order of Ancient Shepherds ^Ashton Unity); Ancient Order of Foresters; Rational Association Friendly Society; Order of Druids; National United Order of Free Gardeners; Independent Order of Oddfellou-s (Kent Unity): (1) Clause 29: That valuations by the State in respect of its scheme be at the cost of the State . Independent Order of Oddfelloivs iEast Anglian Unity): Royal Oak Benefit Society : i2i Clause 29: That valuations be made every five years, and that societies be allowed to arrange for the valuation of the State benefits to be made at the same time as their ordinary valuations are due. Hearts of Oak Benefit Society : ( 3) Clause 29, section 1: Amend to provide that approved societies may continue to appoint their own valuers, who shall be duly qualified actuaries, and that their valuations shall be accepted l»y ihc insurance commissioners. Ancient Noble Order of United Oddfellows {Bolton Unity): (4) Clause 29, section 1. page 23, line 16: Delete 'three," substitute "five," or as an alternative:— '' That the funds of an approved society other than State funds he valtied triennially, notwithstanding any provision contained in any other Act of Parliament governing friendly societies." (5) Clause 29, section 2. page 23, line 23: After the word "branch " insert " is." Rational Association Friendly Society: Clause 29, section 2: Add a new .sub-section (c): "That the most recent available tables of sickness and mortality experience be u.sed as a standard for valuations of ail aj)- proved societies." Cl.\u.ses 30 & 31. Ancient Order of Foresters ; Loyal Order of Ancient Shep- herds iAshton Unify): (1) Clause 30, pa^-e lil. line !»: Delete "the,' and in.sert such. 264 NATIONAL INSUKANCE BlLt. App. C Hearts of Oak Benefit Society : {2) Clauses 3U and 31: Amend to provide that distribu- tions .o£ surplus and arrang'ements to meet deficiencies shall take plaoB, or be made every five years, as the experience of societies shows that three years Avould be too short a period for action to be taken in these directions. Royal Oiak Benefit Society : (3) Clauses 30 and 31: That the same provision with reference to surpluses and deficiencies of branches of an approved society be made applicable, as far as possible, to local conunittees Avhere such are formed by centralised societies . Ancient Order of Foresters : (\) Clause 31, pages 25 and 2G, in relation to sub-sec- tion (c): That steps be taken to satisfy the society or the branch that the levy is paid, or credited to its account in the Government's insurance fund. Anient Onder of Foresters ; Loyal Order of Ancient Shep- herds (Ashton Unity'): [2) Clause 31, pag-e 26, sub-section (d;: Insert after "Avithin"in seventh line: "A reasonable time not less than." Ancient Order of Foresters: (3) Clause 31, page 26: " That section 1, sub-.section (g), be amended to provide that a member of a branch shall be liable to the same conditions before transfer to another branch on a deficiency being shoAAii on valuation. Ancient Order of Forester.s ; Loyal Order of Ancient Shep- herds (Ashton Unity): 1^4) Clause 31: Add at the end of clause, page 27: ■'(^3) Nothing in this or the preceding .section shall affect any funds of the society or branch other than those under this part of this Act." Clause 32. Roycil Oak B&nefit Society : Clause 32: That deposit contributors receive sick pay for a limited number of weeks in each year, say, ten for the first year; fifteen for the first tAvo years; and twenty for the first three years. APPENDIX C. 265 App. C Clause 34. ^ Anvlent Older uf Foresters; Loyal Order of Ancient Shep- herds [^ Ash ton l')iiti/): {\) Clause 34, pag-e 30, sub-section (4), liue 17: Delete " not " and delete all after " contributor " on line 18 to end of sub-section. (This "would enable married women, not ■' workers," to become voluntary contributors.) (2) Clause 34: Add at end of clause, page 30 (to be neAv sub-section (7)): "Nothing in this section or any part of the Act shall be so construed as to interfere A\ith the present benefits of married women who are members of an approved society at the passing of the Act." Royal Oak Benefit Society : (3) Clause 34: That married women who are not em- ployed, but are the wives of employed members, be included in the scheme for medical benefit^ only. Aatioruil Independent Order of Oddfellows: (^4) Clause 34: That the Chancellor of the Excliequer be pressed to reconsider his decision with regard to the accept- ance of married A\omen as conti'ibutors under the Bill. Independent Order of Rechahites : (5) Clause 34: TJiat females on marriag'e receive a sur- render value for sickue.ss contributions paid basetl on clear- ajice value applicable thereto as between ages at entry and iiijiniagc. Clause 3o. Ancient Or,der of Foresters; Loyal Order of Ancient Shep- herds ( Ashfon Unity); Hearts of Oak Benefit Society : (\) Clause 3.5, pag^ 31, section 3, line 14: Add "and this seotioji shall nut apply to any person who is a member and ha.s regularly- contributed for at least 12 months to an approved society." Royal Oak Benefit Society : (2) Clause 3;}: That societies be allowed to admit aliciis for State bcjioHts. 266 NATIONAL INSURANCE BILL. App. C. Clause 38. Loyal Order of Ancient Shepherds {Ashton Unity); Ancient Order of Foresters: (^1/ Clause 38, line 5: After "member" insert "but in- sured persons under the ag'e of 16 shall be allowed such benefits as may be pix)vided for them in the approved society to which they belong- in addition to the benefits herein pro- vided for. ' [^2) Clause 38: Amend this «and all clauses relating to persons under 16 years of ag-e to provide that no personal contributions shall be demanded until they are of age to be paid benefits. Clause 39. Loyal Order of Ancient Shepherds (^Ashton Unity); Surrey Reformed Benefit Society: (1) Clause 39, section 1, line 2: After "Act," iu.sert "by members of approved societies shall be paid over to the society or branch of which they are members." Rational Association Friendly Society : (2) Clause 39, section 1: Add "That the sum per capita allowed to an approved society for administrative or management purposes, shall, upon the coming into opera- tion of this Act, be paid to such society as to one -fourth of the amount so allowed in two months, and a further one- fourth at five months, a further one-fourth at eight months, and the balance at 12 months; thereafter the sum allocated shall be paid to approved societies every three months, and shall be held by the approved societies for their exclusive use as an administrative or management fund." (3) Clause 39, section 3: Add "And any sums standing to the credit of an approved society to the extent of four- ninths of the contributions of it-s members, after having satisfied the claims arising for the benefit under this Acr to the extent of four-ninths, may be invested by such society in the name of its trustees, provided such investment is in accordance with the rules of the society and bears interest at more than 3 per cent, per annum." Loyal Order of Ancient Shepherds (Ashton Unity); Ancient Order of Foresters; Grand United Order of Oddfellows; Independent Order of Rechabites ; National United Order of Free Gardeners: (4) Clause 39: That provision be made for supplying APPENDIX C. 267 funds to societies to meet expenditure ^\•itllout interfering- App. C- Avith voluntary funds. Hearts of Oak Benefit Society : Order of Druids; Indepen- dent Order of Oddfellows [Kent Unity): Ancient Order of Romans : ^5) Clauses 39 and 40: Amend to provide that approved societies shall receive all moneys payable for benefits, Avhich such societies will be called upon to administer, or to which their membei-s are entitled, subject to the said societies being able to satisfy the insurance commissioners of their con- tinuous solvenc-y, and tlieir conformity to all needful reg-ula- tions. Further, that the societies may continue to them- selves invest all moneys available for the purpose of invest- ments in any securities which are authorised by Parliament as suita])le foi- the societies' investments, subject to the ap- proval of the insurance commissioners. Order of Druids: (6) Clause 39: That no proposed scheme of State insur- ance can be acceptable to friendly societies unless provisions be inserted providing- that the whole of the contributions of members, including those for State benefits, may be paid to the societies direct as heretofore. Cl.\use 40. Order of the Sons of J'eniperance : ('lause 40: To cT,scertain if there is any povssibility of a hig-her interest than 3 i)er cent. That the Chancellor be approached Avith the object of iiaving the surphis capital accruing unfka- the Insurance Bill lent on mortgage "as per present friendly .society practice " to members for the purpose of jmrchasing a house or houses. Clause 41. Loi/al Order of Ancient Shepherds (Ashton Vnity); Ancient Order of Foresters; Grand Vnitcd Order of Oddfellows : il Clause 41. section I. line 3: .After " cuinmis.siinicrs." insert "an adequate proportion of whom shall be persons having not les.s than ten years' actual e.vperience in the Avorking of a rcg-istercfl friendly society." ^68 NATIONAL INSURANCE BILL. App. C. Ancient Order of Foresters: {2) Clause 41: In liue 30, after 'in respect of" insert "the affairs under this Act of ." (3) Clause 41: That the Chancellor of the Exchequer be requested to a|T[)oiut a special commission, including a number of expert friendly society men who have had ex- perience in the working- of friendly societies, to draft the bye-laws and regulations for the management and working of this scheme. Clause 42. Order of the So)is of Temperance: {\) Clause 42: To ascertain the proportion of represen- tatives from each body constituting the advisory committee. Hearts of Oak Benefit Society : {2) Clause 42: Amend to provide that in the appoint- ment of the advisory committee, in respect of the repre- s.eiitatives of approved societies, the insurance commis- sioners shall appoint the nominees of the national conference of friendly societies and of any other repre- sentative body that may be formed, and be duly authorised to represent the friendly societies. Clause 43. Hearts of Oak Benefit Society : (1) Clause 43, section 1, sub-section (^b): For the ap- pointment of representatives of approved societies, make such regulations as shall ensure as near as possible the equal representation of the various societies. (2) Clause 43: Amend to provide that there shall be a local Health Committee in eveiy borough or district. (3) Clause 43: Amend so as to provide larger represen- tation of friendly societies. Clause 46. Ancient Order of Foresters: Clause 46, page 41, section 7: That it be made clear that an approved society is to have repaid excessive cost of sickness after sviccessful inquiry in manner prescribed. APPENDIX C. 269 CjLAUSE 48. App. C Ancient Noble Order of United Oddjelloivs (Bolton Unity) : Clause 48: Add at end of clause: "But no such regula- tions shall come into force until they have been presented to the Houses of Parliament for forty days, and have not been rejected or amended by them." Clause 49. Grand United Order of Oddfellows: Clause 49, section 1: Amend to pi'ovide for an appeal by ap-grieved societies. Clause 50. Order of the Sons of Temperance: [\) Clause .)0, section 1: To ascertain if this would alter tlie present procedure of purely friendly society members. (2 ) Clause oO, section 1 : To ascertain in the case of dis- putes if arranoements are to be made to ensure attendance of witnesses before the committee a])pointed to hear appeals, as at present no such power is ali'orded friendly societies to insist upon attendance of witnesses. Clause 51. Ancient Order of Foresters : Loyal Order of Ancient Shep- herds (Ashton Unity): Rational Association Friendly Society ; Grand United Order of Oddfelloivs ; National Independent Order of Oddfelloirs ; Nottingham Ancient Imperial United Order of Oddfelloivs : (V) Clause 51: Tliat the whole of the clause be deleted. Hearts of Oak Benefit Society : (2) Clause 51: Amend to provide that any loss to the landlord arising fiom the objection of this clause shall be defrayed by the Treasury. ClATJSK 'f-'). Ancient Order of Foresters: i\ 1 f'liMi-^c 5.'): (',i) Tha< (his Ifi;jii(>sI tim con- foroncf cdniMiiltee in pr<'])iirinu' any scheme iindoi' clinisp 55 ^70 NATIONAL INSURANCE BILL. App. C. dealing- with existing- funds to ofier options of benefits amongst which shall be a {1) j^aid up life policy, (2) an- nuity payable at 65; and (h) That this clause be referred to the conference committee to make such suggestions and recommendations for the guidance and protection of dis- tricts and branches as they may deem necessary and advis- able to meet the provisions of this clause. Liverpool Clerks' Association: (2) Clause 55: After the word "'scheme" (23rd line), add: "which notwithstanding anything contained in this part of this Act, shall be framed strictly in accordance with the rules of such friendly society or branch current at the time of the passing of this Act." Ancient Order of Foresters: (3) Clause 55: Add at end of line 36: 'and every such scheme shall include provision for regulating the voting at meeting-s, so that those members wdio are or become in- sured persons under this Act shall have no votes in regard- to any funds or benefits to which they are not contributors or entitled." Rational Association Friendly Society: {4) Clause 55, section 1: Follow line 36: ' But no member of an existing society at the coming into operation of the Act, if he ceases membership in the approved society and pays to the State scheme only, shall have any claim upon the accumulated funds of the society of which he was a member." National Independent Order of Oddfellows : (5) Clause 55: That if the present funds of friendly societies are to be applied to the benefit of the present members thereof in such manner as may be approved by the registrar, provision should be made in the Bill wdiereby the registrar sliall not have the powder to refuse to sanction any scheme which is recommended by a qualified actuary. Independent Order of Rechobites: (6) Clause 55: Add after "ways," "provided, however, that any contributions for the funeral benefit of a member or a member's wife or child, or any contributions for super- annuation benefit for which any member is or has been previously insured in any friendly society, shall not be APPENDIX C. 271 taken iutu accouut in any learrangenient of contribution(> App- C which may be made."' Clauses 60 to 81. Loyal Order of Ancient Shepherds (Ash ton Unity); Ancient Order of Foresters : Clauses 60 to 81: That the national conference of frieucUy societies recommend Parliament to have the health insurance and unemployment provisions separated and made two measures. Clause 87. Loyal Order of Ancient Shepherds (Ashton Unity); National Independent Order of Oddfellows ; Grand United Order of Oddfellows ; Hearts of Oak Benefit Society ; Nottingham Ancient Imperial United Order of Oddfelloivs : Independent Order of Bechahites : Ancient Order of Bomans : Clause 87: Thai in view of ihe additional labour involved on friendly societies in preparing for the scheme, the con- ference recommend that at least twelve months elapse from the passing of the Act before it comes into operation, and suggest January 1st, 1913, as every approved society will have to prepare schemes for re-adjustment of contributions and benefits ro submit to the registrar. It is recommended that the Treasury take into consi{loration an augmentation of the staff of the registry office to deal with the scheme without undue delay. Schedules. Ancient Order of Foresters: {\) First Schedule: Tiiai all Jieces.sary stei)s be tuken to .secure that agricultural labourers working ])artly for em- ployers and partly for themselves are pro])crly recognised under Part I. of Schefinitioii of an ajiprovod societv. Independent Order of Oddfellows {Kent Unity): (20 1 P'\f]iiNif)ii of colh'cting- .societies, insurance coni- panio-, and (lividing societies. t2 276 NATIONAL INSURANCE BILL. App. C ^,21; The following- does not appear quite clear, and the — question might be submitted to the next meeting: " AVhat would be the position of a member under the Bill, who is already a member of one or more societies? Can he still re- tain his membership, or will he have to join under the State scheme, as it would appear to read at present? " Ancient Order of Romans: (22) That this congress is of opinion that the Bill as at present constituted is detrimental to the interests of regis- tered friendly societies. (23) That this congTess is of opinion that no State Insur- ance Bill is complete unless it makes some provision for Avidows nnd orphans. APPENDIX \). '^^' APPENDIX D. App.D. AMENDAIENTS DESIKED BY BKITISH MEDICAL ASSOCIATION. Incomk Limit of those entitled to Medical and Maternity Benefits. Clause H. pa^-e ti. sub-clause (1) {n), line 4, before the word "medical"' insert the words "except as hereinafter provided.' Clause 8, page 8, sub-clause (7), insert new suli-dause (g'l as follows: — (<>•) to medical l)enefit who is in receipt of an average income fioni all soiu'ces exceeding 21. per week. Clause 14 {1), page 14, line 35, after the word "persons" insert the words "entitled to such benefit." Administration of Medical and Materniiy Benefits. Clause Li (i), page Li, line 24, after words "sickness benefit" insert the word "and." Clause 13 (Ij, lines 24 to 26 inclusive, delete all words from "and maternity" down to words "medical benefit," inclusive. Clause J 3 (1), page 13, line 29, before the word "sana- torium" insert tlie woids "medical, maternity, and," and for the word "benefit" substitute tlie word "benefits." Clause 14 (1), page 14, line 32, delete the words ";ij)- provcd society and." Clause 14 ('2), page 14, line 37, delete the words "society or." (Clause 14 (3), page 15, delete. Clause 10 Ci), page Ui, lino^ J 7 to L», inchisive. delete all woj'ds from the woids •and shall ' in line 17 to the words "Health Committee ' iji line !'.» iuclusive; and delete all words from the words "by the" in line 21 down to the word "society" in line 22, iuclusive. T8 NATIONAL INSURANCE BILL. App. D. Clause 45 (1), i)age 38, line o, before word "sanatorium" insert the words " raedical, maternity, and.' Clause 45 (1), page 38, lines 5 and 6, delete all words from the word "deposit" down to the words "benefit and," inclusive . Free Choice of Doctor. Clause 14 (^1), page 14, line 34, delete the words "duly qualified" and substitute the word "registered," and alter the numbering of the clause to clause 14 (1) (a). Clause 14 (1 i, page 14, add the following new sub-clauses (,b), (c), (d),\ej, and (f): ( b) xHl arrangements of the local Health Committee with medical praciitioners for attendance and treatment of insured persons shall be subject to the approval of the insurance commissioners. ( c; The local Health Committee shall jjrepare a list of registered medical practitioners who have entered into arrangements with the committee for giving attendance and treatment to insured persons whose medical benefit is administered by the committee. (d) In the list of registered medical practitioners the local Health Committee shall include all registered medical practitioners who apply to be included unless in respect of any such practitioner the insurance connnissioners are satisfied after due enquiry that his appointment would be prejudi- cial to the efiiciency of the medical service of the insured. (e ) The insurance commissioners shall have power at any time after due enquiry to remove from the list of registered medical practitioners for any district any practitioner whose conduct is deemed by them to be prejudicial to the efiiciency of the medical ser- vice of the insured. (f ) Each insured person shall be entitled to select from the list so prepared a medical practitioner, subject to the consent of such practitioner, to attend him when required. Medical Representation in Administration. Insurance Commissioners . Clause 41 (1), page 35, line 17, at the end insert the following Avords, "and shall include registered medical prac- APPENDIX D. 279 titioners who have had persunal experience of general App. D. practice among the classes from which the insured are drawn . ' Advisory Committee. Clause 42, page 36, line 3, after the word " societies," insert the following words ''and registered medical prac- titioners who have had personal experience of general prac- tice among the classes from which the iusiu-ed are drawn." Local Health Committees. {Fifnt Alternative Amendment.) Clause 43, sub-clause (2), page 36, line 10. fV)r tire Avurd nine"' substitute the Avord '"twelve.' Line 11, for the word "eighteen" substitute the word ■ twenty-four. ' Line 12, for the word 'third" substitute tlie word " fourth." Lino IG, for the word 'third" substitute the word " fourth." Line 21, delete the words 'the remaining" and for the word "third" substitute the word "fourth." Line 26, for the word "third" substitute the word ■foiu'th." Line 31, insert the new sub-paragraph (d) as follows: — " (d) As to the remaining one-fourth thereof by the registered medical practitioners resident in the county or county borough." Clause 43 (5), page 37, lines 10 — 12, inclusive, delete the words "but so" down to "medical practitioners." Second Alternative Amendment.) Clause 43, sub-clause o, page 37, line 9, for the word "fourth" substitute "third." Lines 10 to 12, inclusive, delete the words "but so" to "medical pi'actitioners " and insert "and sliall include members, to the number of at least one-fourth of the whole committee, selected from registered medical practitioners nominated by the registered medical practitionere re- siding in the county or county borough." Local Medical Committees. New ciau.se to follow clause 1 I, page 38— (1) A local mcdi(.'al comnnttee sli:ill be rdiineii in the area of each coujitv and countv borough con- 280 NATIONAL INSURANCE BILL. App. D. .si.stiiig- of registered uieclical practitioner« elected by the registered medical practitioners who are engaged in medical practice in such county or county borough. {2) The number of members of each medical committee and the mode of election and term of office of such members shall be determined by the insur- ance commissioners. {3) The local medical committee shall be consulted by the local Health Committee on all matters afiect- ing the arrangements with registered medical ])ractitioners to give attendance and treatment to the insured and shall discharg-e such other duties and exercise such poA\'ers as shall be deter- mined by the insurance commissioners. Power to Approved Societies to subscribe to Hospitals, &c. Clause 17, page 16, delete. Clauses of the Bill referred to above, as Amended, and New Clauses to read as follows — Liuteb and conditions of benefits.] — Clause '8 (I) la;. Ex- cept as hereinafter provided medical treatment and atten- dance, including the provision of proper and sufficient medi- cines (_in this Act called "medical benefit "j. Clause 8 (7), new sub -clause (g): (g') To medical benefit who is in receipt of an average income from all sources exceeding 21. per week. Benefits to be Administered by approved societies or the local Health Coinmittee.] — Clause 13 (1 1, Sickne.ss benefit and disablement benefit shall be administered, in the case of insured persons who are members of an approved society, by and through the society, and in other eases by and through the local Health Connnittees: medical, maternitj and sanatorium benefits shall in all cases be administered by and through local Health Committees. Administration of medicnl benefit.] — Clause 14 (1) (a),' Every local Health Conuniitee shall for the purpose of ad- ministering medical benefit, make arrangements Avith regis- tered medical practitioners for insured persons entitled to such benefit to receive attendance and treatment to the satis- faction of the insurance commissioners from such practi- tioners . APPENDIX D. 281 Insert uew sub-clauses (b), (c), (d), (e), aud (f): App- D. (b) All arraug-emeuts of the local Health fouHiiittee — - Avitli .medical practitioners for attendance and treatment of insured persons shall be subject to the approval of the insurance commissioners. (CI The local Healtli Committee shall prepare a list of registered medical practitioners who have en- tered into arrang-emeuts with the connnittee for g'iving- attendance and treatment to insured per- sons whose medical benefit is administered by the committee . {d j in the list of registered medical practitioners the local Health Committee shall include all regis- tered medical practitioners who apply to be in- cluded, unless in resjject of any such practitioner the insurance commissioners are satisiied after due enquiry that his appointment woidd be pre- judicial to the efficiency of the medical service of the insured. {e) The insurance commissioners shall liave power at any time after due eucjuiry to remove from the list of registered medical practitioners for an}- district any practitioner whose conduct is deemed by them to be prejudicial to the efficiency of the medical service of the insured. {t) Each insured person shall be entitled to select from the list so prepared a medical practitioner, sub- ject to the consent of such practitioner, to attend him when required. Clause 14 {2), Every such committee shall also make pro- vision for the supply of proper aud sufficient <:[rugs aud medicines to insured persons, and no arrangement shall be luade Avith a medical ])ractitioner under which he is bound or agrees to ])rovide drugs or medicine for any insured per- son at an inclusive fee, without the consent of the insurance cc')iefit.] — Clau.se IG (li, Whore the mother of the child is herself an insured person maternity benefit shall be treated as a benefit for her; if she 18 not h(M>olf an insured i)ers(jn the benefit shall be treated aa a benefit for Jier husband, and shall be administered by the local Health Committee, and shall be jiayable in resjiecl of a posthumous child. Power to n/)i>rovrd societien lo subscribe to hospitals, cfc] — Clause 17, Delete. ^82 NATIONAL INSURANCE BILL. App. D. Constitution of mswcmce com)im>ie 43 (^1) As in Bill. (2; As in Bill. (3) As in Bill. (4 J As in Bill. (o) The lemaining- members of the committee, not ex- ceeding- in number one-third of the members aj)pointed in manner aforesaid, shall be ap- pointed by the insurance commissioners, and shall include members to the number of at least one-fourth of the whole committee, .selected _ from registered medical ])ractitioners nominated ' by the registered medical practitioners residing- • in the county or county borough. I 6) As in Bill. (7) As in Bill. Appointinent of local medical cuiitiiiitteen.y-iiiiw clause to follow clau.se 44 — (Ij A local ]u(3dical committee shall be formed in the area of each county and county l)oroug-h consist- ing of registered medical practitioners elected by the registered medical ])ractitioners who are engaged in medical ])ractico in such county or county borough. 2i Tlio nuialiei- of inoinborH of each medical com- mittee and the mode of election and term of otfico ■i^4 NATIONAL INSURANCE BILL. j\pp. J). of such members shall be determined by the iu- surance commissioners. (3) The local medical committee shall be consulted hj the local Health Committee on all matters affect- ing the arrangements with registered medical practitioners to give attendance and treatment to the insiued and shall discharge such other duties and exercise such powers as shall be deter- mined by the insurance commissioners. Income.'] — Clause 45 (1), All sums available for medical, maternity, and sanatorium benefit in a county or county borough, and all sums payable in respect of administrative expenses in any year, shall be paid or credited to the local Health Committee at the commencement of that year. APPENDIX E. 2®'^ APPENDIX E. App.E. AMENDMENTS DESIEED BY THE PHARMACEUTICAL SOCIETY OF GREAT BRITAIN. Desired amendments wight be given effect to by the sub- joined alterations, which are indimted by putting the new n-ording in hold type. Clause 14, section (2): " Every such (;approved) society or (local health) coiu- niittee shall, subject to regulations on a scale system to be framed by the insurance com- missioners, make provisiou for the supply to in- suited persons of pro])er and sufficient drugs and medicines by duly qualified pharmacists or others carrying on the business of a pharma- ceutical chemist, or chemist and druggist, under the provisions of clause 3 of the Poisons and Pharmacy Act, 1908; and n5sioners; with central office in London, and with branch offices as the Treasury may think fit, and the comniissionors shall be ;>])- l)ointod bv the Troasiirv and shall include representatives of the General Medical Coun- cil and the Councils of the Pharmaceutical Society of Great Britain and the Pharmaceu- tical Society of Ireland." 286 NATIONAL INSURANCE BILL. App. E. Clause 42: aiieiit advisory committee. " The insurance commissioners shall, as soon as may be after the passing- of this Act, appoint an advisory committee for the purpose of giving- the insur- ance commissioners advice and assistance in con- nection with the making and altering of regula- tions under this part of this Act, consisting of representatives of associations of employers and approved societies, and of duly qualified medi- cal practitioners and duly qualified pharma- cists, and such otJier persons as the commissioners may appoint." Clause 43, section (5): anent local Health Committee. " The remaining membei-s of the committee, not ex- c^eeding in number one-foui'th of the members ap- ])ointed in manner aforesaid, shall be appointed by the insui-ance commissioners, but so that of the members so appointed, two at least shall be duly qualified medical practitioners, and two at least shall be duly qualified pharmacists." FEINTED BY C. F. EQ-WOETH, 88, FBTTBB LANE, B.C. Los Angeles This book is DUE on the last date stamped below. i^L^ ^ 'yj{\L-'lS)f « ?»L2!>tS^ 6 FormL9 — 15m-10,'48(B1039)444 Oi^lViJiKSiTY of CALIFUKM AT LOS ANGELES LIBRARY Illlllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll AA 000 572 020 6