View report page

55
Under "Finance" and in regard to maintenance grants it states that the
National Insurance Act requires Insurance Committees to make arrangements
for insured persons to receive treatment, and empowers them to extend their
arrangements so as to include also the dependants, or any class of dependants,
of insured persons. The Act also provides that any estimated excess of
expenditure over income may be met as to half by the Local Authority and as
to the other half from the Exchequer in cases where the expenditure has been
sanctioned by the Local Authority and the Treasury. It has now been decided
that the Exchequer will definitely pay half of the deficiency in all cases where
the Local Authority has accepted the like responsibility. It has, however, been
represented that it would be a great advantage in the interests of the community
as a whole, if schemes could be undertaken which would cover not only insured
persons, and their dependants, (who together form the great bulk of the
population), but also those who fall within neither category. The Government
are willing, therefore, that in this case, also, the Exchequer should, under the
conditions described below, bear half of any deficiency. The intention is that
the amount of the annual grant should be one-half of the total net cost incurred
within reasonable limits, after deducting the amounts received from the Insurance
Committees out of the moneys available under the Act for sanatorium
benefit, and any sums received in respect of the treatment of non-insured persons
or otherwise.
The National Insurance Act requires that Insurance Committees should be
primarily responsible for seeing that insured persons, and any class of the
dependants of insured persons to whom they have extended sanatorium benefit,
receive the appropriate treatment, and this responsibility necessarily remains
under the system now proposed. Subject, however, to this responsibility, it is
competent to the Insurance Committees to enter into arrangements with the
Local Authorities for providing institutional treatment and to pay over the
sums available under the Act for the purposes of such treatment.
The Council, on the 5th February, 1013, informed the London County Council
that the grant for the maintenance of the St. Pancras Tuberculosis Dispensary
should be allotted to the Council direct.
Sanatorium Benefit.—By the Insurance Act provision is made to give what
is known as sanatorium benefit to insured persons suffering from tuberculosis
(not pulmonary tuberculosis alone), but these persons are not entitled to such
benefit unless the Insurance Committee recommends the case (Section l(J (3) ).
Dependants of insured persons may also receive this benefit if the Insurance
Committee think pioper (Section 17 (1) ). It is not necessarily treatment in
a sanatorium. It may be given in one of the following forms :—(a) At home
(domiciliary treatment); (A) At a dispensary; (c) As an out-patient of a
hospital ; (d) In a hospital ; (e) In a sanatorium. The Insurance Committee
itself has no power to provide the treatment, it can only make arrangements
with other bodies or persons to give it. There is no legal obligation on local
authorities to build sanatoria or dispensaries, but in order to obtain a share of
the capital sum of a million and a half provided by the Finance Act, 1911,
local authorities have to satisfy the Local Government Board as to the
suitability of their schemes. Apart from the above mentioned sum, the
Insurance Act (Section 16 (2) ) provides a sum of Is. 3d. per insured person
for defraying the expenses of sanatorium benefit, but since January last, in