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accordance with an arrangement made by the Treasury, this amount has been
depleted to the extent of 6d. per head, which has been allocated to the panel
doctors. In London this represents a sum of about £36,000 per annum. One
penny per head has also been earmarked for administration expenses, leaving
only 8d. per head out of the original Is. 3d. provided by the Act. According
to the Press, the London Insurance Committee report that the amount
remaining is inadequate for dispensary and out-patient hospital treatment,
the provisions of drugs and accessories, and administration expenses, and
that the Committee had made representations to the Treasury on this
inadequacy. The Treasury replied regretting that they saw no prospect
of making arrangements whereby domiciliary treatment of insured persons
suffering from tuberculosis could be provided for out of funds other than
those appropriated under the National Insurance Act, 1911, for the purposes
of sanatorium benefit, and that, pending the putting into operation of the
provisions of Section 17 of the Act or the adoption of a general scheme for the
treatment of tuberculosis on the,lines proposed in the recent Local Government
Board circular.it will be necessary that the expenditure of the Insurance
Committee in respect of all forms of treatment, including domiciliary, should
be kept within the amount available under sub-section (2) of Section 16.
It has been previously pointed out that under Section 17 the Treasury and
the Local Authority may, if they think fit, meet the deficiency in equal shares.
Domiciliary Treatment—Reference has already been made to the < >rder of
the Local Government Board with regard to the domiciliary treatment of
insured tuberculous persons.
The following important communication, dated the 28th September, 1912,
was addressed to the Acting Clerk of the London Insurance Committee by the
National Health Insurance Commission (England): —
" In reply to your letter of the 17th instant, relating to the temporary
scheme of your Committee for the administration of sanatorium benefit,
I am directed by the National Health Insurance Commission (England)
to point out that their letter of the 16th ultimo had reference to the supply
of medicines and accessories of treatment for insured persons recommended
for sanatorium benefit. Under Section 16 of the National Insurance Act
an Insurance Committee is required to make arrangements with persons
or local authorities (other than poor law authorities) undertaking the
treatment of tuberculosis, with a view to providing treatment for insured
persons suffering from tuberculosis, and in such cases the medicines, etc.,
must be supplied by the persons or local authorities undertaking the
treatment. Section 15 (5) of the Act to which you call attention deals
solely with the administration of medical benefit.
In reply to your second enquiry I am to state that your Committee
are not themselves empowered to supply any beds, special forms of food,
and other accessories of treatment direct, but that arrangements may be
made for the provision of any such accessories as may be ordered for the
patient in the course of the treatment by the persons or local authorities
undertaking the treatment."