« PreviousContinue »
NATIONAL HEALTH INSURANCE ACT, 1924.
78. PROVISION FOR DEFICIENCIES NOT MET OUT OF CONTINGENCIES FUND OR Central Fund.-(1) Any deficiency not made good from any contingencies fund or the Central Fund or, in the case of a society in relation to which an employer has undertaken any obligation, by the employer in pursuance of that obligation, shall be made good in accordance with a scheme for that purpose to be prepared by the society, or, in the case of a deficiency in a branch, by the branch subject to the approval of the society, and submitted to the Minister for his sanction, and any such scheme shall provide for making good the deficiency, within a period of five years, or such other period as the Minister may require in any particular case, from the expiration of six months after the date on which the valuation report is issued to the society, in any one or more of the following ways:
(a) By a compulsory levy by way of increase of the weekly rate of contributions upon members of the society or branch being insured persons:
(b) By reducing the rate of sickness benefit either for the whole period during which sickness benefit is payable or any part thereof :
(c) By deferring the day as from which sickness benefit becomes payable : (d) By reducing the period during which sickness benefit is payable :
(e) By increasing the period which is required by this Act to elapse between two periods of disease or disablement to prevent the one being treated as a continuation of the other :
(f) By any other method approved by the Minister and on the sanction of the Minister being given to the scheme, the society or branch shall proceed to make good the deficiency in accordance therewith.
(2) Payment of the amount of any compulsory levy made in accordance with a scheme sanctioned under this section may be enforced in such manner as may be provided by the rules of the society or branch, and, where those rules so provide, shall be lawful for the society or branch in the case of any member to enforce payment of the amount of the levy by giving notice in the prescribed manner to the employer of that member requiring him to pay the amount of the levy, and upon such notice being given, that amount shall be payable as if it were part of the contribution to be paid by the employer on behalf of the member, and all the provisions of this Act relating to the payment of such contributions and the recovery thereof from members shall apply accordingly.
(3) If within six months after the declaration of a deficiency or, where an inquiry as to excessive sickness is pending under this Act, such longer period as the Minister may determine, such a scheme as aforesaid has not been submitted to and sanctioned by the Minister, or if at any time thereafter it appears to the Minister that the society or branch to which the scheme relates is not enforcing the provisions of the scheme, the Minister may take over the administration of the affairs of the society or branch under this Act, and shall, as soon as possible thereafter, take such steps as he may think necessary to make good the deficiency by any or all of the methods mentioned in subsection (1) of this section, and for that purpose shall be entitled to exercise all or any of the powers given to the society or branch by this Act.
(4) The Minister after taking over the administration of the affairs of any society or branch shall within a reasonable time, not exceeding three years, make arrangements for the restoration to the society or branch of its powers of self-government, or, failing that, for the dissolution of the society or branch.
(5) Any question or dispute arising between the Minister and the society or branch in respect of the amount of the deficiency, or as to the adequacy of any scheme proposed for making it good, shall be submitted to an independent valuer to be appointed by the Lord Chief Justice of England, and the valuer so appointed shall, subject to the provisions of this Act and of any regulations, act, so far as practicable, on his own knowledge and experience, and shall have power to determine how and by what parties the costs of proceedings, including his own remuneration, not exceeding such amount as the Treasury may prescribe, are to be defrayed, and his decision shall be final and conclusive.
(6) A scheme made under this section shall not affect any person who becomes a
14 & 15 GEORGE 5, CHAPTER 38.
member of the society or branch after the date as at which the valuation was made or any member over seventy years of age.
(7) Any member liable to a levy payable at intervals may relieve himself of the liability thereto, and a member subject to a diminution of benefits by virtue of any such scheme may, with the consent of the society or branch, acquire a right to undiminished benefits, on payment to the Minister of the capitalised value of the levy or diminution of benefits, as the case may be, ascertained in the prescribed manner. 79. RESTRICTIONS ON TRANSFER FROM SOCIETY IN DEFICIENCY.-(1) Where on a valuation a deficiency has been disclosed in the case of any society or any branch of a society and a scheme for making good the deficiency has been made under this Act, no insured person who was a member of the society or branch at the date as at which the valuation was made shall be entitled, till the deficiency has been made good, to be transferred from that society or branch to another society or to any branch of the same society except on payment to the Minister at the time of his transfer, to be credited to the first-mentioned society or branch, of an amount to be ascertained in the prescribed manner equal to the capitalised value of any levy which would have been payable by him, or of any reduction of benefits to which he would have been liable, if he had not ceased to be a member of that society or branch.
(2) If any insured person ceases to be a member of any society or any branch of a society at any time between the date as at which a valuation of the society or branch is made (being a valuation on which a deficiency is subsequently disclosed) and the date on which the scheme for making good the deficiency comes into operation and becomes a member of some other society or branch, he shall on demand pay to the Minister, to be credited to the first-mentioned society or branch, such an amount as he would have been required to pay if he had remained a member of that society or branch and were about to be transferred to another society or branch, and if he fails to do so he shall be subject to such reduction, suspension or postponement of benefits as may be prescribed, and the necessary adjustments shall be made in the accounts of the societies or branches concerned.
80. SPECIAL PROVISIONS AS TO SOCIETIES WITH Branches.—(1) Where a society with branches is so organised that the branches in different national areas are grouped together for the purposes of this section, the branches in any of those areas may, if and to such extent as the rules of the society so provide and if the number of members of the branches being insured persons in the area exceeds five thousand, be treated for the purposes of the provisions of this Act relating to valuations, surpluses and deficiencies as if they formed a separate society.
(2) The rules of any society with branches may provide for the branches reinsuring with the society their liabilities in respect of any benefits or, if the society is so organised as aforesaid, for such reinsurance either with the society or with the group. (3) Where a society with branches has among its members insured persons who are not members of any branch and the benefits of those members are administered by the society itself, those members shall be treated for the purposes of the provisions of this Act relating to valuations, surpluses and deficiencies as if they formed a separate branch.
81. POWER TO SEPARATE MEN'S AND WOMEN'S FUNDS.-Where an approved society, not being a society with branches, has amongst its members both men and women and the rules of the society so provide, the provisions of this Act with respect to valuations, surpluses and deficiencies shall apply to the society as if it were a society consisting of two branches, the one comprising the male members and the other comprising the female members.
Provisions relating to Finance of Insurance Committees.
82. ACCOUNTS OF INSURANCE COMMITTEES.-(1) Every insurance committee shall keep proper books and accounts in the prescribed form and shall, when required, submit their accounts to audit by auditors appointed by the Treasury.
(2) The provisions set out in Part I. of the Fourth Schedule to this Act shall
NATIONAL HEALTH INSURANCE ACT, 1924.
have effect with respect to the accounts of insurance committees and the audit thereof.
83. PROVISION OF FUNDS FOR INSURANCE. COMMITTEES.- (1) All sums payable in respect of the members of approved societies and deposit contributors resident in the county or county borough for the purposes of medical benefit and administration expenses in any year shall be paid or credited to the insurance committee at the commencement of that year, or at such time or times and in such instalments and in such manner and proportions as may, with the consent of the Treasury, be prescribed.
(2) Subject to the provisions of this section there shall be paid in each year to insurance committees in Great Britain out of the funds out of which benefits are payable under this Act, on account of the cost of medical benefit, a sum of nine shillings and sixpence, and on account of the administration expenses of those committees such sum not exceeding sixpence as may be prescribed, in respect of each of the total number (calculated in the prescribed manner) of the persons who are entitled to medical benefit as being or having been members of an approved society.
(3) Payments under this section shall be made in accordance with regulations to be made with the approval of the Treasury, and any such regulations so made may make special provision as to the sum to be paid on account of the cost of the medical benefit of, and otherwise with respect to, members of an approved society who are persons employed as masters or seamen serving on foreign-going ships.
(4) It shall be lawful for any local authority, out of any fund or rate out of which the expenses of the authority are payable, to subscribe such sums as they may think fit towards the general purposes of the insurance committee.
84. TRAVELLING EXPENSES, &c., OF MEMBERS OF INSURANCE COMMITTEES.(1) If the special circumstances of any county or county borough are such that the Minister considers that the travelling expenses of the members of the insurance committee for that county or county borough should be repaid to them by the committee, the Minister may authorise the committee to repay the whole or any part of any such expenses, and any sum so repaid shall be treated as part of the administration expenses of the committee.
(2) In addition to any allowances for travelling expenses which may be paid under this section an insurance committee may pay to the members of the committee subsistence allowance and compensation for loss of remunerative time in accordance with a scheme prepared by the committee and approved by the Minister, and there shall be paid out of moneys provided by Parliament towards the expenses of an insurance committee under any such scheme, such sum (if any) as the Minister, with the consent of the Treasury, may determine, so, however, that the aggregate amount paid under this subsection shall not exceed twenty-eight thousand pounds in any one year.
85. CONTRIBUTIONS BY LOCAL AUTHORITIES TOWARDS MEDICAL BENEFIT.—(1) If in any year the amount payable to an insurance committee in respect of all persons for the administration of whose medical benefit they are responsible is insufficient to meet the estimated expenditure thereon, the committee may, through the Minister, transmit to the Treasury and to the council of the county or county borough an account showing the amount so payable and the estimated expenditure, and the Treasury and the council of the county or county borough may, if they think fit and if satisfied that the amounts so payable and the proposed expenditure are reasonable and proper in the circumstances, sanction the expenditure.
(2) The Treasury and the council of the county or county borough sanctioning any such expenditure as aforesaid shall thereupon each be liable to make good, in the case of the Treasury out of moneys provided by Parliament, and in the case of the council of a county or county borough, out of the county fund or borough fund or borough rate, as the case may be, one-half of any sums so sanctioned by them and expended by the insurance committee on medical benefit in the course of the year in excess of the amounts so payable to the insurance committee as aforesaid.
(3) The council of any borough or urban or rural district may agree with the
14 & 15 GEORGE 5, CHAPTER 38.
council of the county in which the borough or district is situate to repay to the council of the county the whole or any part of the sums payable by that council in accordance with the provisions of this section towards the excess expenditure on medical benefit so far as that excess is properly attributable to the borough or district, and any sums payable by the council of the borough or district in pursuance of such an agreement shall be payable, in the case of a borough, out of the borough fund or borough rate, and, in any other case, as part of the general expenses incurred by the council in the execution of the Public Health Acts.
(4) An agreement under this section may provide that the county council shall not raise any sum on account of any expenditure incurred by them under this section for the purpose to which the agreement relates within the area of any borough or urban or rural district the council of which has entered into such agreement, during the continuance of the agreement.
86. PROVISION BY INSURANCE COMMITTEES FOR EXPENSES OF PANEL AND PHARMACEUTICAL COMMITTEES.-(1) The insurance committee, if requested so to do by any panel committee or any pharmaceutical committee, may be authorised by the Minister out of moneys available for the provision of medical benefit within the area to allot to each of those committees respectively for the administration expenses of the committee, such a sum as may be determined by the insurance committee with the consent of the Minister not exceeding twopence in all in respect of each year in respect of each insured person entitled to obtain medical treatment and attendance from the practitioners who have entered into agreement with the insurance committee.
(2) Any travelling expenses incurred by members of any panel committee or pharmaceutical committee in attending meetings of the committee or of any subcommittee thereof, and any expenses incurred by any such members on account of subsistence while so attending, shall be deemed to be administration expenses of the panel or pharmaceutical committee, as the case may be.
87. POWER OF INSURANCE COMMITTEES TO SUBSCRIBE TO ASSOCIATION OF COMMITTEES. An insurance committee may pay as general expenses incurred by them in the execution of their duties any sum, not exceeding in respect of any year ten pounds, or any such greater amount as the Minister approves not exceeding twenty pounds, as a subscription to the funds of any association of insurance committees whose objects are approved by the Minister, as well as any reasonable expenses of the attendances of representatives, not exceeding in any case four, at meetings of any such associations, on a scale to be approved by the Minister.
PART V-CENTRAL ADMINISTRATION.
88. NATIONAL HEALTH INSURANCE JOINT COMMITTEE.—(1) For the purposes of this Act there shall be a Joint Committee (in this Act referred to as the Joint Committee ") which shall consist of the Minister, who shall be chairman, the Secretary for Scotland and the Minister of Labour for Northern Ireland, together with one other person appointed by the Minister, being a person having special knowledge and experience of national health insurance in Wales.
(2) The Joint Committee shall be a body corporate by the name of " the National Health Insurance Joint Committee," and shall have an official seal which shall be officially and judicially noticed, and the seal of the Committee may be authenticated by any member of or the secretary to the Committee, or by any person authorised by the Committee to act on behalf of the secretary.
(3) The Joint Committee shall make regulations providing for the appointment of deputies to act for the several members of the Committee at meetings of the Committee at which those members are unable to be present.
(4) The Joint Committee may make such financial adjustments as may be necessary between the several funds under the control and management of the Minister,
NATIONAL HEALTH INSURANCE ACT, 1924.
the Scottish Board of Health and the Ministry of Labour for Northern Ireland, and for the purposes of co-ordination shall exercise and perform such powers and duties of the Minister, the Board and the Ministry under this Act, either alone or jointly with any of them, as regulations of the Committee may prescribe.
(5) The Joint Committee may make regulations as to the valuation of societies and branches which have among their members persons resident in any two or more national areas.
(6) The Documentary Evidence Act, 1868 (31 & 32 Vict. c. 37), as amended by the Documentary Evidence Act, 1882 (45 & 46 Vict. c. 9), shall apply to the Joint Committee as if that Committee were included in the first column of the Schedule to the first-mentioned Act, and as if the chairman or other member or the secretary, or any person authorised to act on behalf of the secretary, of the Committee, were mentioned in the second column of that Schedule, and as if the regulations referred to in those Acts included any document issued by the Committee.
Determination of Questions and Disputes.
89. DETERMINATION OF QUESTIONS BY MINISTER.-(1) If any question arises(a) whether any employment or any class of employment is or will be employment within the meaning of this Act, or whether a person is or was a person employed within the meaning of this Act, or whether a person is entitled to become a voluntary contributor; or
(b) as to the rate of contributions payable by or in respect of any insured person; or
(c) as to the rates of contributions payable in respect of an employed contributor by the employer and the contributor respectively; or
(d) as to the person who is or was the employer of an employed contributor; the question shall be determined by the Minister, in accordance with regulations made for the purpose:
(i) if any person is aggrieved by the decision of the Minister on any question arising under paragraph (a) or paragraph (d), he may appeal therefrom on any question of law to a judge of the High Court selected for the purpose by the Lord Chancellor, and the decision of that judge shall be
(ii) the regulations may provide for questions under paragraph (b) being determined, in the case of any person who is or is about to become a member of an approved society, by the society:
(iii) the Minister may, if he thinks fit, instead of himself deciding whether any class of employment is or will be employment within the meaning of this Act, submit the question for decision to the High Court, and the decision of that Court shall be final.
(2) The Minister may, on new facts being brought to his notice, revise any decision given by him under this section, other than a decision against which an appeal is pending or as respects which the time for appealing has not expired, and an appeal shall lie against any such revised decision in the same manner as against an original decision.
(3) Provision may be made by rules of court for regulating appeals and references to the High Court under this section, and those rules shall provide for limiting the time within which an appeal to the High Court under this section may be brought and for the determination in a summary manner of any appeals or references to the High Court under this section, and for requiring notice of any such appeals to be given to the Minister.
(4) The Minister shall be entitled to appear and be heard on any appeal or reference under this section.
90. DECISION OF DISPUTES.—(1) Subject to the provisions of the last-preceding section of this Act