Volume 1
National Health Insurance. : Report [and Appendices Vols 1-4] of the Departmental Committee on Sickness Benefit Claims under the National Insurance Act.
- Great Britain. National Health Insurance Joint Committee.
- Date:
- 1914
Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Credit: National Health Insurance. : Report [and Appendices Vols 1-4] of the Departmental Committee on Sickness Benefit Claims under the National Insurance Act. Source: Wellcome Collection.
Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.
547/570
![18 December 1913.] Mr. F. W. Daniels. [Continued. of cases the doctor can tell immediately what a person is suffering from. If it has no relation whatever to the condition we are talking about, he can certify for the illness without asking her about her condition. 14.884. (Miss Wilson.) You said that you had special sick visitors ; can you tell us a little more what sort of people the special women sick visitors are P— One is a trained nurse, and the other is a woman who has done a good deal of visiting among insured persons and friendly society members. They are two well- educated, sympathetic women. They would not lie about a woman to the society, and, on the other hand, they would give what they consider to be an abso- lutely fair report. They are people we can trust absolutely. 14.885. The nurse does no nursing ? — None whatever. 14.886. She does not mind doing the detective work, and does not consider it to be unprofessional ?—■ I do not send our visitors out as detectives at all. That is a mistaken idea altogether. Sick visiting is not detective work. 14.887. Not in all the cases ?—It should not be in any case. The visit of a visitor ought to do the patient a great deal of good, if the visitor goes about it with knowledge and tact. The main object of the sick visitor is to find out how the sick person stands, and it is as much in the insured person's interest as in that of the society. 14.888. What instructions do you give them when they find a woman doing household work ? Do you tell them to put the woman off the funds, if she is found doing dusting ?—That would be only a trivial matter of superintending the house, and I question whether it would be reported. If she were doing washing, or, as I had a case reported, scrubbing the front doorsteps, that would be reported. 14.889. Tou expect your visitors to tell you what sort of household work they are doing ?—Yes. 14.890. You keep some hold over them, if they are not reasonably doing the work ?—Certainly. I simply write and say that complaint was made of such-and- such a character, and ask what they have to say about it. The members always have a chance of putting their side of the matter. 14.891. Do you make it quite clear to your sick visitors that they are not detectives ?—Certainly. 14,892-3. And that they are not to get people off the funds if they possibly cat) ? I do not. see that that is any part of their business, unless, of course, they find some one malingering. Their primary object is to see the condition of the patient, so that we may know how she is. 14.894. Have you any scheme under section 9 (2) of the Act for cases where the sick pay is not more than two-thirds of the wages ?—We have not. 14.895. Are you thinking of setting it up ?—No; I have suggested in the statement I made that the sick pay should bear some relation to the wages they are ordinarily earning. 14.896. Why are you not preparing it ?—We are waiting to see the report of this Committee, before any amendment of the rules takes place, or any is suggested. 14.897. You have suggested that a grant should take the place of payment for any sickness connected with pregnancy ?—Caused by pregnancy. 14.898. Have you any idea what that grant should be ?—I am not concerned with the amount. I would rather a person had a fixed sum when she was confined to cover the whole business. 14.899. The amount has some relation to the period for which you think they should be paid ?—I think four weeks should be sufficient, Personally, I think that in most cases it would pay a society to pay 31., rather than the 30s., than to have the trouble they get before and after confinement at the present time. 14.900. Do you mean another 30s. in addition to the maternity benefit ?- I am not ^suggesting another 30s. I hid Suggesting that societies wo,ild be better off if they paid 'M. to cover the matter. 14.901. You do not express an opinion ?—1 am not in a position to do so; it is a matter rather for the Commissioners than myself. 14.902. I am not quite clear as to your practice as regards payment during pregnancy on the State side. Have you been paying cases of total bodily disable- ment, even if there was no specific complication such as varicose veins ?—The rule we have generally adopted is that, if a person who is pregnant goes on the funds, the illness must be absolutely distinct from the condition she is in. but, at the same time, the illness may be caused by the iiregnancy. If it is caused by the pregnancy, then we have always paid. 14.903. Supposing there was a case of a woman in a condition of advanced pregnancy, and there was no doubt that she was totally unable to work, and yet there was no other illness, either connected or uncon- nected with pregnancy, have you paid in such cases ? —I am afraid not, unless the doctor could certify that there was an illness. In most of these cases of com- plaints, we do not know that they are pregnant until the maternity claim comes in; that is our trouble. 14.904. Do you remember any case in which there was complete disablement in which you refused pay- ment solely on that ground, that there was no complication?—We have not refused anyone yet. 14.905. Have you paid where the doctor has certified debility with pregnancy, or would you consider that debility was not an illness?—Debility covers a multi- tude of sins. As soon as we see debility, we always prosecute inquiries immediately. 14.906. Have you refused any such cases ?—My usual rule has been always to communicate with the doctor, and to act upon his advice. We have done that in ail cases of pregnancy up to the present. 14.907. If you were satisfied in a case in which the doctor has certified debility and pregnancy that there was complete incapacity, would you pay ?—Yes. 14.908. Does the same apply to dyspepsia or anaemia with pregnancy ?—In all cases of doubt, I always communicate with the doctor in attendance on the sick patient. 14.909. So that it is possible that you have paid for some cases in which there was really no complication ? —It is quite possible. 14.910. In which you were satisfied that there was complete disablement ?—There comes in the difficulty for the doctor. He does not know what he should, or should not, certify ; that is the trouble. 14.911. You believe in having your committees run by women ?—Certainly. 14.912. Do you find that to be an important factor in educating the women to understand what insurance is ?—I think so. 14.913. You are rather hopeful that in another year your claims will not be so high, simply through better education in that respect ?—Certainly, and if we can educate 1 he doctors too. 14.914. What sort of women have you on the committees ? Have you representatives of all the different trades of which you have given us a list ? —Yes. 14.915. They are really the members themselves ?— Yes; there are three on the women's central committee who are honorary members. In every other case they are employed persons and insured under the Act. Those on the district committees are all insured persons. 14.916. Is there no case in which a district committee is run by honorary members ?—Not a single case, so far as I know. 14.917. Is there not a disproportionate number of your better educated members, such as school-teachers, i)ii the committees?—There are very few, because few a,re insured. 14.918. So your less educated members are quite thoroughly represented on all these committees?—- Certainly. 14.919. It is a thoroughly democratic govern- ment ?—Certainly; a too democratic government, I am afraid. 14.920. Have you got any women working in trades in which there are scheduled occupational diseases](https://iiif.wellcomecollection.org/image/b21361125_001_0547.jp2/full/800%2C/0/default.jpg)
