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.
549/570
![18 December 1913.] Mr. F. W. Daniels. [Continued. 14.952. Do you think that they are not going back to work ?—I think that it is more than likely that they are not going back to work. 14.953. You are not talking of persons who are receiving benefit at the time they are married ? — I am. Supposing a person has received maternity benefit, she claims sick pay after. She says she may go back to work, but is not certain. They should say what they are going to do within a certain time. This is a product of the last three months. I have had 30 or 40 such cases. 14.954. In the case where the woman is not receiving benefit at the time, and says that she does not want to be suspended on marriage, and, although she is not working at the moment, she intends to go back to work, have you found any difficulty there ?—I have not as yet; I expect a reply within a reasonable time. We have had no difficulty on that point, but the difficulty is that when you get a married woman on the funds, she may be going back to work, and when you ask her. she says that she is not sure. 14.955. Do you pay her ?—We are obliged to. If we stopped her pay, she would complain that she was an insured person, and that we were stopping her dues. 14.956. Tou pay her as long as she is incapaci- tated ?—We have paid up to the present, but it is one of the points that require to be clearly defined. 14.957. Do you think that before the woman came on the fund she ought to have told you that she was not going back to work ? Do you say that she has pretended she was working beforehand, when she was not, in order te get the benefit ?—A good many married women work up to the time they are confined. After they are confined they keep sick, and have an allowance. If you write and ask them if they are going back to work, they reply that it is uncertain and that they may. 14.958. In any case you would pay so long as they are incapable ?—-We have up to now, but it is a very difficult point to settle, and the officials of friendly societies are in an extremely difficult position. 14.959. (Dr. Smith Whitaker.) As to your proposals with regard to pregnancy claims, in your memorandum of evidence there is a statement as follows : Some '• alteration is needed in regard to illnesses preceding ■' and following pregnancy. At present they are the most difficult cases to deal with. My view has always been that it would be much better to have a definite grant to cover the whole business. You then proceed to quote the rule of your parent society in the matter. It was not quite clear to me. either from that, or from your statements in answer to the Chairman and Mr. Watson, what you mean by the whole business ?—I mean the whole sickness and illness attendant upon the pregnancy, and confinement. 14.960. You mean all illnesses arising out of the condition of pregnancy ?—Yes. I am not including sicknesses which are absolutely distinct from that condition. 14.961. If such a principle were adopted, you would have to discriminate in the case of a pregnant woman, between sickness that, so far as could be ascertained, was due to pregnancy, and sickness that, so far as could be ascertained, was due to some other cause?—That is so. 14.962. And you have to rely on the doctor's certificate to enable you to make that discrimination ? —Certainly. 14.963. One is doubtful, from the practical point of view of administration, whether the doctor would be able to give you the information ?—I should have thought that in the majority of cases they could easily discriminate. 14.964. There are some cases in which, as, for example, if a woman had broken her leg, there would be no difficulty in saying that that was not due to pregnancy ?—But there are different ailments arising from that condition, and it would only be in those illnesses that the matter would be debatable. 14.965. Suppose the doctor certified that a woman was unable to work from heart disease and preg- nancy, and that he could tell you from his previous knowledge of the case, that the heart disease had not prevented the woman from working before she became pregnant, and, so far as he knew, would not prevent her, but that it was the combined effect of the heart disease and the pregnancy that prevented her from working, in which class would you place that case?— In the pregnancy class. 14.966. If pregnancy was part of the cause ?— Certainly; that is why the grant should be increased. If it was a quite distinct illness, the society should pay as for an ordinary illness. 14.967. If the illness was due directly or indirectly to pregnancy, do you say that it should fall under the pregnancy head ?—I think so. At present the doctors are at sixes and sevens, and do not know where they are. There is a great deal of money being paid away, that ought not to be paid, while some are not getting what they are entitled to. 14.968. Coming to Mr. Watson's point, what would you expect of your doctor if he saw a case of illness ? Would it not mean that he would be bound, in the case of every married woman claiming sickness benefit, to enquire into the question of possible pregnancy ?— As a layman I should have thought not, except in rare cases. In the majority of cases the doctor can easily tell whether the illness arises from that or not. 14.969. If you were toM that there were cases such as the one I have just stated, where there might be nothing to put the doctor on the track of possible pregnancy, and the doctor had gone on treating the patient for some time, without expecting pregnancy until the later months, what would you say ?—I quite appreciate that there are difficulties. There are bound to be difficulties arising out of these conditions, but those difficulties would be very small compared with what they are to-day. 14,970-1. Do I understand your proposal to be that whenever the illness is due to pregnancy, directly or indirectly, there is to be no sick pay in the ordinary sense, but merely a lump sum grant of a fixed amount ? —That is what I suggest, unless the illness is quite distinct from the pregnancy. 14.972. So that the woman who had no illness, and who was able to work throughout the earlier part of her pregnancy, and the woman who was incapacitated for several weeks or could not work at all during pregnancy, would both receive the same sum ?—That is the only difficulty. 14.973. The society is to limit its liability in all cases of pregnancy, and throw such risk as there is on the woman ?—I think that would be a great deal better. We have only had a few cases in the parent society, and we have not had a single difficulty arise under that rule. 14,974. Turning to some other points, first with regard to these figures as to the proportion of cases —attended by doctors— that were certified as unfit for work, I understood you to say that some doctors had been unable to give you any information, or had only been able to make guesses, but that other doctors had been able to give you definite figures, although they were not complete figures?—Two or three have given me figures for a few weeks, but in the majority of cases—I might say in all the cases— it is an approximate estimate. I gather that most of them say that during the whole year about three- fourths of the patients according to the figures on the doctor's list, would have consulted them, and of the three-fourths, it is suggested that one-fourth came on the funds. 14.975. But these are only guesses ?—Yes. I happen to know all these men. They are not our own doctors, but the doctors who have sent in these returns are very reliable men. 14.976. Have they sent in definite figures ?—~No, only approximate figures. I have had no definite figures except in the case of the man whose letter I read. 14.977. I do not understand the difference between the man who gives approximate figures and the man who just makes an estimate ?—I should say an estimate was approximate figures. You used the word guesses; I do not think that any of these men](https://iiif.wellcomecollection.org/image/b21361125_001_0549.jp2/full/800%2C/0/default.jpg)
