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.
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![18 December 1913.] Mr. C. W. Woodcock. [Continued. are only in these figures to the extent of 2s. a week ?— That is so. 15.069. An adjustment by way of increase has to be made to these figures in order to bring them up to an exact comparison with 1912 ?—Yes, that is so. 15.070. Did you say that there are 3,000 of these members ?—Yes. 15.071. Have you any suggestion as to the amount by which the figures ought to be adjusted ? Would it be safe to say one week's sickness for each member on the average ?—Yes, I should think that would be fair. 15.072. So that [if we added that sum we should have 25,768?. ?—Yes. 15.073. That compares for nine months with 38,000L in the previous year for 12 months ?—Yes. 15.074. And these are the figures upon which you base your opinion that the claims have not increased in 1913 ?—That is so. 15.075. On the general subject of the inquiry made by the Committee, you say that you have reason for believing that claims which are not justifiable are being made in respect of sickness benefit ?—Yes, I think every society experiences the same thing. Speaking in a general way, men will go to a doctor and claim sickness benefit when there is nothing the matter with them at all. They are simply born tired individuals. They have some rheumatic pains. The doctor cannot see a pain, I take it. The men get on to the funds. I have met this class of individual. We are making every effort we possibly can to stop it. We practically know our men from one end of the line to the other. We get to know them and their peculiarities, and I have a system in my books of marking an individual with a cross which is significant. If he does come on, we go and see if he has got one of these aches and pains, or we inquire about him, and sometimes we find that he has been imposing on the funds. Probably his illness has been brought about by drinking. 15.076. Are you now speaking of something which has come to your knowledge since the Insurance Act was passed or since benefits began under the Insurance Act, or something with which you have always been acquainted ?—I am speaking from both—since the Act and before. 15.077. But specially since the Act?—I cannot say so. I think that the same happens now as it did before. I have brought one or two cases with me. I found one at Nottingham, or my man did, who was certainly suffering from idleness. His wife took in some lacemaking, and he was stopping at home to assist her and to look after the baby. He got his certificates all right, though the doctor had never seen the man. We stopped his sick pay. 15.078. Do you mean the doctor had never seen the member in the first instance ?—No. He declared him on without seeing him. Lumbago is another troublesome thing. A St. Pancras man came doubled up with an awful pain in his back. He was prescribed for, because he looked very bad. That was on a Thursday. On the Sunday he was walking majesti- cally in front of a Salvation Army band playing the cymbals. On the Thursday after he went for another certificate, and he was fired. He is better now. 15.079. These experiences are not more pronounced now than they were before the Insurance Act came into operation, are they ?—It is difficult for me to say that definitely. At the commencement I am afraid that it was serious. The Act came into operation on January 13th, and they had not got over Christmas, and we had two or three cases where the man had had more than was good for him, and had gone down to get on the insurance fund for which he was paying. I have two really bad cases, and the same thing perhaps would have happened before, but at the com- mencement advantage, I think, was taken of it. 15.080. You have given us your opinion that the total claims in 1913, for the nine months which have elapsed, are, if anything, below the claims in the cor- responding period of 1912. That certainly seems to indicate that whatever tendency there may be to malinger, or put in unjustifiable claims this year, applied with equal force to 1912, and you also told us that the society reduced the contracts of its members, so that their total sickness benefit is only the same now—12s. a week—as it was in 1912. Seeing that the members can get no more sickness benefit this year than they could last year, and seeing also that your total expenditure this year is rather less propor- tionately than last year, is there any reason for think- ing that the excess, if there be excess, is induced by any special conditions set up under the Act ?—No, only the fact that it is State benefit, and that people are able to get this benefit easier; but 1 think that we have minimised it considerably by our management. I think the probability is that the claims would have been heavier, if we had not taken measures to keep them in check. 15.081. But the claims have not been particularly heavy in 1913 anyhow. There was no more money to be got than in 1912?—I am afraid that I must say. with all due respect to the doctors, that there was a great ease in getting the certificates—more than under the old regime. 15.082. You think in consequence of the attitude of the doctors that there would have been an excessive experience in 1913, but for something else that came along and counteracted it?—I think so. 15.083. Will you tell lis what that something else is, in your opinion?—We set up a sickness visiting system. We had always had a sickness visiting system, and men were appointed on the line. Names of sick visitors were submitted to the committee, and they were appointed by the committee in each town and district and so forth. We have a number in London, iJirmmn'ham, Manchester, and so on—140 altogether. 15.084. Is that the present number, or the number you had before the Act ?—It is the number now. We have increased it. 15.085. What had you before 1913 ?—About 135. 15.086. If the number of sick visitors is the same practically, what special feature of sick visiting is set up in 1913 ?—Under the old system the sick visitors could get the names from the doctors of the men that went on the club. Now the doctors are not in any way under the control of the club, and they will not in many cases give the sick visitors the names. We had to set up some machinery to get these men's names, and we found it difficult, but I am pleased to say, through the kindness of the company, we have been able to utilise their staff in all the large centres to make the entry for us—name and address, name of illness, date on and off, number of days, and the doctor's name and address. This book is kept in certain places, in London, for instance, in Somerstown and St. Pancras, and some of the small centres round about. They keep the book in the time office. The certificates have to be brought to the time office, because there has to be some reason for the man being off duty. The clerk enters the particulars in the book, and the sick visitor takes the man's name, and visits him straight away. That system is inaugurated in all the large centres of our system. 15.087. You say that under the old system the sick visitor obtained the names of the sick members in his district from the doctor ?—Yes. 15.088. Is the sick visitor a whole-time servant?— No, he has to do it in his shifts. I always take care, when a man applies for an appointment, to ascertain his hours of duty. If he is a signalman it is 8 or 10 hours, and if he is a shunter 8 hours. That is all taken into consideration, so that he will be able to visit these men at various times, and not at one particular time, because if you do that he will put his coat on when the visitor has gone. We work them round in shifts. In London we have a system that they work in circles. A man does not go over the same district each time, and the patient never knows who is coming. I give them postcards and stamps, and if a visitor has a doubtful man in his district, he drops a card to someone to call on him an hour after he has been there, and frequently the man is trapped. We adopt that system all round. There are a lot of individuals we are on the look-out for. They are on the fund, but they want to get out. That is what we do, and we could not do it unless we had such a system](https://iiif.wellcomecollection.org/image/b21361125_001_0553.jp2/full/800%2C/0/default.jpg)
