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. 0. W. WOODCOCK. [Continued. have before me the sub-committee's report: Tour •' sub-committee, after carefully considering the state- ments made to them, beg leave to report that: (a) Iu their opinion the doctor was prevented by urgency of professional duties from attending the '• insured person at the time he was summoned, but ;< that the doctor should have visited the insured person on the day he was summoned immediately his engagements permitted, notwithstanding that the insured person failed to summon him again that day, although the doctor had requested the patient's messenger so to do, if there was need for his attend- ance; and (b) The doctor, although not attending the insured person, issued four certificates to the effect that the insured person was incapable of work. Your sub-committee beg leave to recommend you to direct the clerk to write to the doctor to the effect that, in your opinion, certificates of incapacity should only be issued by him in cases in which he has satisfied himself by examination that the insured person is incapable of work, and that you strongly disapprove of the irregular method adopted by him in this case. 15.138. (Mr. Watson.) That was the end of the case so far as you are concerned?—There was a sequel. There was another doctor called in at a charge of 11. The man wanted us to pay the bill. I refused, and sent it on to the Birmingham Insurance Committee, and I have not heard anything from them about it since. I sent up the bill in November last, and I got an acknowledgment on November 17th, and I have not heard anything further. That is one. case where a doctor is not doing quite the thing. I have another case here. 15.139. (Chairman.) Ave you going to take any further steps ?—No, I have let the matter drop. 1 thought that we had taken the matter up sufficiently, though I agree that they rather whitewashed the doctor. 15,140-1. (Mr. Watson.) You say that the doctors are more lax hi the matter of the certificates than they were in your society in the old days ?—I should hardly like to go so far as that. I daresay that there was laxity then, but it did not seem to come out as it does now. We are anxious to keep down malingering, and to bring the sinner to justice. We are anxious as a committee to make this thing go, and we are doing all we can, and I think that if we have a complaint against a doctor we ought to state it. 15.142. You must not think that I hold a brief for the doctor, but I seem to remember some doctors' certificates under the old conditions, where everything on the certificate was printed, and the doctor simply bad to hand it out. Do you think that the present condition of affairs leads to greater laxity than may have existed under that system ?—I think, if I might make a suggestion, that if the doctors would not hold so much aloof from the societies, and would let us know if they have a doubtful case, we would make special efforts to try to bring the man to book. [ know that it is a difficult thing for a doctor, because if he says This man is no use; he is malingering, that man at once goes and tells his mates, I am going to transfer, and that doctor not only loses that man but perhaps 20 or 30 others, who go in sympathy. Of course where you have a medical referee, you can put the onus on him. What we have done in the past, and what we can now do under om- rules, is to send him for a special examination. Where the doctor has said, •' I am sure that he is a wrong one, I have reported him to my committee, and, if he is a Derby man, I have taken him to Birmingham, or if he is a London man, I have taken him to Derby, so that he shah go out of the district in which the doctor resides. I think that this is better. One doctor at Derby has examined men from London and Nottingham and so on. I have taken them from the district altogether. 15.143. You are speaking now of the old system ? --That is the old system. 15.144. Have you any more cases ?—I have got here the case of a man, a shunter, in Manchester. He was declared on for influenza. I found on inquiry that he had been doing a bit of betting, and that he had won. He was so troubled about it that he went from Manchester to Liverpool, and although certified as suffering from influenza, he walked all the way home from Liverpool to Manchester. 15.145. (Cliainuan.) What was certified to be the matter with him ?—Influenza, and he walked from Liverpool to Manchester. 15.146. (Dr. Fulton.) While he had the influenza ? —I do not know. The doctor says so. The man says, I am in disgrace because I won a bet. He had been backing a horse for somebody else, and had got into trouble. He had lost a day's work. That was the English of it, so he got a certificate which exonerated him at the works. 15.147. (Mr. Watson.) Do you bring this case to us as a complaint against the doctor ?—I do not say that it is a complaint against the doctor, but it is an extra- ordinary thing to me that a man should declare on, and should be certified to have influenza and yet be able to walk all the way from Liverpool to Manchester. 15.148. How does the circumstance of his having been to Liverpool come to your knowledge ?—We got to know from the works that he had not started work. I know when a man is at work. I have a letter before me from the agent of the district telling me, This man has not turned up as he should have done. When I go and inquire about it, I find that that is what lias happened. 15.149. You sent an inspector to visit the man in the ordinary way, and he could not find him because he was on the high road between Manchester and Liverpool ?—He had gone. 15.150. You think that the doctor should not have given a certificate when the man could walk all that way ?—I wondered whether he was suffering. I think that it was an excuse to exonerate him from blame at work. You know a man may sometimes get discharged. 15.151. How old is the case ?—November 29th. 15.152. Have you any other case ?—I have another case here from Nottingham. He is a capstan man. That is a very easy job. He woi'ks the machinery for lifting the goods about the yard. Lads will do it up here. He is a man who suff#rs from being tired, or idleness. We visited him, and he looked so very well that we told him that we should not pay him any- thing. 15,153. (Chairman) What did the doctor certify him to be suffering from ?—Rheumatism. I sent my inspector to make full inquiries, and then I wrote to the doctor in fault and I had this letter : I have your letter about . The man suffers greatly from rheumatism. You may remember that he was off work for seven months in the early part of last year. He goes on to say, I did give him a certi- ficate without seeing him, knowing what he suffers from. I intended to go the next day, but I must have omitted to put him on the list. ' I have not paid that man any sick pay, and he has started work. There are one or two instances I have brought up here with me thinking that they might interest the Com- mittee. There is a city man. This man got in a state of gin-and-water. He got too much to drink. He denied emphatically that he was drunk, but he had been seen drunk. We stopped his pay, and we have suspended him from benefit for six months. 15.154. What was he certified to lie suffering from ? —Rheumatism. He said that he was in bed, but we knew that he had been seen drunk down by the docks. My man said to him, You were in bed at the time ? Yes, he said, I was. After talking a bit my man said, You were not drunk down at the docks at such a time ? He answered, Me drunk ? No. I was not near drunk. Of course, he fell into the trap. 15.155. (Mr. Watson.) Is your complaint that the doctor did not give adequate attention to the case, or do you instance it as one of the difficulties that you have in sick visiting ?—As to the difficulty we have in sick visiting. Sick visiting is sometimes awkward in outlandish places. 15.156. You have just given us a case where you say that the doctor certified the member to be suffer- ing from rheumatism, although your sick visitor saw](https://iiif.wellcomecollection.org/image/b21361125_001_0556.jp2/full/800%2C/0/default.jpg)
