I move amendment No. 9:—
Before Section 22 to insert the following new section:—
(1) The Minister may, in his absolute discretion, grant or refuse to grant to any person a licence (in this Act referred to as a health insurance licence).
(2) The Minister may from time to time attach to a health insurance licence such conditions as he thinks proper.
(3) Where the holder of a health insurance licence does not comply with a condition attached to the licence, he shall be guilty of an offence and shall be liable on summary conviction thereof to a fine not exceeding £40 together with, in the case of a continuing offence, a further fine not exceeding £2 for every day on which the offence is continued.
(4) Subject to the next following sub-section the Minister may, in his absolute discretion, revoke a health insurance licence.
(5) The Minister shall, at least 21 days in advance, give notice of his intention to revoke a licence to the holder thereof.
This amendment and amendment No. 10 might be considered together. As I indicated on the Second Reading, I felt it would be necessary to provide in this legislation for a control over the number of bodies engaged or proposing to engage in this form of health insurance. The position is that there is a limited market available for this class of insurance. It is limited by a number of factors but it is large enough to provide, I think, a worthwhile service. However, it is not so large that it could bear unlimited competition. Up to the stage at which the advisory body, having examined this problem carefully over a period of 12 months, issued their report, the position was that no commercial insurance company in this country was prepared to provide this form of cover for the people. One company had provided it for a short period of, I think, two years, but it found it uneconomic and pulled out. Accordingly, when the Advisory Body reported, there was, in effect, no cover of any kind being provided or proposed by any company entitled to operate insurance in this country.
Since the introduction of this Bill, I became aware that it was reasonable to believe that an outside syndicate which, for a particular reason, was entitled to carry out this type of health insurance in this country proposed to use the material collected and contained in the Advisory Body's report and to put such a scheme of insurance on offer here. If it did so, it might well mean that, by the time this board was in operation, a fair portion of the limited market available would have disappeared and this board then would start its activities under considerable disadvantage. I felt that that was not a prospect conducive to the success of the scheme. I felt it would be regrettable if this form of insurance were operated or controlled not only without public scrutiny through our Parliament here but also from sources outside the country. Accordingly, as I indicated, I propose to safeguard that position and the purpose of these amendments is to carry out that intention.
I shall now deal with both amendments together. It will be provided in amendment No. 10 that, in effect, no body or organisation may carry out health insurance here without a licence from the Minister for Health. Care is, however, taken to safeguard the position of a whole variety of existing insurance schemes which, in effect, do not interfere with the market intended for this body. These schemes are set out in amendment No. 10. First of all, the prohibition would not apply to benefits provided by a Minister of State, a trade union or society registered under the Friendly Societies Acts. That would refer to the health insurance, say, carried out by the Department of Social Welfare. It would also refer to the activities of some 30 friendly societies which disburse sickness benefit of one form or another to their members. Certain trade unions also carry on a form of sickness benefit or sickness insurance. It is not intended that any of that class of insurance should in any way be interfered with.
Secondly, it is proposed to exclude from the prohibition "a contract which is attached to or dependent on a contract of assurance on human life and under which the assurer has no right of cancellation and which also provides for the payment of moneys in case of sickness, injury or disease of the insured...."
That class of contract is a contract which is provided by some insurance companies whereby you assure your life but, added to the life assurance, there is provision for certain payments in the event of sickness or accident, as specified in the policy. It is not proposed to interfere with that class of insurance.
It is not proposed to interfere with "a contract of insurance under which benefits are payable in respect of sickness, injury or disease of an amount calculated by reference to the duration of the sickness, injury or disease and not to the nature or cost of any hospital, medical, surgical or other health service, provided in respect of the sickness, injury or disease..."
That is a particular form of insurance under which a person can insure, under a contract provided, for a certain weekly or other payment to him if he has an accident or gets sick but the payment has no reference to his hospital or medical expenses. It is a contract for a fixed weekly payment if a certain contingency arises.
It is not proposed to interfere with "a contract of insurance against or otherwise in relation to any accident causing or being a contributory cause of sickness, injury or disease to the person insured thereunder or to any other person under which benefits are also payable in respect of such sickness, injury or disease..."
These exemptions are insurance policies which also provide cover against the medical and hospital expenses arising from the accident. Cases in point are ordinary insurance policies, motor insurance policies and employers' liability or public liability policies. Again, it is not proposed to interfere with such forms of insurance.
Lastly, the prohibition will not apply to any contract of insurance made before the passing of the Act. In other words, if anyone has taken out a contract of health insurance, as defined here, with any insurance company entitled to engage in the business here, such contract will not in any way be interfered with. As I indicated, the prohibition with regard to health insurance is provided for in amendment No. 10.
In amendment No. 9, there is the machinery with regard to licences. It is provided that the Minister may, in his absolute discretion, grant or refuse to grant to any person a licence to carry on this form of insurance. There is a provision that the licence may contain conditions and, if the licensee does not act in accordance with these conditions, he will be guilty of an offence. There is provision that a licence granted may be revoked at any stage.
Generally, the effect of the two amendments would be that the activities of the new board would be safeguarded. The market would be retained for them without interfering with the kind of smaller schemes that have traditionally been in operation. I feel that, if power of this kind were not provided, the idea of health insurance could not possibly operate because this board, operating on limited funds—as I think it should operate—would at best find itself engaged in a sort of cut-throat competition with large syndicates controlling large moneys outside the State and the end, I think, would be the disappearance of this kind of scheme and this kind of experiment.
I have quite naturally an aversion to monopolies of different kinds. I think, generally speaking, competition is desirable and initially I was disposed to provide for competition in relation to this form of insurance also. On closer examination I was compelled to the view that, if these safeguards were not provided, the whole idea of health insurance would fail, with results which I do not think would be desirable. I am moving both amendments.