I move that this Bill be now read a Second Time. When the National Health Insurance Act was first introduced there was no arrangement made for the provision of a scheme of medical benefit for Ireland, and one of the results of that was that the assured societies had a great difficulty in establishing the bona fides of claims for benefits; they had difficulty in establishing that the persons applying for benefit were really sick, and various arrangements were made with a view to getting over that difficulty. Subsequently the Exchequer of the time made a grant of 2/6 per head for the purpose of making special payment to doctors for providing certificates. There was some difficulty in the beginning about it, but from 1915 down the medical profession accepted the scheme by which payments were made from this particular fund for the grant of medical certificates to persons applying for benefits to assured societies.
In May, 1924, a committee was set up to examine into the question of national health insurance generally, and among other questions to report upon whether it was desirable that a scheme of medical benefit on a contributory basis should be set up in the country, and, if so, on what lines it should run. In anticipation of the bringing forward of proposals for the establishment of a scheme of medical benefits, the National Health Insurance Commissioners did not, after the financial year 1923-24, make arrangements for the provision of a medical certificate fund. When, therefore, the report of the National Health Insurance Commission was delayed, it was found necessary to introduce, first in 1924, then in 1925, and then in 1926, legislation to enable a medical certification fund to be set up. The line upon which the 1924 Act went was that it gave authority for providing that approved societies should contribute 10d. per member for the year towards a medical certification fund.
The 10d. was made up as follows:— Out of the 4/10 per head paid to approved societies for the purpose of administration a reduction of 5d. was made, as it was felt that 4/5 only, and not 4/10, was necessary for the work of carrying on administration. Under the scheme 6d. per head was allowed to insurance committees for the purpose of carrying out their work. In actual practice it was found that only 4d. of the 6d. was necessary, and authority was taken to appropriate 2d. of the 6d. That provided 7d. As the result of the weekly contribution having to be brought to the nearest halfpenny there was a concealed margin in the annual contribution that provided another 3d., so that the 10d. was made up in that way. Any additional funds necessary to cover medical certification were to be provided from unclaimed monies in the Stamps Sold Account. The 10d. was made up in that way for the year 1924. In 1925 and 1926 it was decided that it was unfair to take from the societies the 5d. due to them for administrative purposes, as they were entitled to put that additional money to benefit in case their administration expenses did not require it. The result was that only 2d. from the moneys available from the insurance committees and the 3d. from the concealed margin were appropriated in 1925-26, the additional moneys required being taken from the Unclaimed Stamps Account. The proposal here is that for the current year the same 2d. and the same 3d. be appropriated and put to a medical certification fund, and that the additional moneys required will be taken from the State grants under sub-head H of this year's Estimates.
The proposal, therefore, that is made here is that the same arrangement will hold this year for the medical certification fund as held last year and the year before. Section 3 deals with a separate matter. When the prolongation of the Insurance Act of 1921 was brought into being, allowing for the keeping in benefit of certain people beyond their three years, it was also considered desirable as regards persons who had only partially paid up their insurance contributions but who had not 26 contributions in the year, that arrangements should be made by which, although they had not paid up 26 contributions in the year, they would be retained in benefit and would receive partial benefits. Section 3, therefore, is a continuation of the section which has been passed during the last few years and the purpose is this—if during the contribution year ending in July a person had one contribution to his credit the Insurance Commissioners would be entitled to take from the unclaimed stamps account a sufficient amount of money to pay up the arrears of that particular person so as to credit him with 26 contributions. In view of the fact that it is desired that a person having paid up a small number of contributions would be kept in insurance, it would not be fair to the approved societies that they would be kept in benefit without at least 26 contributions being paid up; and it is proposed that up to 26 contributions be paid from the unclaimed stamps account. That has a bearing on another matter that we are dealing with this evening and that is the non-re-enactment of the Prolongation of the Insurance Act, 1921, because it means that a person who during the last contribution year pays one contribution, will, under this particular section here, be kept in benefit for the next contribution year to the extent of at least half benefit. The Act is an Act entirely on all fours with the Act of 1925 and the Act of 1926 and it is brought forward now simply because the legislation, which it was thought might have been introduced before now as a result of the work of the Committee dealing with the National Health Insurance and the proposal arising out of the Commissioners' work, has not and will not be brought forward before the end of this year.