I would like to get some information from the Parliamentary Secretary as to what are his proposals for dealing with what I can only describe as the very unsatisfactory position of national health insurance legislation in this country. The Department has had presented to it from time to time over the past 15 years various reports on the valuation of the individual national health insurance societies, and recently the Department had presented to it the report of the Actuary on the unified national health insurance society. The publication of that report is usually accompanied by rather sensational Press headings indicating an alarming increase in the amount of sickness benefit and an alarming increase in the amount of disablement benefit to men and women and an effort is made by a thoughtless examination of the position to create the impression that the national health insurance society is in a very bad way financially. Of course, anybody who takes the trouble to examine the real position of national health insurance in this country will know that probably the position of the national health insurance society in this country is stronger than in any European country at the present time. In this country the basis of valuation of the unified national health society and of the 65 separate societies which preceded it was the British method of valuation. That method of valuation provided for the contingency that you had to be sure you had a sum of money on reserve to meet the claims of the last man who would be alive in the national health insurance society. In the circumstances in Britain that was probably an understandable arrangement because in Britain you had hundreds of individual national health insurance societies each of them competing for members among the insured population. A society might have 2,000 members, and after a given date no other person might join that society; the members might flow to all the other societies; the particular society might be left with 2,000 members, and in this circumstance it had to budget for the possibility that there would be last man in that society or a last dozen men. Therefore, they had to have some actuarial reserves against that person or persons.
The whole position has entirely changed in respect of this country. Here you have not the hundreds of societies you have in Britain. You have not even the 65 societies which preceded the amalgamation. You have one society, one society only, and legislation which compels the insured population to be members of that society. Therefore, there is not in our circumstances the need to provide for the last man, that theoretical factor which is a characteristic of valuations based on standards of that kind. Since our legislation here compels the insured population to join this particular society, so long as the race lives and the legislation lasts, there is never going to be a last man in that particular society. There is always going to be a flowing in of members, even if on the other hand there is going to be a flowing out of members. The contingency of the last man is completely eradicated now by the system of having one National Health Insurance Society in this country. Notwithstanding the fact that the circumstances here are different, we are still maintaining a British basis of valuation, in fact, a basis of valuation which very few people in this country understand, and still fewer can explain. That system of valuation which exists today is standing definitely in the way of any improvement in the scales of benefits for members of the National Health Insurance Society. It is a fallacy to say that the society is in any financial difficulties. Its assets amount to, I think, about £4,500,000. It is probably one of the very few organisations that has £4,500,000 to its credit to-day. In addition to that, it is putting aside each year about £250,000. How a society with that annual surplus and with such substantial reserves can be in financial difficulties passes my comprehension.
If we look at the basis on which National Health Insurance is financed in other countries, we can see the enormous difference between the position in these countries and here. In certain Continental countries where the scheme of National Health Insurance is very much better than ours, where the benefits are higher than ours, and where the scheme of treatment for sick insured persons is something that we have never yet dreamed of, the basis on which the society is financed affords a striking object lesson to us.