In the case of Denmark, the figures which are given relate to December, 1956, and December, 1957. The Times gives no figures for the Six Counties, but it is common knowledge that unemployment there has increased so substantially that recently the matter was specially referred to in the House of Commons. Unemployment elsewhere is on the increase; here it is on the decline. Though I say that, I do not wish it to be understood that our position leaves any ground for complacency. Nevertheless, so that there may be no misunderstanding as to the position here and elsewhere, it is essential to realise the significance of the predominating factor, the world trend, in regard to employment. I am justified, then, in repeating what I said at the outset, that the need for an additional £872,000 to supplement the original Vote of £3,620,000 is due, not to an increase in unemployment but to other causes, of which three are of major importance.
The first of these was the virulent influenza epidemic which this country, in common with most of Europe and most of Asia, experienced last year. It is estimated to have increased by £120,000 the amount which normally would be required to meet claims for disability benefit. Next, there was quite an unexpected and, indeed, incomprehensible increase in expenditure on disability benefit, arising otherwise than by reason of the epidemic to which I have referred. This unexpected, abnormal factor imposed an additional charge on the Social Insurance Fund of no less than £153,000; and it therefore demands that a special reference be made to it, particularly as the circumstances in which this additional charge arose still require explanation.
If we take at their face value—as, for the purpose of the social insurance code, the Department of Social Welfare as a rule must do—the medical certificates issued on which claims to disability benefit are passed, it would appear that after the 1st April last, in the experience of certain practitioners, there was an extraordinary increase, not in the number of insured persons falling ill but in the duration of incapability in very, very many cases. Because of that, though the number of persons claiming benefit showed little, if any, increase, nevertheless by reason of the prolongation of the periods covered by medical certificates of so many individuals, there was a marked increase in the amount demanded from the Social Insurance Fund. Examination of this position disclosed the significant fact that the increase in the duration of illness did not appear to be general. It was not, in fact, a general increase, it was not spread over all certifiers but was traceable to the fact that, in or about that date, certain medical certifiers began to issue many more certificates than they formerly did. So far, I have not succeeded in obtaining a satisfactory explanation of this peculiar development—though we shall continue to search for one.
In the meantime, however, I wish to repeat what already has been conveyed to each medical officer, as follows. Insured persons who apply for medical certificates of incapacity for work must present themselves for examination in order that the certifier may determine whether they are incapable of work. If they do not, medical certificates must not be issued in respect of them. If a certifier has signed an agreement for general certification and an insured person is unable to attend at the certifier's surgery or dispensary for examination, the certifier must visit the insured person and examine him before issuing the certificate.
No doubt, the greater number of medical certifiers fulfil their obligations in this matter conscientiously. Some, however, unfortunately do not. I trust that, now that they have been made aware of the seriousness of their obligations, we shall have no ground for complaint even in regard to them.
The two matters which I have mentioned—the increase in the cost of disability benefit, which may properly be ascribable to the influenza epidemic and the increase in the claims for disability benefit arising out of the greater number of medical certificates having been issued in the circumstances which I have mentioned— account for £273,000, leaving £599,000 to be accounted for. This figure can be split into three main items, as follows. The first is £143,000, arising out of overexpenditure on unemployment benefit. The second, of £500,000, was occasioned by the fact that when the original Estimate was prepared towards the end of 1956 the contribution income of the Social Insurance Fund was overestimated to the extent of £500,000; and the third, of £48,000, was due to the fact that the amount drawn from the Exchequer to meet claims on the fund arising during the year which ended on the 31st March, 1957, was deficient by that sum. These three items amount to £691,000, and with the £273,000 excess expenditure on disability benefit, the figure comes to £964,000.
