Dáil Éireann díospóireacht -
Wednesday, 19 Feb 1930

Vol. 33 No. 4

In Committee on Finance. - Vote No. 43.—National Health Insurance.

Professor O'Sullivan

I beg to move:

Go ndeontar suim bhreise ná raghaidh thar £2,621 chun íoctha an Mhuirir a thiocfidh chun bheith iníoctha i rith na bliana dar críoch an 31adh lá de Mhárta, 1930, chun Tuarastail agus Costaisí an Choimisúin Arachais agus chun. Ilsíntiúsí agus Ildeontaisí mar gheall ar chostas Sochar agus Costaisí Riaracháin fé sna hAchtanna um Arachas Sláinte Náisiúnta, 1911 go 1929 (maraon le Deontaisí áirithe i gCabhair).

That a supplementary sum not exceeding £2,621 be granted to defray the Charge which will come in course of payment during the year ending on the 31st March, 1930, for the Salaries and Expenses of the Insurance Commission and for sundry Contributions and Grants in respect of the cost of Benefits and Expenses of Administration under the National Health Insurance Acts, 1911 to 1929 (including certain Grants-in-Aid.)

General Mulcahy

It is anticipated that the payments in respect of sickness, disablement benefit, etc., will be £182,400 instead of £176,500 as estimated. The number of people insured has risen more rapidly than was anticipated. The present estimate is £470,000. There is also the fact that the amount paid out in sickness and other benefits has increased proportionately and the number of people insured has increased as compared with the previous year.

Mr. Lemass

What particular advantages are derived from the fact that the medical certification scheme is now based on the dispensary district instead of on the county in view of the extra cost involved?

General Mulcahy

For some years past, medical certification was based on dispensary districts. I have endeavoured to get agreement with the doctors that it would be more satisfactory and, in a way, more equitable to base the distribution of fees for medical certification on a county basis. Very great differences arise under the dispensary system between the amounts a doctor in one dispensary receives for a certificate issued and the amount received by a doctor in another dispensary district. It has seemed to me and to the National Health Insurance Commissioners unsatisfactory that there should be these big discrepancies. It has seemed unjustifiable from the point of view of the ordinary equitable distribution of money for certificates. The doctors are the persons mainly concerned in the matter. They have opposed a change from distribution on the dispensary district to distribution by county. The National Health Insurance Commissioners estimate that it costs £800 a year more to distribute medical certification on a dispensary basis than on a county basis. In the National Health Insurance Act of 1929, statutory power has been given to take such amount annually from the Medical Certification Fund and to refund to the Treasury as the Minister for Finance in consultation with the Commissioners may think fit. It is proposed this year, in respect of the year under discussion, to transfer £800 to the Treasury as being the amount that it costs to distribute the medical certification moneys on a dispensary rather than on a county basis. The matter has been discussed between ourselves and the doctors, and reluctantly, no doubt, the doctors have agreed to sacrifice that amount of money rather than to have the Medical Certification Fund distributed on a county basis.

Vote agreed to.