There are four matters dealt with in this Bill, viz.:—
(1) an amendment of Section 17 of the National Health Insurance Act, 1923, so far as it refers to the insurability of seamen,
(2) the constitution of the Committee of Management of Cumann an Arachais Náisiúnta ar Shláinte;
(3) the position of soldiers under both the National Health Insurance Acts and the Widows' and Orphans' Pensions Act, and
(4) the recovery from employers of contributory pensions lost owing to their default.
This is the order in which they occur in the Bill and I will deal with them in that order.
Amendment of Section 17 of the Act of 1923 enables reciprocal arrangements to be made with Great Britain to have the criterion for payment of health insurance contributions, in the case of seamen employed on a ship registered in one country but owned in the other, either the country of registration of the ship or the country in which the owner resides or has his principal place of business. The existing law does not permit of the country of residence of the seaman being made the test. In order to enable this to be done, if considered desirable, the proposed amendment of Section 17 of the Act of 1923 is being made.
In Great Britain amending legislation to that effect has already been passed in the National Health Insurance and Contributory Pensions Act of 1935. It will be understood that the legislation of itself will make no change in the existing position of seamen, but will merely place the Minister in a position to agree to the amendment of the reciprocal arrangements (subject to the consent of the Minister for Finance) if he is satisfied that it is in the best interests of seamen to do so.
Constitution of the Committee of Management of the Unified Society.
Prior to the passing of the 1933 Act one of the conditions precedent to the approval of a society was that its constitution should provide for its affairs being subject to the absolute control of its members. In framing the 1933 Act it was felt that it would not be unreasonable to give employers representation on the committee on the grounds that they contributed largely to the funds and that they had an interest in the administration of the benefits. It was similarly considered desirable that the State which also contributed largely should be represented on the committee. This was effected by giving the Minister power to appoint three trustees who become ex officio members of the committee. This course had the additional advantage of providing an effective safeguard for the custody of the funds. It was, however, considered essential that the old principle of giving a controlling interest to the members themselves should be preserved, and the Act provided that there should be nine members representative of insured persons. The proposed committee was, therefore, to consist of:
Three trustees appointed by the Minister;
Three representatives of employers also appointed by the Minister;
Nine representatives of insured persons to be elected in the prescribed manner by members of the Unified Society.
The provisional committee set up to bring the Unified Society into being are due to go out of office on or before the 13th July next, and it now becomes necessary to make regulations providing for the manner in which the representatives of insured persons are to be elected.
This question of an election by the members of the Unified Society of nine persons to represent them on the committee of management presents many difficulties, the most serious of which is the nomination of candidates. Even assuming that the difficulty of the nomination of suitable candidates could be overcome, an election by ballot would be both expensive and haphazard in view of the fact that the electorate of over 500,000 is widely scattered throughout the Saorstát and that the names of the candidates would convey nothing to the voters, the vast majority of whom would probably not vote at all. The real difficulty, however, is the nomination of candidates. It would not be possible to limit the number of candidates to be nominated. It is probable that a disproportionate number of candidates would be nominated: the number could conceivably be 500,000. Furthermore, it would be impossible to secure that the candidates, if elected, would be suitable and competent to be entrusted with the control and management of the affairs of the Society.
The Government have explored every avenue with a view to finding some practical solution of the problem without interfering with the principle that the management and control of national health insurance business should be in the hands of the insured persons themselves. To leave the nomination of the members' representatives to Labour organisations might possibly have met the difficulty but for the fact that such organisations include in their membership only a small proportion of the working population.
Furthermore, it is probable also that that membership is mainly concentrated in the urban areas, and that consequently in many cases Labour would have no claim to the nomination of representatives for the rural areas.
In all the circumstances, the Government believe the problem of the insured persons' representation on the committee can best be solved by giving to Labour the right to nominate three members and by adopting a delegate system of election for the remaining insured persons' representatives on the committee. Under this system, delegates (who must be insured persons) will first be chosen for each county and county borough area, on the basis of one delegate for every 5,000 members. These delegates will meet and elect from among themselves on a territorial basis five members to act on the committee of management. The difficulty here is the selection of the delegates. An attempt to elect them would be open to the same objections as apply to the direct election of members of the committee, and it is, therefore, provided that they shall be nominated by the county and county borough councils, these bodies being regarded as sufficiently democratic to be entrusted with the duty. It is believed that by taking the county or county borough as the unit for the selection of delegates the widest possible representation can be given to the insured members. Each county under this arrangement will be entitled to nominate at least one delegate. Moreover, the provision in the Bill for territorial elections ensures a fair representation to both rural and urban interests.
Bearing in mind that the Committee of Management is responsible for the direction and control of a scheme which is financed by contributions compulsorily collected from insured persons and their employers, and supported to a very appreciable extent at the cost of the taxpayer, the Government take the view that, in order to ensure a proper standard of administration, there should be an independent chairman, who would be appointed by the Minister for Local Government and Public Health.
The new committee of fifteen members provided by the Bill is therefore as follows: a chairman to be appointed by the Minister; the three trustees for the time being, appointed by the Minister; three members representative of employers of insured persons, to be appointed by the Minister; three members to be nominated by the National Executive of the Irish Trade Union Congress; and five members to be elected territorially in a manner to be prescribed by delegates nominated by county and county borough councils.
Of these five members, two will be elected by the Leinster delegates from among their own number, two by the Munster delegates from among their own number and one by the delegates from the remaining counties in Saorstát Eireann from among their own number. This provision ensures that the insured persons in all the provinces will have direct representation on the Committee of Management of the Society.
It is to be noted that the insured persons will be in the majority on the committee, thereby preserving the principle that the insured shall have a controlling voice in the affairs of the Society.
The Bill also contemplates that the chairman, trustees, and employers' representatives, who are all to be appointed by the Minister, shall hold office for a prescribed period, and that the remaining eight members shall be appointed annually. Provision is also made for the payment to the committee members of such allowance (if any) as the Minister may from time to time determine, and also for the payment of travelling expenses and allowances for maintenance and loss of wages to the delegates, who will be appointed for three years.
The position of soldiers under the National Health Insurance Acts and the Widows' and Orphans' Pensions Act.
Some 1,200 or 1,300 serving soldiers failed or were not afforded an opportunity to exercise the option given them by the Act of 1923 of becoming insured during their army service. Under the existing law these men are not entitled to be insured in respect of their army service, as the option was not exercised within the statutory period of three months allowed for bringing them into insurance. Power is sought in the Bill to bring these men into health insurance as from the 6th January, 1936. It is also proposed in the Bill to make health insurance compulsory in future for all soldiers who enlist for long service, or who re-enter the armed forces for long service. It is not proposed to insure as soldiers men enlisted for short periods of service unless they were already insured persons under the National Health Insurance Acts, in which case they will be insured as ordinary contributors at the full employed contributor rate (8d. a week).
This opportunity is also taken, subject to the general principles just mentioned, to re-enact the main provisions of the National Health Insurance Acts in relation to the armed forces, with a view to clarifying the entire position.
Provision is also made in the Bill to qualify at once for widows' and orphans' pensions at the contributory rate all soldiers in the permanent force who had over 104 weeks of continuous army service on 6th January, 1936, and to ensure that those with less than 104 weeks' continuous service on that date shall become qualified for contributory pensions on the completion of 104 weeks' army service.
Recovery of lost benefit under the Widows' and Orphans' Pensions Act.
The last section of the Bill empowers the dependent of a deceased workman or the Minister on behalf of such dependent to recover from an employer the amount of any loss sustained under the Widows' and Orphans' Pensions Act by reason of such employer's default in the payment of contributions. The employer's liability will extend over the period from the date of his employee's death up to four weeks after the date on which all the contributions in arrears are paid up.
