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Scotland Insured

THE passing- into law of the Amending Act suggested this booklet. It appeared an opportune moment for presenting a picture of the whole problem and supplying within the covers of one volume the information which it is essential all who are brought within the four corners of the Act should know. I have not sought to deal with Part II. of the Act as that does not apply generally to those who must come under Part I. For the purposes of Part II. Scotland is included fin the area—Scotland and Northern—which also includes Northumberland, Cumberland, Westmoreland, and Durham. It may, however, be useful to summarise the results of Part II. here. The following figures are for the United Kingdom. The number of unemployment books issued was only slightly less than the estimated total of 2,532,000. Of these less than one-fifth had been previously insured against unemployment. The income of the unemployment fund is at the rate of £2,400,000, and the invested balance in July of this year was £1,610,000. In the six months in which the scheme has been operative 400,000 individual claims have been made against the fund, three-quarters of which were direct and only one-quarter through Unions, etc. It is interesting to note that 62 per cent, of such claims were covered by benefit.

The operation of Part II. has acted beneficially on Trade Unions. Membership has increased in those which previously gave such benefits, and 21 Trade Unions have since begun to give unemployed benefit. In addition no fewer than 275 associations with a membership of over one million have been approved to receive the State contribution for schemes of voluntary insurance against unemployment. Briefly, the number of people protected against unemployment has increased six-fold and funds are accumulating at a rate which will enable workmen to face the next cyclical trade depression with accumulated funds of several millions.

The facts and figures of Health Insurance talk for themselves in these pages. They present an amazing achievement. True, the Act is still the subject of hostile criticism. There arc always some meagre souls who resent the success of anything they are opposed to and who grudge the admission of their own lack of foresight in spite of the experience of their own eyes. The author of the scheme—Mr. Lloyd George—has been the target for all rifles, and often the firing from the butts has not been within the rules. But his great scheme is emerging from the confusion of the scaffolding and the debris associated with laving foundations, and as the lines of the building are being seen the magnificence of the structure appeals to more and more eyes.

He has been fortunate in his craftsmen, particularly in Scotland. The Commissioners have shown grit and courage, have .overcome difficulties and met disappointments with a single eye to the ultimate success of the scheme, and to-day they are on the threshold of having 100 per cent, of the possible insurable persons insured. It is a great record in administration and a pride to us to know that wre have done it for ourselves.

An attempt was made during the discussion of the Amending Act to abolish the separate Commission, but a resolute resistance was offered to the proposal by Scottish Liberal members with the result that the suggestion was defeated by an overwhelming majority. It was a political Bannockburn. Another more insidious proposal, though not defeated, was so altered as to leave Scotland unscathed if Scotsmen so desire.

It was proposed to amalgamate separate societies in Scotland with their centralised Society in England for purposes of valuation. This meant sacrificing any advantages gained in administration in Scotland. It also meant breaking the contract under which Scotsmen had joined the scheme. Moreover it meant that three-quarters of a million Scottish insured persons would have been taken out of the ultimate control of our own Commission and it requires no acute observation to conclude that such a step meant the abolition of the Scottish Commission.

A second fight was made against these proposals, with the result that should such amalgamation take place any insured person has the right to transfer at once into a Scottish National Society. Moreover such amalgamation cannot take place without an inquiry being- held and, if required, a poll of the members. No Scottish insured person therefore need go outside his native country for any purpose, and he will be. a wise man if he insists on remaining outside any scheme for joint valuation. On the results of valuation depend increased benefits or reduced contributions, and unless all the omens are false it will pay insured persons in Scotland to reap their own harvest.

All interested should study carefully Section 16 (1) of the National Insurance Act, 1913, and if they desire to remain a Scottish entity should at once send, through their Society, a representation to the Joint Committee to be treated as if they formed a separate Society. This must be done within six months of August 10th, 1913, i.e., on or before February 14th, 1914. Delay is dangerous. After that date the foolish virgins will be left lamenting their oilless lamps. Clause 16 creates a new position, and it must be dealt with at once. The responsibility of delay can only rest with those who, having the opportunity, do not immediately seize it. After the fight that was made on the floor of the House of Commons, there is no excuse for any dilatory proceedings. Action will now reap the reward which those most conversant with Scottish conditions, characteristics and ability to administer, feel certain will accrue from separate valuation in Scotland.

The doctors of Scotland have a great opportunity. Malingering is the vogue of the moment, and attempts are made to prove that the Act is being made the plaything of the born-tired. It is incidentally worthy of note that Scotland, however, is not included in the special enquiry which is being made into this practice. The doctor is the sheet anchor of the Society. He must certify. It is easier to give a certificate than to refuse it. And it may be that to keep patients there may be the temptation to be generous. We feel certain that this will not be the case and that a courageous exercise of duty, even at the expense of temporary unpopularity and, it may be, of some patients, will be the rule and scarcely ever the exception. Already there is a call for a Referee. Is this because professional jealousy is such as to put several off-side? Let the medical profession bear in mind that free choice of doctor does not mean freedom either to ruin Societies or to break down National Insurance. Let them remember that Scotland expects them to play their great part in this fine scheme to combat disease, and that the public will not be unmindful of their services if they are in line with the great tradition of the profession.

Finally, it should not be lost sight of that the Act is more than an Insurance Act. It is a vast lever for social progress. As experience matures and the far-reaching provisions of the original Act are put into force to compel better conditions of housing, sanitation and public health, the greatness of the measure will appear. As one approaches the horizon it recedes and a fresh horizon takes its place. The horizon of the Act now is bounded by administrative effort to secure that all who ought to be within the four corners of the Act are there. Now that that is achieved we must look ahead to a newer and wider horizon which we can make possible through the social, economic and industrial facts thrown up by investigation made necessary by the operation of the Act. Book-keeping, the collection of statistics, investigation are mundane and uninviting. But they are the sappers and miners that eventually enable us to meet the real obstacles to progress. They open up to us eventually the real field the Act will enable us to occupy.

J. M. Hogge
5, Hartington Place,

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