I move:—
Go ndeontar suim ná raghaidh thar £211,241 chun slánuithe na suime is gá chun íoctha an Mhuirir a thiocfaidh chun bheith iníoctha i rith na bliana dar críoch an 31adh lá de Mhárta, 1936, chun Tuarastail agus Costaisí Oifig an Aire Rialtais Aitiúla agus Sláinte Puiblí i dtaobh Riaracháin na nAchtanna um Arachas Sláinte Náisiúnta, 1911 go 1934, agus chun Ilsíntiúisí agus Ildeontaisí, ar a n-áirmhítear Deontaisí áirithe i gCabhair mar gheall ar Chostes Sochar agus Costaisí Riaracháin fé sna hAchtanna san.
That a sum not exceeding £211,241 be granted to complete the sum necessary to defray the Charge which will come in course of payment during the year ending on the 31st day of March, 1936, for the Salaries and Expenses of the Office of the Minister for Local Government and Public Health in connection with the Administration of the National Health Insurance Acts, 1911 to 1934, and for sundry Contributions and Grants, including certain Grants-in-Aid in respect of the Cost of Benefits and Expenses of Administration under the said Acts.
During the last year the major part of the actual process of unification has been completed and the members of all the old approved societies and branches have now been merged in the unified society. The progress made in the matter has been more rapid than was anticipated. The society at first occupied temporary premises but in the early part of last year central premises of a suitable character were acquired in Upper O'Connell Street, which now form the head office of the society. Branch offices have been opened in Cork, Limerick and Waterford. The first transfer of societies was effected on 1st January, 1934, when 16 societies comprising 163,000 members were taken over. One society was taken over on the 30th April, and another on the 2nd June. This was followed by eight societies comprising 131,000 members at the end of June, and the remainder were taken over at various dates between that and the 15th December last when the transfers were completed. The total number of members transferred was approximately 483,000. The transfers were carried through with the least possible inconvenience to insured persons and continuity was preserved in the payment of benefits to those who were incapacitated at the time of transfer.
In selecting the staff of the society the Committee gave preference so far as efficiency permitted to the staffs of the old societies which had been displaced and apart from agents 188 members of such staffs have been given employment in the unified society including the secretary, treasurer, chief clerk and all the staff officers and deputy staff officers. Compensation has been paid by the society to 149 persons under Section 22, amounting to £93,970, and to 1,726 persons under Section 23 amounting to £12,730. The latter were mainly part-time agents. About 680 cases remain to be completed, making the estimated total compensation £128,750.
It is already apparent that the annual cost of administration by the unified society will be considerably less than that under the old scheme and the society estimate from the particulars now available that there will be a saving of 5d. per head on the capitation rate of 4/5 available for administration. This will amount to £10,000 per annum.
A certain amount of publicity has been given to alleged cases of delay or irregularity in the payment of benefits by the unified society. Any complaints of this kind which have reached the Department have been investigated, and in the great majority of them it is found that there is no genuine grievance and that they have arisen through erroneous ideas on the part of the insured persons themselves as to the benefits to which they were entitled. It is an essential feature of the scheme, as it is of every insurance scheme, that certain qualifying conditions must be fulfilled before the right to benefit accrues. Again, unless the number of contributions paid in a contribution year reaches the required number, benefits are reduced during the ensuing benefit year if arrears are not paid. This has been a very common form of complaint during the early months of the year. Although every individual insured person who was in arrears was notified before the 10th November last, and full instruction given as to the method of payment and the effect of non-payment, many of them ignored the instructions and then complained when their benefits were stopped or reduced. Some in claiming benefit have omitted to give particulars by which they could readily be identified, others have taken no trouble to have their cards stamped or to send them into the society at the proper time. All omissions or irregularities of this sort entail delay, but the delay is in no way attributable to the society.
There is one other point to which I would like to refer. Quite a number of insured persons have sent in one medical certificate and complained they have got no benefit. Benefit can only be paid when there is proved incapacity extending over a period. The first certificate merely proves that the person is ill on a particular day; there must be a second certificate proving a period of incapacity before benefit is payable.
It is not claimed that the society is infallible. It would be too much to expect that an occasional error would not arise in dealing with such a large volume of work—some 28,000 payments a week—but I am satisfied that the work is being well done, and that every possible effort is being made to consider the interests of the insured persons, and to give them the full advantage of the scheme even in cases where they themselves are slow to co-operate.
The total Estimate of £316,841 compares with a figure of £311,376 for the preceding year, but the items in the latter figure have been altered from those in the original Estimate owing to the changes effected when the Supplementary Estimate was introduced. In dealing with salaries for instance, the amount now appearing for last year is £62,341, but the amount in the original Estimate was £64,641. The difference of £2,300, which represented savings on the salaries sub-head as originally estimated was used in the Supplementary Estimate to meet deficiencies on other sub-heads of the Vote. The actual increase in the Estimate for salaries as compared with the Estimate made at the corresponding period last year is £420 and not £2,720, and this increase is more than accounted for by the ordinary incremental (and bonus) increases.
The increase in State grant is due to increased expenditure on benefits and to the increased number of contributions which, it is estimated, will be paid in 1935. There has been a steady increase in the annual contribution income of the Health Insurance Fund which, in 1934, is estimated to have reached £628,000. The expenditure on benefits has, however, also increased and, in 1934, is estimated to have been £782,000. The number of medical certificates issued under the medical certification scheme to insured persons increased from 1,339,000 in 1933 to 1,410,000 in 1934. The average number of persons in receipt of benefits weekly through the year was 27,330.
Under the provisions of the National Health Insurance Act, 1929, during the 12 months ended 31st December, 1934, sums totalling £484 16s. 11d. were recovered for insured persons by the Department from employers in respect of benefits lost through neglect to pay contributions. The accumulated funds forming the assets of National Health Insurance amounted to £3,646,320 at the end of 1934, indicating an increase of £94,540 during the year. As the annual income derived from dividends and interest, etc., however, is £183,670, it is evident that the income from other sources, i.e., contribution and State grant, is about £89,130 short of the expenditure.