Other widely adopted additional benefits are ophthalmic benefit (including the provision of spectacles), treatment in convalescent homes, and the provision of medical and surgical appliances.
Insured persons who do not join an approved society within a certain time of ter their entry into insur ance fall automatically into a special class known as deposit con tributors. Such persons are only entitled to benefits up to the limit of the amount standing to their own individual credit as the result of the contributions paid in respect of them, but the usual proportion of the cost of their benefits is paid by the State. The number of deposit contributors at the end of 1926 was 282,400. It is always open to a deposit contributor at any time to join any approved society which is prepared to admit him to member ship. By the Act of 1928 a special insurance section was set up through which any deposit contributor who can prove that he is unable, by reason of the state of his health, to obtain admission to an approved society, is able to obtain the full normal benefits of the scheme on an insurance basis.
The general supervision of the scheme of national health insurance on behalf of the central gov ernment is vested in the Minister of Health in England and Wales, and in the Scottish Board of Health in Scotland, and the cost of the central administration is borne by the Exchequer. It rests with the Minister to determine doubtful questions of insurability, to enforce the payment of the statutory contributions, and to sat isfy himself that the scheme is properly administered by approved societies and insurance committees. The Minister is empowered to withdraw approval from a society which is found, after enquiry, to be administering the scheme in a manner prejudicial to the interests of its members.
The total number of insured persons at the end of 1936 was approximately 16 million, of whom more than 92 per cent were members of approved societies. The total income of the scheme for the year was about L35 million, of which .124-1 mil lion was derived from the contributions of insured persons and their employers; £6 million was paid by the Exchequer, and nearly £6 million was derived from interest on accumulated funds. The
expenditure on benefits was about £32 million and the total cost of administration by approved societies, insurance committees and the central departments was approximately £5 million. The cost of administration was, therefore, about 14 per cent of the total revenue of the scheme. The total accumulated funds at the end of 1936 amounted to £131 million.
Health Insurance.—A Royal Commission was appointed in 1924 to enquire into the scheme of national health insurance and to recommend any altera tions or extensions which might be thought desirable. After hear ing evidence from representatives of all bodies or persons par ticipating in, or affected by, the scheme, the commission issued their report in 1926 and arrived at the conclusion that "national health insurance has established its position as a permanent fea ture of the social system in this country and should be continued on its present compulsory and contributory basis." The com mission, however, made many recommendations for the improve ment of the scheme in detail. Amongst the most important were that medical benefit should be extended to include a consultant and specialist service ; that the insurance medical service should be properly co-ordinated with other health services, and that in order to promote this end the insurance committees should be abolished and their powers transferred to the county and county borough councils. A further important recommendation was that there should be a partial pooling of the surpluses of approved societies in order to provide the necessary funds for the proposed extension of medical benefit, and also to mitigate to some extent the inequalities between different approved societies arising out of favourable or unfavourable experience as revealed on valuation. A minority of the commission reported in favour of the abolition of the approved society system and the transfer of the adminis tration of the cash benefits, as well as medical benefit, to the local health authorities.