1911.

Provided that, if the special circumstances of any county or county s. 62-63. borough (a) are such that the Insurance Commissioners consider that the travelling expenses of the members of the committee should be repaid to them by the committee, the Insurance Commissioners may authorise such repayment, and in such case may increase the said sum of one penny to such sum, not exceeding twopence, as they may determine (b).

(3) It shall be lawful for any local authority, out of any fund or rate out of which the expenses of the authority are payable, to subscribe such sums as it may think fit towards the general purposes of the Insurance Committee.

Local medical

62.-Where a local medical committee has been formed for any county or county borough (c) or for any area for which a district committee committees. has been formed and the Insurance Commissioners are satisfied that such committee is representative of the duly qualified medical practitioners resident in the county or county borough or such area as aforesaid, they shall recognise such committee, and, where a local medical committee has been so recognised, it shall, subject to regulations made by the Insurance Commissioners, be consulted by the Insurance Committee or district committee, as the case may be, on all general questions affecting the administration of medical benefit, including the arrangements made with medical practitioners giving attendance and treatment to insured persons, and shall perform such other duties, and shall exercise such powers, as may be determined by the Insurance Commissioners (d).

Excessive Sickness.

causes of excessive

63.-(1) Where it is alleged by the Insurance Commissioners or by Inquiries into any approved society or Insurance Committee that the sickness which has taken place among any insured persons, being, in the case where the sickness, &c. allegation is made by a society or committee, persons for the administration of whose sickness and disablement benefits the society or committee is responsible, is excessive, and that such excess is due to the conditions or nature of employment of such persons, or to bad housing or insanitary conditions in any locality, or to an insufficient or contaminated water supply, or to the neglect on the part of any person or authority to observe or enforce the provisions of any Act relating to the health of workers in factories, workshops, mines, quarries, or other industries, or relating to public health, or the housing of the working classes, or any regulations made under any such Act, or to observe or enforce any public health precautions, the Commissioners or the society or committee making such allegation may send to the person or authority alleged to be in default a claim for the payment of the amount of any extra expenditure alleged to have been incurred by reason of such cause as aforesaid, and, if the Commissioners, society, or committee and such person or authority fail to arrive at any agreement on the subject, may apply to the Secretary of State or the Local Government Board (e), as the case may require, for an inquiry (f) and thereupon the Secretary of State or Local Government Board (e) may appoint a competent person to hold an inquiry.

66

(a) The words or county borough' were inserted here by Section 31 (2) of the
National Insurance Act, 1913 (p. 82).

(b) Subsistence allowances and compensation for loss of remunerative time also may
now be paid: see Section 31 (1) of the National Insurance Act, 1913 (p. 82).
(c) See footnote (a) on preceding page.

(d) Panel Committees representative of doctors on the panel were constituted by
Section 32 of the National Insurance Act, 1913 (p. 82), which Committees may in
special cases be recognised as Local Medical Committees.

(e) See footnote (b) on preceding page.

(f) Section 38 (1) of the National Health Insurance Act, 1918 (p. 115), provides that where an allegation with regard to excessive sickness is made by an approved society or Insurance Committee, the society or Committee shall, in the event of their failing to arrive at an agreement with the person or authority concerned, refer the matter with a statement in support of the allegation to the Insurance Commissioners, and shall not make an application for an inquiry unless the Commissioners are of opinion that a prima facie case for an inquiry is disclosed, and authorise such an application to be made.

1911. s. 63.

(2) If, upon such inquiry being held, it is proved to the satisfaction of the person holding the inquiry that the amount of such sickness has

(i) during a period of not less than three years before the date of the inquiry; or

(ii) if there has been an outbreak of any epidemic, endemic or infectious disease, during any less period;

been in excess of the amount of sickness which, in the opinion of the person holding the inquiry, would have occurred if there had been no default by any person or authority as aforesaid, the amount of that (a) extra expenditure found by the person holding the inquiry to have been incurred under this Part of this Act by any societies or committees where the allegation is made by the Insurance Commissioners, or, if the allegation is made by a Society or committee, by the society or committee in question, by reason of such cause shall be ordered by him to be made good in accordance with the following provisions :

(a) Where the excess (b) is due to the conditions or nature of the
employment or to any neglect on the part of any employer
to observe or enforce any such Act or regulation as aforesaid,
it shall be made good by the employer:

(b) Where such excess (b) is due to bad housing or insanitary
conditions in the locality, or to any neglect on the part of any
local authority to observe or enforce any such Act or regulation
or such precautions as aforesaid, it shall be made good by such
local authority as appears to the person holding the inquiry
to have been in default, or, if due to the insanitary condition
of any particular premises, shall be made good either by such
authority or by the owner, lessee, or occupier of the premises
who is proved to the satisfaction of the person holding the
inquiry to be responsible:
(c) Where the excess (b) is due to an insufficient or contaminated
water supply, it shall be made good by the local authority,
company, or person by whom the water is supplied, or who
having imposed upon them the duty of affording a water supply
have refused or neglected to do so, unless the local authority,
company, or person prove that such insufficiency or con-
tamination was not due to any default on the part of the
authority, company, or person, but arose from circumstances
over which they had no control (c).

(3) Where any such inquiry as aforesaid is held in respect of bad housing or insanitary conditions in any locality, it shall be lawful for the local authority to serve notice upon the owner, lessee, or occupier of any premises which are the subject-matter of the inquiry, and where it is proved that such notice has been served and that any such extra expense as aforesaid, or any part thereof, has been caused by the act or default of such owner, lessee or occupier, the person holding the inquiry may order the owner, lessee, or occupier to repay to the local authority the amount of the extra expenditure or part thereof which has been so caused (c). (4) [Repealed by Section 38 (2) of the National Health Insurance Act, 1918 (p. 115).]

(5) The Insurance Commissioners shall make regulations as to the procedure on inquiries under this section, and a person holding an inquiry under this section shall have all such powers as an inspector (d) of the

(a) Substituted by Section 38 (2) of the National Health Insurance Act, 1918 (p. 115), for the words "been in excess of the average expectation of sickness by more than ten per cent., and that such excess was in whole or in part due to any such cause as aforesaid, the amount of any " formerly inserted here.

(b) The words "or such part thereof as aforesaid " formerly inserted here were omitted by Section 38 (2) of the National Health Insurance Act, 1918 (p. 115). (c) For modifications of this sub-section in Scotland, see Section 80 (11).

(d) In Scotland this includes a person acting under Sections 7 or 8 of the Public Health (Scotland) Act 1897: see Section 80 (3).

Local Government Board has for the purposes of an inquiry under the Public Health Acts (a), and shall have power to order how and by what parties costs, including such expenses as the Secretary of State or Local Government Board (b) may certify to have been incurred by them, are to be paid, and an order made by such person under this section may, by leave of the High Court (c), be enforced in the same manner as a judgment or order of the Court to the same effect:

Provided that a society or committee shall not be ordered to pay the costs of the other party to the inquiry if the person holding the inquiry certifies that the demand for an inquiry was reasonable under the circumstances, and, when he so certifies, the Treasury may repay to the society or committee the whole or any part of the costs incurred by it.

(6) Without prejudice to any other method of recovery, any sum ordered under this section to be paid by a local authority may, in accordance with the regulations of the Local Government Board (d) with the approval of the Treasury, be paid out of the Local Taxation Account (e) and deducted from any sums payable either directly or indirectly out of that account to the local authority (f).

(7) For the purposes of this section, any expenditure on any benefit administered by an Insurance Committee shall be deemed to be expenditure of that Committee, but any sums paid to any such Committee under this section to meet extra expenditure on sickness benefit or disablement benefit shall be dealt with for the benefit of deposit contributors in accordance with regulations made by the Insurance Commissioners.

(8) Where under this section any sum is paid to the Insurance Commissioners, the Insurance Commissioners shall apply the same in discharge of any expenses incurred by the Commissioners under this section and shall distribute the balance amongst the societies and committees which appear to the Commissioners to have incurred extra expense on account of the excessive sickness in such proportions as the Commissioners think just.

(9) Where an association of deposit contributors resident in any county or county borough (g) has been formed under regulations made by the Insurance Commissioners, the Insurance Committee for the county or county borough shall, if so required by the association, take proceedings under this section on behalf and at the expense of the association.

Supplementary Provisions.

1911.

s. 64.

64.-(1) If under any other Act of the present session (h) any sum Provision of is made available for the purposes of the provision of or making grants sanatoria,&c. in aid to sanatoria and other institutions for the treatment of tuberculosis or such other diseases as the Local Government Board (b) with the approval of the Treasury may appoint, such sum shall be distributed by the Local Government Board (b) (i) with the consent of the Treasury in making grants for those purposes, and the Treasury before giving their consent shall consult with the Insurance Commissioners:

Provided that such sum shall be apportioned between England, Wales, Scotland, and Ireland in proportion to their respective populations ascertained in accordance with the returns of the census taken in the year nineteen hundred and eleven.

(a) In Scotland, the Public Health (Scotland) Acts, 1897 and 1907: see Section 80 (17). (b) See footnote (b) on p. 42.

(c) In Scotland, the Court of Session: see Section 80 (17).

(d) In Scotland, the Secretary for Scotland: see Section 80 (3); in Ireland, the Lord Lieutenant: see Section 81 (5).

(e) In Scotland, the Local Taxation (Scotland) Account: see Section 80 (3); in Ireland, the Local Taxation (Ireland) Account: see Section 81 (5).

(f) For modifications of this sub-section in Scotland, see Section 80 (4).

(g) In Scotland, a burgh or police burgh: see footnote (c) on p. 13.

(h) See Section 16 (1) (b) of the Finance Act, 1911 p. 122).

(i) In Wales, this power is exercised by the Welsh Insurance Commissioners, who are to have regard to the provision of institutions by the King Edward VII. Wels Memorial Association: see Section 82 (3) and (4).

1911. 3. 64.

(2) If any such grant is made to a county council, the Local Government Board (a) may authorise the county council to provide any such institution, and, where so authorised, the county council shall have power to erect buildings and to manage and maintain the institution and for that purpose to enter into agreements and make arrangements with Insurance Committees and other authorities and persons, and to do all such things as may be necessary for the purposes aforesaid (b), and any expenses of the county council, so far as not defrayed out of the grant, shall be defrayed out of the county fund (c) as expenses for general county purposes, or, if the order of the Local Government Board (a) so directs, as expenses for special county purposes charged on such part of the county as may be provided by the order (d).

(3) For the purpose of facilitating co-operation amongst county councils, county borough councils, and other local authorities (not being Pool Law authorities) for the provision of such sanatoria and other institutions as aforesaid the Local Government Board (a) may by order make such provisions as appear to them necessary or expedient, by the constitution of joint committees, joint boards (e), or otherwise, for the joint exercise by such councils and authorities (f) of their powers in relation thereto, and any such order may provide how, in what proportions, and out of what funds or rates the expenses of providing such institutions, so far as they are not defrayed out of grants under this section, are to be defrayed, and may contain such consequential, incidental and supplemental provisions as may appear necessary for the purposes of the order, and an order so made shall be binding and conclusive in respect of the matters to which it relates.

(4) An Insurance Committee may, with the consent of the Insurance Commissioners, enter into agreements with any person or authority (other than a Poor Law authority (g)) that, in consideration of such person or authority providing treatment in a sanatorium or other institution or otherwise for persons recommended by the Committee for sanatorium benefit, the Committee will contribute out of the funds available for sanatorium benefit towards the maintenance of the institution or provision of such treatment, such annual or other payment, and subject to such conditions and for such period as may be agreed, and any such agreement shall be binding on the Committee and their successors, and any sums payable by the Committee thereunder may be paid by the Insurance Commissioners and deducted from the sums payable to the Committee for the purposes of sanatorium benefit.

(a) See footnote (b) on p. 42.

(b) In the application of this sub-section to Scotland, a county council is empowered for the purpose of providing institutions for the treatment of tuberculosis, &c., to borrow in terms of the Local Government (Scotland) Act, 1889, such sums as may be required, and to acquire, purchase, or take on lease any land; and for the purpose of providing treatment in such institutions for all persons suffering from tuberculosis, &c., it may exercise the same powers as are possessed by local authorities under the Public Health (Scotland) Act, 1897, for the treatment of infectious diseases: see Section 41 (1) and (3) of the National Insurance Act, 1913 (pp. 84 and 85).

(c) In Scotland, the general purposes rate: see Section 80 (12).

(d) In the case of grants to county councils and county borough councils in Ireland, the council may, subject to the sanction of the Local Government Board, exercise the powers given to them by Part 11. of the Tuberculosis Prevention (Ireland) Act, 1908. and any expenses of the council so far as not defrayed out of the grant shall be defrayed in manner provided by that Part of that Act: Hoo Section 81 (14).

(e) Such joint committees or boards are now made bodies corporate by Section 16 of the Local Government (Emorgency Provisions) Act, 1916 (p. 124).

(f) As regards the representation, on such joint committees, joint boards, or other bodies for the joint exercise of the powers here referred to, of burghs and police burghs in Scotland which under the provisions of Section 80 (4) are held to be within a county, see Section 41 (4) of the National Insurance Act, 1913 (p. 85).

(g) See, however, Section 39 of the National Insurance Act, 1913, as to the Metropolitan Asylumns Board (p. 84).

1911.

Insurance

65.—The Insurance Commissioners may make regulations (a) for any of s. 65-66, the purposes for which regulations may be made under this Part of this Act or the schedules therein referred to, and for prescribing anything Power to which under this Part of this Act or any such schedules is to be prescribed, Commis and generally for carrying this Part of this Act into effect, and any regula- sioners to tions so made shall be laid before both Houses of Parliament as soon make as may be after they are made, and shall have effect as if enacted in this regulations, Act:

Provided that, if an address is presented to His Majesty by either House of Parliament within the next subsequent twenty-one days on which that House has sat next after any such regulation is laid before it, praying that the regulation may be annulled, His Majesty in Council may annul the regulation, and it shall thenceforth be void, but without prejudice to the validity of anything previously done thereunder (b).

66. (1) If any question arises—

&c.

(a) as to whether any employment or any class of employment Determina-
is or will be employment within the meaning of this Part of
this Act or as to whether a person is entitled to become a
voluntary contributor; or

(b) as to the rate of contributions payable by or in respect of any
insured person; or

(c) as to the rates of contributions payable in respect of an
employed contributor by the employer and the contributor
respectively; (c)

the question shall be determined by the Insurance Commissioners, in
accordance with regulations made by them for the purpose:

Provided that

(i) if any person feels aggrieved by the decision of the Insurance
Commissioners on any question arising under paragraph (a),
he may appeal therefrom to the county court (d), with a further
right of appeal upon any question of law to such judge of the
High Court as may be selected for the purpose by the Lord
Chancellor (e), and the decision of that judge shall be final (f);
(ii) the regulations of the Insurance Commissioners may provide
for questions under paragraph (b) being determined, in the
case of any person who is or is about to become a member of
an approved society, by the society;

(iii) the Insurance Commissioners may, if they think fit, instead
of themselves deciding whether any class of employment is
or will be employment within the meaning of this Part of this
Act, submit the question for decision to the High Court (g)
in such summary manner as subject to rules of court may be
directed by the court, and the court, after hearing such parties
and taking such evidence (if any) as it thinks just, shall decide
the question, and the decision of the court shall be final.

(2) This section shall come into operation on the passing of this Act.

(a) For extensions of the regulation-making powers of the Commissioners, see Section 28 of the National Insurance Act, 1913 (p. 81), and Section 31 of the National Health Insurance Act, 1918 (p. 113).

(b) The provisions of this sub-section as to the laying of regulations before both Houses of Parliament and the proceedings consequent thereon are applicable also to special orders made under Section 19 of the National Insurance Act, 1913 (p. 79), and Section 1 of the National Insurance (Temporary Employment in Agriculture) Act, 1916 (p. 91), instead of the procedure ordinarily applicable to special orders which is prescribed by Section 113 (2) of this Act.

(c) This Section has been extended by Section 27 (2) of the National Insurance Act. 1913, to include questions as to who is the employer of an employed contributor (se? p. 81).

(d) In Scotland, the Sheriff Court: see Section 80 (16).

(e) In Ireland, the Lord Chancellor of Ireland: see Section 81 (5).

(f) In Scotland, the appeal is to the Court of Session: see Section 80 (16).
(g) In Scotland, the Court of Session: see Section 80 (17).

tion of questions by Insurance

Commis. sioners,