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Private Agencies for Public Purposes: Some New Perspectives on Policy Making in Health Insurance Between the Wars*

Published online by Cambridge University Press:  20 January 2009

Noelle Whiteside
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Abstract

The approved societies, who were charged with the administration of health insurance in Britain, have long been blamed for the failure of the scheme to expand its coverage or scope in the interwar period. This paper takes a closer look at the administrative process and argues that societies were more vulnerable to central regulation than is commonly thought and were unable to resist cuts in public subsidies and extensions in liability introduced at their expense. They provided a convenient scapegoat for policies emanating primarily from the economic orthodoxy subscribed to by both government and the Treasury, modified to protect the unemployed during the slump. Health insurance policy was dominated to a large extent by the Government Actuary, who aimed to guarantee the cost effectiveness of the scheme. This paper also shows how administrative definitions and practices affected the classification of claimants to state social insurance at this time. It re-establishes the major weaknesses of the system, arguing that – in the light of recent discussions about reviving a system of national health insurance – we have much to learn from looking again at the experience of the interwar period.

Type
Articles
Information
Journal of Social Policy , Volume 12 , Issue 2 , April 1983 , pp. 165 - 193
Copyright
Copyright © Cambridge University Press 1983

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References

REFERENCES

Beveridge, W. H. (1923), Insurance for All and Everything, pamphlet, London.Google Scholar
Cmd 1644 (1922), Interim Report of the Interdepartmental Committee on Health and Unemployment Insurance (Watson), HMSO, London.Google Scholar
Cmd 1821 (1923), Final Report of the Interdepartmental Committee on Health and Unemployment Insurance (Watson), HMSO, London.Google Scholar
Cmd 2406 (1924/1925), Widows, Orphans and Old Age Pensions Bill: Report by the Government Actuary, HMSO, London.Google Scholar
Cmd 2596 (1926), Report of the Royal Commission on National Health Insurance, HMSO, London.Google Scholar
Cmd 3548 (1930), Report by the Government Actuary on the Sickness and Disablement Experience of a Group of Approved Societies, HMSO, London.Google Scholar
Cmd 3920 (1931), Report of the Committee on National Expenditure (May), HMSO, London.Google Scholar
Cmd 3978 (1931), Third Valuation of the Assets and Liabilities of Approved Societies, HMSO, London.Google Scholar
Cmd 6404 (1942), Report on Social Insurance and Allied Services (Beveridge), HMSO, London.Google Scholar
Deacon, A. (1974), In Search of the Scrounger, Bell and Sons, London.Google Scholar
Gilbert, B. B. (1970), British Social Policy 1914–1939, Batsford, London.Google Scholar
Honigsbaum, F. (1979), The Division in British Medicine, Kogan Page, London.Google Scholar
Ministry of Health (1939), National Health Insurance and Contributory Pensions Insurance, HMSO, London.Google Scholar
Political and Economic Planning (1937), Report on the British Health Services, London.Google Scholar
PRO (1921), Correspondence between the ministries of Health and Labour; PIN 7/75.Google Scholar
PRO (1922), Papers of the Committee on Health and Unemployment Insurance (Watson); PIN 1/1.Google Scholar
PRO (1923a), Press cuttings of election speeches, 11 1923; ACT 1/247.Google Scholar
PRO (1923b), Papers of the Committee on Insurance and other Social Services (Anderson); PIN 1/2.Google Scholar
PRO (1923c), Memorandum on state subsidies to sick visitors; PIN 5/8.Google Scholar
PRO (1924), Correspondence and papers of departmental committee on health insurance; ACT 1/233.Google Scholar
PRO (1925a), Discussions on funding Widows, Orphans and Old Age Pensions Bill: deputation from NCEO to Prime Minister and Minister of Health, 1925; PIN 4/96.Google Scholar
PRO (1925b), Minutes of the Consultative Council, 9 06 1925; PIN 5/26.Google Scholar
PRO (1925c), ‘Report of the Actuary on clauses of the Bill relating to NHI’, 10 1925; ACT 1/238.Google Scholar
PRO (1926), National Economy Bill Papers: committee stage; ACT 1/239.Google Scholar
PRO (1927a), Memorandum, 05 1927; ACT 1/294.Google Scholar
PRO (1927b), ‘Report of the Government Actuary on Sickness and Disablement Experience 1921–1927’; PIN 4/27.Google Scholar
PRO (1928a), Chamberlain's presentation of provisional bill to Cabinet, 23 01 1928; CAB 24/192 CP9.Google Scholar
PRO (1928b), National Health and Pensions Insurance: pooling of surpluses; MH 62/33.Google Scholar
PRO (1929), Survey of RMO referral experience, 1926–1928; PIN 4/27.Google Scholar
PRO (1930a), National Health Insurance Joint Committee: subcommittee on sickness claims: minutes for 3rd 02 1930; PIN 4/29.Google Scholar
PRO (1930b), Report on RMO surveillance: 11 1929–03 1930; PIN 4/33.Google Scholar
PRO (1930c), Department of Health for Scotland's notes on the Actuary's Report; PIN 4/27.Google Scholar
PRO (1930d), Memorandum on draft of Cmd 3458/1930: n.5, n.d; PIN 4/11.Google Scholar
PRO (1931a), ‘Notes on the Government Actuary's Report, January 1931’; PIN 4/27.Google Scholar
PRO (1931b), ‘Summary of branch responses to circular issued by the British Iron, Steel and Kindred Trades Society, January 1931’; PIN 4/35.Google Scholar
PRO (1931c), ‘Report of the Welsh Board of Health for 12 12 1930–12 February 1931’; PIN 3/42.Google Scholar
PRO (1931d), Draft circulars and other papers, 03 1931; PIN 4/35.Google Scholar
PRO (1931e), NHIJC Subcommittee (see PRO (1930a) above): minutes 12 03 1931; PIN 4/35.Google Scholar
PRO (1931f), Watson to Hurst, 10 and 11 07 1931; ACT 1/439.Google Scholar
PRO (1932a), Kinnear to Minister of Health, 26 02 1932; PIN 4/11.Google Scholar
PRO (1932b), Minute by Robinson to the Minister of Health, 4 03 1932; PIN 4/11.Google Scholar
PRO (1932c), Memorandum on meeting with selected representatives of the National Consultative Council, 21 03 1932; PIN 4/11.Google Scholar
PRO (1932d), Actuary's memorandum to the minister, 9 04 1932; PIN 4/11.Google Scholar
PRO (1932e), Epps to Kinnear, 23 05 1932; ACT 1/483.Google Scholar
PRO (1932f), Minutes of women's deputation to Minister of Health, 05 1932; ACT 1/483.Google Scholar
PRO (1932g), National Insurance and Contributory Pensions: bill papers; PIN 4/11.Google Scholar
PRO (1932h), ‘National Health and Contributory Pensions Bill of 1932’; ACT 1/483.Google Scholar
PRO (1934), ‘A Survey of the recent history of National Health Insurance and Contributory Pensions’: Kinnear; PIN 3/41.Google Scholar
Royal Commission on National Health Insurance (RCNHI) (1925–1926), Minutes of Evidence vols. 1–4, HMSO, London.Google Scholar
Royal Commission on National Health Insurance (RCNHI) (1925–1926), Appendices and Index parts 1–4, HMSO, London.Google Scholar
Thane, P. M. (n.d.), ‘The working class and the origins of the welfare state’ (unpublished).Google Scholar
Yeo, S. (1979), ‘Working Class Associations, Private Capital, Welfare and the State in the late Nineteenth and Twentieth Centuries’ in Parry, N., Rustin, M. and Satya-murti, C. (eds), Social Work, Welfare and the State, London.Google Scholar