Catalogue description Records of the National Health Insurance Commissions and Joint Committee, Ministry of Health Insurance Department and Welsh Board of Health

The National Insurance Act 1911 introduced the first limited scheme of national health insurance. Four Insurance Commissions, for England, Scotland, Wales and Ireland, were appointed by the Treasury to administer the scheme through approved societies and local insurance committees.

The scheme was introduced in July 1912. It provided for medical benefit through attendance and treatment by medical practitioners accepting insured patients; for cash benefits for sickness, disablement and maternity; and, where surplus funds allowed, for additional benefits including specialist medical, hospital or dental treatment and skilled nursing services. Each commission had both central and outdoor staff, the latter consisting of an inspectorate assisted by health insurance officers and organised in England and Wales on a divisional basis.

The central staffs of the commissions were administrative, financial, actuarial and medical. The chief actuary came to serve all the commissions and also other government departments. In 1917 he was given the title government actuary, and in 1919 became the head of a separate Government Actuary's Department. Each commission had a medical member who, together with the chief medical officer, supervised the work of the medical officers performing medical inspection duties, the appointment of medical referees and the organisation of a regional medical service.

When the Ministry of Health was established in 1919 it assumed the powers and duties of the English and Welsh commissions. These it discharged through its Insurance Department and through the Welsh Board of Health. The Irish commission was transferred to the control of the chief secretary for Ireland, and in July 1919 the Scottish commission's powers were given to the new Scottish Board of Health.

The National Health Insurance Joint Committee, constituted as a result of the National Insurance Act 1911, co-ordinated the work of the four National Health Insurance Commissions; its staff were merged with those of the English commission in 1912. The joint committee consisted of representatives of each commission under a chairman who could sit in Parliament and was in practice a member of the government. It was empowered to make any necessary financial adjustments between the funds under the control and management of the various commissions and to regulate the valuation of approved societies in connection with the central fund of the Association of Approved Societies.

When the Ministry of Health was formed in 1919 the joint committee was reconstituted. The joint committee took over from the Treasury the issue of regulations governing the administration of national health insurance. On the transfer of insurance functions to the Ministry of National Insurance in 1944-45 the joint committee was reconstituted to represent that department and the Ministry of Labour for Northern Ireland alone. It was dissolved in July 1948.

The department was formed in 1919 from the administrative staff of the former National Health Insurance Commission for England and Wales to administer the national health insurance scheme introduced in 1912. It dealt with all the work previously carried out by the commissions except medical services. The Insurance Department was responsible for the maintenance of central insurance records and for the co-ordination of approved societies through their national association. In addition the minister was advised by a Consultative Council on National Health Insurance.

In 1925 the department was charged with the administration of contributory pensions under the Old Age, Widows' and Orphans' Contributory Pensions Act of that year. The department bore statutory responsibility for the administration of both contributory and non-contributory pensions of insured persons, but not until 1928-29 was the actual administration of 'by virtue' pensions taken over from the Board of Customs and Excise. Cases of dissatisfaction with ministerial awards under the act of 1925 were referred to referees selected under regulations made by the National Health Insurance Joint Committee.

The department was also responsible for administering the National Health Insurance Act 1924. Benefits were awarded to contributors by local insurance committees or approved societies. Disputes and appeals were resolved by the Minister or by specially appointed Referees, or by the High Court.

In 1945 responsibility for health and pensions insurance was transferred to the Ministry of National Insurance. The insurance committees and approved societies continued to function under that department until the introduction of the comprehensive system of national insurance in July 1948. They were then replaced by local executive councils.