THE INSURANCE COMMITTEE
FOR THE
COUNTY OF LONDON
by Nick Cooper © 2004-2009
The 1911 National Insurance Act established for the first time a contributory
system of insurance against illness and unemployment for British workers
aged between 16 and 70 who earnt less that £160 per year. Wage-earners
paid 4d per week, with employers contributing 3d and the state 2d. This entitled
the worker to free medical attention - including prescriptions - and a guaranteed
7s per week benefit for up to fifteen weeks of unemployment in any one year.
"Labour Exchanges" were established to provide information on vacancies,
as well as to pay unemployment benefits, while medical benefits were administered
by local "Insurance Committees." These Committees maintained a "Patient Register"
of contributors; a "Medical Register" of General Practitioners (GPs) with
whom they could register as patients; and a register of approved pharmacists
to dispense prescriptions. The Committees also acted as arbiters in complaints
brought by patients against GPs or pharmacists - and vice versa - as well
as administering Sanatorium Benefits for sufferers of tuberculosis, the major
public health issue of the day. In almost all respects, the Insurance Committees
have a direct line of descent to the Primary Care fuctions of the present
day National Health Service (NHS)
Under the terms of the 1911 Act, the Insurance Committee for the County of
London (ICCL) was established in June1912, faced with the monumental task
of administering the medical needs of the working population of the capital
with the "information technology" of the day: manual card indexes, hand-written
ledgers, and mechanical calculating machines! By the start of 1914,
when the population of the County of London was 4.5 million, the Committee
had 1.6 million registered contributors, all kept track of by a large
staff of clerks and "assistants," but with the declaration of war on
4 August came the realisation that staffing levels - which were already
acknowledged as being inadequate - would be further adversely affected by
the rush of men to join the forces.
At its meeting of 24 September 1914, the Committee decided that, "the positions held
by members of the permanent staff, who have joined, or may join, any of His
Majesty's Forces in connection with the present War, be kept open for them
until their return from naval or military service, and that in each case
the ordinary increment of salary due from the Committee be allowed during
such service." In the case of temporary staff, "arrangments shall be made,
as far as possible and subject to the requirements of the Committee at the
time of their discharge, to re-instate them in employment." Generously, it
was also decided to continue to pay the full salaries of enlisted permanent
staff, "less Army or Navy pay and Army separation allowance," and that temporary
staff would be paid in full for two weeks following enlistment. [MH 65/13,
pages 180-181]
In February 1916 it was noted that 19 of the 27 male junior assistants on
the staff had enlisted, and by April the same year, 33 out of 61 male assistants
of all grades on the permanent staff had joined up for immediate service,
and 27 had attested under Lord Derby's Scheme as being prepared to serve.
In addition, 74 assistants on the temporary staff had joined up, and 20 were
waiting to be called up under the Derby Scheme. [MH 65/14, 1916, pages 45
& 74] The solution was to employ more and more female assistants, who
at the time could be quite legally paid less than men.
In 1914 the ICCL had occupied offices at 5 Chancery Lane, but by mid-1915
they had moved to larger premises in a former school in William Street,
Clerkenwell, the building being re-named "Insurance House." After being in
occupation for just over a year, the following restrained observation was made
in the Committee minutes of 28 September 1916:
"We understand that the London County Council propose to alter the name of
the street in which the Committee's offices are situated from William Street
to Insurance Street. This suggestion appears to us to be very appropriate
to the nature of the Committee's work, and at the same time, the name is
sufficiently distinctive to avoid any confusion such as had arisen owing
to the present name of the street. We approved, therefore, that the
Committee had no observation to offer on the proposal to change the name
of the street from William Street to Insurance Street." [MH 65/14, 1916,
page 137]
In mid-1922 - two years after the end of the War - a request was made
by employees of the committee for a lasting memorial to their former colleagues:
"War Memorial
Report by the Clerk of the Committee that it was the desire of the staff
to erect a tablet in the building to the memory of those who fell in
the Great War and asking permission to be allowed to do so.
Staff - Dependents
Report by the Clerk of the Committee stating that he had ascertained
that four members of the staff were killed in the War; that three of
these were young unmarried men and left no dependents; that the fourth
left a widow and a young daughter but that up to the present it had not been
possible to contact the widow." [MH 65/54, 1922, pages 20-21]
The request was readily agreed to:
"The memorial took the form of a brass tablet on an oak base on which were
inscribed the names of the fallen Officers. The tablet was fixed in the entrance
hall of the Committee's office at Insurance Street and was unveiled on
Remembrance Day, 11th November, 1922, by Sir Thomas Neill, J.P., the then
Chairman of the Committee, in the presence of several members of the Committee,
relatives of the fallen, and of the staff, including several former colleagues.
A short religious service was conducted by Captain the Rev. J.R. Batey, Honorary
Chaplain to the Forces. Sir Thomas Neill made a short but impressive speech
appropriate to the occasion and the proceedings terminated with the singing
of the National Anthem." [MH 65/18, 1923, page 5]
The War also made huge demands on the nation's doctors, and in fact by 1918
more than half of them - some 13,000 - were on active service. Even by the
end of 1915, more than a hundred London doctors on the ICCL's panel were
abesented in connection with the War, and at least one of them subsequently
died in Royal Army Medical Corps service.
There is a slight anomally in that the existing plaque does not appear to
be brass, so either it is a replacement, or else it is the original that
has been plated at some point. During the 1929s the ICCL changed its name
to the "London Insurance Committee," and in 1948 it became part of the NHS.
I have as yet been unable to trace the movements of the plaque after the
Clerkenwell offices were vacated, and even when the latter occurred. The
former Insurance House is now home to an internet and marketing
consultancy, and while the road is now called "Naoroji Street," the
name-plate also gives the previous name.
The memorial plaque is now prominently located in the entrance
foyer of 1 Lower Marsh, Waterloo, home to the following NHS organisations:
The South East London Strategic Health Authority, Lambeth Primary Care Trust,
and the South East London Shared Services Partnership. Fittingly, the functions
of latter includes the modern-day equivalents of the Medical and Patient
Registers maintained by the ICCL covering the boroughs of Lambeth, Southwark
and Lewisham.
REFRENCES
PUBLISHED SOURCES:
Doctors in the Great War (Ian R Whitehead, Pen & Sword, 1999)
ORIGINAL DOCUMENTS HELD AT THE NATIONAL ARCHIVES, KEW, SURREY:
MH 65/13 - London Insurance Committee: minutes (Jan - Dec 1914)
MH65/14 - London Insurance Committee: minutes (Jan 1915 - Nov 1916)
MH65/18 - London Insurance Committee: minutes (Jan 1922 - Nov 1923)
MH65/52 - London Insurance Committee: general purposes sub-committee minutes
(Jan 1920 - Nov 1923)
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| PAGE HISTORY: |
| 10/11/04 |
Provisional version - first upload |
| 23/06/09 |
Corrections |
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