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46
GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA.
It is suggested in Circular 1346 of the Ministry of Health that where
detailed information regarding the Health Services of the Area was
given in the report for 1930, it will be sufficient for the purposes of this
report to indicate any alteration or development which has taken place
during 1933. Accordingly, as these services have been somewhat fully
dealt with in recent years, the report for 1930 being a full or survey
report, they are again on this occasion discussed briefly.
Nursing in the Home.—The nursing of general illness in the home is
undertaken by the three District Nursing Associations which operate
in the City. The service is free for those without means ; from others,
contributions are invited according to circumstances. The City Council,
as Maternity and Child Welfare Authority, pays these associations for
nursing services in connection with puerperal fever and pyrexia and
other illnesses arising before, during, or after confinement; also for
ailments in children up to 5 years of age, including measles and whooping
cough. The nursing of primary pneumonia and influenzal pneumonia is
also provided for by the Council through the agency of the associations.
These services are most efficiently and satisfactorily carried out. Under
the existing arrangements, 1s. 6d. is paid to the association for each
nursing visit; 2,434 visits were paid in 1933 at a cost of £182 11s. 0d.
Midwives.—Thirty were practising in the area in 1933. This
number includes the qualified midwives of the outdoor departments of
Westminster and Middlesex Hospitals, the staff of the Ormond Home,
Chelsea, and other institutions. Confinements at home attended by midwives
numbered 580.
Midwifery Services.—A complete midwifery service, indoor and outdoor,
is provided by Westminster Hospital under agreement with the
City Council for women attending the welfare centres. This scheme
includes ante-natal clinics, both in-patient and out-patient services, and
the assistance of consultants and bacteriologists. In connection
with the practice of midwives apart from this hospital scheme certain
difficulties have arisen to which full reference is made in the succeeding
paragraphs.
Medical Assistance to Practising Midwives.— In October, Sir Frederick
Menzies, County Medical Officer drew attention to difficulties experienced
by midwives in obtaining the assistance of medical practitioners in
difficult or abnormal cases. The London County Council as the authority
for administering the Midwives Acts, supervises the practice of midwives,