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3
Report of Public Health Committee to Borough
Council, 31st October, 1917.
Scheme for rendering medical assistance to Midwives in
urgent cases of labour of necessitous women residing in
the Borough.
In consequence of a letter from the London County Council of the
8th June, 1917, enquiring if this Council would be prepared to consider
the adoption of a scheme in the Borough for rendering medical assistance
to midwives in urgent cases of labour, we have had the matter
under consideration and decided that such a scheme would be valuable
as an adjunct to the work of maternity and child welfare already
operating in the Borough.
We have been in communication with the practising midwives
in the Borough, and with certain medical practitioners, who are
engaged in midwifery practice, and have undertaken in the past to
render assistance to midwives.
The scheme is limited to the cases in which, under Rule 2 (3) of the
Central Midwives' Board, midwives are required to summon medical
assistance, viz.: "In the case of a woman in labour at or near term,
where there is any abnormality or complication." The scheme is
intended to cover the case of such emergencies, and does not provide
medical attendance for illnesses arising out of a confinement, but
in certain instances the fees paid cover any subsequent attendance
after the first or emergency visit, which may be needed to complete
the case as a case of confinement.
The scheme and the suggested scale of fees have been approved
(under Section 77 of the Public Health (London] Act) by the Local
Government Board under the date 11th October, 1917, such fees
ranging from 5s. for attendance on the slighter cases to £2 2s. for the
more serious cases.
In normal times some 400 cases of labour amongst Chelsea women
are attended annually by midwives; and it is estimated that in about
15 per cent. of these labours medical assistance is summoned by midwives
in accordance with the rules of the Central Midwives' Board.
We estimate that the annual cost of the scheme will be about £90,
of which half will be returned by a grant from the Local Government
Board.
The estimated cost of the scheme to the Boroguh for the remainder
of the current financial year will be £19.
In certain of the cases in which medical assistance is rendered, the
patient may be in a position to repay and be desirous of repaying
to the Council a certain proportion of the doctor's fee.
As the amount so recovered will probably be small, and as the
amount can hardly be estimated at the present time, we have not
considered it necessary to allow for such rebate in our estimation
of the cost of the scheme.
Recommending that the scheme above outlined for rendering skilled
medical assistance to midwives in urgent cases of labour amongst