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There are certain advantages to be expected from this course:
(1) I am sure the Committee would not desire to interfere with
the training of medical students at Guy's, especially as
the results of the scheme at present in operation have been
so good.
Every mother receiving treatment is seen personally at
least once before confinement by Mr. McNair or Mr.
Frank Cook, and is under regular ante-natal supervision
at the Clinic; the maternal mortality rate at present is
56 per 1,000. On the other hand, the employment of
the handy woman who works in conjunction with the
student does not seem to be an ideal arrangement, and
it certainly helps to bolster up the position of the handy
woman. I do not see any reason to fear that the payment
of midwives by the Council would interfere with
the work of the Guy's Charity provided that maternity
nurses were employed directly by the hospital authorities
and that payment was made to the same authorities.
(2) The payment of such fees would ease the financial situation
for many families and with the aid of the Maternity
Benefit would enable the mother to employ a doctor if she
desired to do so as well as a "home help."
(3) Interference in the conduct of the labour on the part of the
handy woman would be entirely eliminated in every
case where a maternity nurse was employed, and it is
unlikely that her services would be refused if these
were free. Such interference cannot effectually be
prevented in any other way.
(4) Ante-natal supervision could be secured in every case by
making this a condition of payment.
There are certain possible disadvantages which require
consideration:—
(1) Patients who at present go into hospital might prefer to
remain at home. This is not likely to happen except in
connection with Bermondsey and Rotherhithe Hospital,
and we are not in a position yet to say whether the