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increases the scope of practice of both general practitioner
obstetricians and midwives at a time when the number of home confinements
is declining year by year and may yet reach a level too low to
maintain the skills of those concerned„ Above all, for the patient,
it provides the security of delivery within the precincts of a
hospital combined with continuity of care throughout the whole of the
pregnancy. labour and puerperium.
Training of Pupil Midwives
In 1965, this borough agreed to accept four pupil midwives every
three months for midwifery district training; three from Fulham
Maternity Hospital and one from Paddington General Hospital.
Each pupil is required by the Central Midwives Board to attend
at least ten domiciliary confinements, but with the falling number of
home births, it became increasingly difficult to provide the necessary
number of cases, Consequently,, in November, 1966, the number received
from Fulham Maternity Hospital was reduced from three to two.
During 1967, there was still difficulty in providing ten cases
for each pupil and it was felt that a further reduction would have
to be made. The projected closure of Fulham Maternity Hospital
meant that no pupils were received from that source, and since
September, 1967, only one pupil has been received from Paddington
General Hospital. This pupil continues to be attached to one
particular midwife for administrative purposes, but undertakes
deliveries with other midwives whose districts are accessible to her.
Obstetric Nurse Training
Nurses in training at St. George's and St® Mary Abbot's Hospitals
are allowed to attend puerperal nursings and ante-natal clinics with
the Council's midwives, but because there have been fewer home
confinements, it has been necessary to restrict these activities to
ensure that no mother should be visited more than once for teaching
purposes®
Midwives Act, 1951
The Council are the local supervising authority for the purposes
of the Midwives Act, 1951, and have a duty to inspect and supervise
all midwives practising in the area.

HEALTH VISITING
The staffing position was maintained, although the number of
health visitors which, in full-time equivalents, was 33.4 at the
beginning of the year had dropped to 31.4 at the end. Because of
the increased load on the nursing officers, which resulted from the