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and at Queen Charlotte's Hospital. One hundred and nineteen patients were
delivered in these units during 1970 by General-Practitioner-Obstetricians
and Domiciliary Midwives, who also provided ante-natal and post-natal care.
Arrangements were finalised for patients to be delivered in Hammersmith
Hospital under the care of their General-Practitioner-Obstetricians and
Domiciliary Midwives, with the first patient being delivered in December
1970, under this schemer.
Midwifery Training
Co-operation with Queen Charlotte's Hospital in providing training
for Pupil Midwives has continued despite the difficulty arising from the
decrease in domiciliary confinements. Sixteen students have received
training during the year as part of the course, involving a single period
of integrated trainings
The Non-Medical Supervisor of Midwives gives regular instruction to
staff of the London Ambulance Service on emergency midwifery procedures,
and serves on the local Maternity Liaison Committees.
Health Visiting (National Health Service Act, 1946, Section 24; & Health
Services and Public Health Act, 1968, Section 11, Subsection 1)
Section 11 of the Health Services and Public Health Act, 1968, extends
the powers of the Local Health Authority to provide Health Visitors and
Nurses in a similar way to the provision of Section 10(2) for the Midwifery
Service.
As with Section 10(2) the aim is to promote the more effective deployment
of staff and to facilitate co-operation between general practice and
Local Health Authority services, It enables Local Health Authorities to
make provision for the visiting by Health Visitors of persons elsewhere
than in their own homes, and for the attendance of Nurses on persons who
require nursing elsewhere than in their own homes.
The National Health Service Act, 1946, (Section 24), made strong recommendations
for a closer relationship between General Practitioners and
services provided by the Local Authority, Further, in relation to health
visiting, the Act stated, "It shall be the duty of every local authority
to make provision in their area for the visiting of persons in their
homes by visitors, to be called 'Health Visitors', for the purpose of
giving advice as to the care of young children, persons suffering from
illness, and expectant or nursing mothers, and as to the measures necessary
to prevent the spread of infection". Thus the Health Visitor was given a
position in the front line of preventive medicine.
It seems logical that the Health Visitor and General Practitioner, in
their common aim for the promotion of community health, should become a
team so that they might practice their skills in the most efficient way.
In the early 1950's experiments in "Liaison Schemes" between Health
Visitors and General Practitioners were started.
Within the limits of staff availability, any approach made by General
Practitioners in the Borough for the attachment of Health Visitors has
been met, The formal arrangements by which Local Authority Health Visitors
collaborate with Family Doctors are achieved by two methods:-
(1) Attachment schemes are those in which a Health Visitor is
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