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the Public Health (London) Act, 1936, or in any hospital or other
premises excluded from the definition of "nursing home" in section
304 of the same Act.
(d) Women, who before 1st January, 1937, have been certified by the
authorities of a hospital or institution approved by the Minister to
have been trained in obstetric nursing and who have notified the local
supervising authority in writing accordingly.
Compensation to Midwives.
The Council compensates private midwives, other than those
attached to the District Nursing Associations, Maternity Homes or
Hospitals, for loss of cases referred by the Ante-natal Clinics to
hospital for confinement, at the rate of 10s. 6d. per case, subject to
the following conditions:-(a) the patient is required to confirm the
statement that she had engaged the midwife to attend her confinement
and had been referrd by the midwife to the clinic; (b) the Medical
Officer of the clinic certifies that she advised the patient to be confined
in a Hospital or Home; (c) no payment is made to the midwife where
the patient herself has applied to be confined in a Hospital or Home.
No request for compensation was received in 1938.
Maternal Mortality and Morbidity.
One woman died in consequence of child-birth during 1938. This
represents a maternal mortality rate of 091 per 1,000 live and still
births as compared with 3 0 and 29 for the preceding two years.
Obstetric Consultant Service and Emergency Obstetric
Service for domiciliary use. .
The Borough Council's Scheme for a Consultant Service has been
in operation in the Borough for many years. The Consultant can be
called upon direct by any medical practitioner in the Borough, but not
by midwives. in any case of difficulty or abnormality and for diagnostic
purposes in connection with puerperal fever and pyrexia. The medical
practitioner calling upon the Consultant is required to inform me at
once and to supply some information concerning the case, and a Consultant
is required to notify me directly his services have been invoked.
The Borough Council guarantees a fee of £5 5s. to a Consultant, and
this fee covers his services however limited or extended they may be.
It may include the Consultant causing the patient to be removed to a
hospital, and any operation performed by him. Upon being informed