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1937] 86
An Emergency Unit consists of at least one Obstetrician and a Nurse, who are
available, with all the necessary equipment for dealing with emergencies, for
attendance at short notice at any home within a certain radius. The Unit may be
summoned by a Doctor or by a Midwife attending a case with, whenever possible,
the approval of a Doctor. It is best operated from a Maternity Hospital or the
Maternity Department of a General Hospital, and should, of course, be available
at all times of the day or night.
The number of cases for which the need for such an Emergency Unit would
apply is strictly limited, and in all probability they would be patients with acute
and severe haemorrhage. The service is not meant to be used for treatment in the
home in ordinary cases or as a substitute for treatment which could be carried out
more efficiently in hospital, but by the very nature of its purpose, such a Unit might
be the means of saving a life in a large proportion of the cases for which it was called
out.
Following consideration of this proposal by the Maternity and Child Welfare
Committee and the Council, an arrangement was arrived at with University College
Hospital. The Hospital agreed to provide a staff for the Unit which would comprise
a Physician of Consultant standing with three alternative Consultants to act as
deputies, one Medical Officer to act as Assistant to the Consultant and one Qualified
Nurse. The fee to be paid by the Council upon each occasion on which the Unit
is called out is 7 guineas, and this fee covers all treatment which may have to be
carried out in the patient's home by the members of the Emergency Unit. The
Council also made a grant to the hospital in respect of the initial cost of the requisite
equipment.
Arrangements have been made for Doctors and Midwives attending Islington
patients to be informed of the establishment of the Emergency Unit and the conditions
of its use. Doctors and Midwives are required to inform the Medical Officer
of Health as soon as possible after the Unit has been called out, and arrangements
have also been made to obtain the assistance of the Police if there should be any
difficulty in calling the Unit.
CONSULTATIVE ANTE-NATAL AND POST-NATAL AND MINOR
GYNECOLOGICAL CLINIC.
A further matter arising out of Circular 1622 on Maternal Mortality to which
favourable consideration was given by the Committee was the Consultative Clinic
as indicated above. Such a Clinic is not intended to deal with routine cases but is
one to which Medical Officers at Ante-Natal Clinics or General Practitioners could
refer difficult cases or cases where there was any doubt as to treatment or diagnosis.
Whilst it is possible to refer such patients to Maternity Hospitals or to the
Maternity Departments of General Hospitals, it was felt that such a clinic established
locally would serve a useful purpose, not the least of which would be a saving to
some mothers of having to wait lengthy periods in a hospital. It is also particularly
hoped that post-natal attendances will be increased. It was proposed that this clinic
should be held in the Clinic portion of the Miriam Price Coleman Day Nursery and be
conducted by an Obstetric Specialist, and arrangements were made for the Clinic
to commence in 1938.