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Consultant Services for Complicated Cases of Midwifery.—It might
appear that skilled obstetric assistance being available in the hospitals in
and near the City, the local authority need not be called upon to
supply this service. But the City Council was impressed with the
possibility that in a difficult case conducted at home, delay in removal to
hospital might occur owing perhaps to doubt in the practitioner's mind
as to any imminent gravity. Further, there is often present a certain
unwillingness on the part of the patient to enter a hospital, together
with natural fears, especially in first confinements. To meet such
circumstances, the Council has provided through the consulting staff of
Westminster Hospital the services by day and by night at the patient's
home of an obstetrician of consulting status. Those services are for
necessitous cases, that is to say, those who cannot ordinarily afford the
services of a specialist. Any medical practitioner in doubt or difficulty
by telephoning to the hospital can have such skilled assistance.
There is a further aspect, namely, the need for skilled assistance to
midwives in difficult cases. In Westminster, as perhaps in other central
districts, practising midwives have for some years past been experiencing
increasing difficulty in obtaining medical assistance in response to
summonses issued under the rules of the Central Midwives Board. One
need not go into the reasons for those difficulties, the attendant circumstances
or possible consequences. The complaints of the midwives have
been investigated and confirmed. They were in the first instance
submitted to the City Council by the Medical Officer of the Local Supervising
Authority administering the Midwives Acts, namely, the London
County Council. The City Council took immediate steps to solve those
difficulties, and with the concurrence of the London County Council has
provided not only medical assistance, but specially skilled medical
assistance to all midwives practising in Westminster who may require it.
These services came into operation on 1st October, 1934. They are the
subject of formal agreements between the City Council and the Governors
of Westminster Hospital.
During the short period of operation of this scheme advantage has
been taken of the new services by a midwife and by a medical
practitioner. In the latter case it may be reasonably claimed that by the
assistance of the obstetric consultant the difficult case of pregnancy was
treated with success in regard to both mother and child.
Ante-natal Services.—In Circular Memo 156/MCW of December, 1930,
the Minister of Health, referring to the function of an ante-natal clinic,
recommends that it should be the ante-natal centre for the maternity
work of the area. When this Circular was issued there were