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53
Midwifery Service.
Midwives Act, 1936.—Reference was made last year to the Bill, now
an Act of Parliament. It is now an obligation for the local authorities
designated under the Act to prepare schemes for submission to the Minister
providing a salaried midwives service either by direct employment of
midwives, by arrangements with welfare councils, or through voluntary
associations. In London the Welfare Councils are the Metropolitan
borough councils, each of which, since the passing of the Maternity and
Child Welfare Act of 1918, has in the way most suitable for its particular
locality developed an adequate maternity and child welfare service,
including district midwifery. In some, municipal midwives are directly
employed; in others, special arrangements are made with voluntary
hospitals or nursing associations for the discharge of these services, while
in others still the districts have been so well served, almost from time
immemorial and long before maternity and child welfare became a duty
of a local authority, by a well-established voluntary hospital or nursing
association that the local authority, beyond extending goodwill and
possibly donations, has found it quite unnecessary to develop a scheme
of its own. Thus the advent of this new Act has found London, unlike
some less fortunately placed areas both urban and rural, well supplied
with district midwifery services catering for all classes, particularly the
very poor. Such objects as are to be achieved in London under this Act
could be met by some measure of co-ordination rather than by a heavy
expenditure on establishing a new service. In the City of Westminster,
at any rate, a complete and unified midwifery scheme has been operating
under the ægis of the Council for some seven years. It is fervently to
be hoped that any measures to be applied in Westminster will not disturb
or disintegrate a scheme which has developed by experience and cannot
be dissociated from the other aspects of maternity and child welfare
without injury and dislocation to the service as a whole.
Trained Midwives for all Confinements.—For women living in the
City who apply through the Council's welfare centres there is a complete
midwifery service. Throughout the greater part of the City the midwives
of Westminster Hospital attend necessitous women on behalf of the Council,
and in the remainder the midwives of the City of Westminster Health
Society practise for the same purpose. The local welfare centres are the
pivots of the scheme in both areas. In both cases the service is restricted
within the City boundaries and to patients introduced through the welfare
centre. For those who do not attend the welfare centres the supply of
private midwives is adequate. Certain other voluntary hospitals, e.g.,
Middlesex, Charing Cross, General Lying-in, etc., and the Ormond Home,