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42
DOMICILIARY MIDWIFERY
The City Council provides a domiciliary midwifery service to meet the needs of mothers who
wish to be confined at home, and for those who are confined in hospital for medical reasons,
but whose social conditions permit planned early discharge.
In the S.W.1 postal area the Westminster Hospital provides the service on an agency basis.
For the remainder of the area the City Council employs three full-time midwives and one part-time
midwife.
The midwives work in close co-operation with general practitioner-obstetricians and provide a
comprehensive service of ante-natal care, and care throughout the confinement and post-natal
period.
Teaching
One midwife is approved as a teacher by the Central Midwives Board and three months' district
training is given to pupil midwives taking Part II Midwifery Training at Paddington General
Hospital (now St. Mary's Hospital, Harrow Road).
Two pupil midwives were trained in 1967.
Nurses from the Middlesex Hospital spend a day working with a domiciliary midwife as part of
their obstetric training.
LOAN OF HOME NURSING EQUIPMENT
The service provided by the City Council under the scheme for the free loan of home nursing
equipment continues to fulfil the needs of Westminster residents and to ease the burden of those
who have the problem of nursing sick relatives at home. The provision of this equipment often
enables the ailing to be nursed at home and thereby postpone or obviate hospital admission.
Items requested tend to follow the pattern of past years, e.g. hospital beds and mattresses,
Egerton beds, hoists, back-rests, commodes, walking aids and wheelchairs. The City Council
is grateful to the Westminster Division of the British Red Cross Society who also act as agents
for issuing smaller items of equipment such as bed pans, urine bottles and waterproof sheeting.
Relationships with the professional and lay bodies in the field continue to be very satisfactory.
FAMILY PLANNING
Under Section 28 of the National Health Service Act, 1946 the City Council is empowered to
provide a family planning service for women likely to suffer detriment to their health as a result of
pregnancy. The facilities which at present exist in Westminster are provided (a) directly by
the City Council and (b) by arrangement with the Family Planning Association and the Catholic
Marriage Advisory Council who are granted the use, free of charge, of accommodation in certain
health service establishments.
The Minister of Health in Circular 15/67 drew attention to the National Health Service (Family
Planning) Act, 1967 which conferred on local health authorities a general power to make arrangements
for the giving of advice on contraception, the medical examination of persons seeking such
advice and the supply (by prescription or directly) of contraceptive substances and appliances.
The existing powers are thereby extended in that local health authorities may now provide (or
arrange for other bodies to provide) advice and supplies to any persons irrespective of marital
status who need them on social grounds as well as medical grounds. The Act also empowers
local health authorities to recover such charges for the provision of advice, the giving of prescriptions
or the supply of substances or appliances as the authority consider reasonable having
regard to the means of the recipient. In this respect the Minister holds the view that advice,
examination, prescriptions and supplies should be free in medical cases, as obtains in the City
at present, but that a charge could properly be made for prescriptions and supplies in non-medical
cases at the discretion of the authority.
Preliminary discussions were held with representatives of the Inner London Local Medical
Committee and the Family Planning Association, the latter indicating their willingness to continue
their present arrangements with the City Council and to participate in any extension of the service
which might be approved by the City Council. Plans are accordingly being made to extend
facilities for Family Planning within the City.
In early 1968 the City Council will be asked to consider a comprehensive report by the Medical
Officer of Health dealing with the revised arrangements which it is hoped will become operative
on 1st April, 1968.