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57
Twenty-two midwives are employed by the Council directly
and during the year 47 midwives notified their intention to practise
midwifery in the Borough. The excess number of midwives
over those who are employed directly by the Council represent
midwives practising in hospitals and a very few who remain in
private practice.
During the year, our midwives attended 1,128 home confinements
and, in addition, 438 mothers who, although confined in
hospital, were discharged early to the care of the domiciliary midwives
under the early discharge scheme described later.
Maternity medical services are provided by family doctors under
the National Health Service Act, 1946, doctors claiming their
fees for this service from the Local Executive Committee. Most
expectant mothers in the borough now book a doctor for their
confinement but if by any chance the booked doctor or his deputy
is not, for any reason, available at the time of the confinement or
if there should be no booked doctor, another doctor on the
Obstetric List is called in by the midwife and he may then claim
a fee under the Midwives Act from the Council. Three such
claims were met during the year.
It is very important that adequate arrangements be made for a
midwife to be called to an expectant mother when she goes into
labour and also that in cases of difficulty the services of a Supervisor
of Midwives should be available, day and night. In close
liaison with the London Boroughs of Lambeth and Southwark, a
shared emergency service operates so that the difficulties of
relatives getting in touch with the booked midwife or the relief
midwife acting for the booked midwife, who may be off duty, are
reduced to a minimum. This scheme has worked extremely well
and has saved much worry and anxiety to relatives.
The domiciliary midwifery service had, until 1st April, 1965,
been administered directly from County Hall for some 30 years.
The change to a much more local form of organization might conceivably
have given rise to problems and difficulties but I am
happy to say that the transition took place very smoothly, although
there have inevitably been some changes in routine procedures.
I should like to take the opportunity of expressing my thanks
to our domiciliary midwives for the excellent co-operation and
help they gave in ensuring that the transition was efficiently carried
out and with certainly no diminution in the high standards of the
service which had traditionally been given to mothers and their
babies.
Maternity Beds
The shortage of maternity beds in parts of the London area
and their uneven distribution have been a source of anxiety for
many years and medical officers and general practitioners have
continued to exercise great care in the selection of cases for hospital
confinement.