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" In 1918 the Council decided to grant 10s. for each case admitted to Hospital, if the
patient was necessitous and if either a reduced or no charge was made. In December,
1920, the contribution of the Council was increased to £1. No amount was fixed as
to what constituted a ' reduced fee,' and for some time past this contribution of £1
has been paid for every St. Pancras case admitted to Hospital." That this universal
contribution is not justified is evident from the figures placed before us.
" In cases of midwifery attended at home, a grant of 5s. is paid by the Council to the
Hospital or institution attending the case. This also was for necessitous cases, or
where a reduced or no fee is charged. In these cases the matter has drifted, and the
5s. is now paid for every case. The following table shows the total payments made
since 1919:—
COST.
YEAR. j
Intern at 10s. ^ Intern at £1. Extern at 5s. Total.
£ s. d. £ s. d. £ s. d. £ s. d.
1919 146 10 0 — 87 0 0 233 10 0
1920* 155 0 0 40 0 0 160 10 0 355 10 0
1921 — 429 0 0 144 10 0 573 10 0
1922 - 549 0 0 164 5 0 713 5 0
1923 — 569 0 0 136 5 0 705 5 0
* Payment for intern cases increased from 10s. to £1 per case in December, 1920.
" I suggest that, in future, the contribution of the Council should be based on definite
figures, and I advise that for each in-patient the contribution should only be paid
where the patient pays less than £3, and for every out-patient case the contribution
should only be made where the patient pays less than £.1, and this should only apply to
cases definitely recommended from the "Welfare Centres, or by the Town Hall staff,
and after reference to the Medical Officer of Health."
The result of our enquiries into this matter reveals the fact that there has been considerable
laxity in dealing with the accounts for midwifery grants, so that the amounts paid to
Hospitals and Institutions for their services have been in excess of what they should have
been.
We recommend—
That the proposals of the Medical Officer of Health in regard to the system of
paying midwivery grants be approved and adopted, and that, in future, such accounts
be submitted to the Public Health (Audit) Sub-Committee.
Compulsory Notification of Measles.
10.—The Medical Officer of Health has reported fully on this subject. He states:—
" Measles was made notifiable throughout the country from 1916 to the end of 1919,
and, after four years' trial, was abandoned by the Ministry of Health. It is
generally conceded that the results obtained do not justify the expenditure, and
the figures for St. Pancras support this view. If notification was not in force,
the majority of the cases would still be known through the schools and maternity
and child welfare centres. Nurses, etc., could then be supplied where their
service were needed."
When the Ministry of Health decided to withdraw their general order respecting the
compulsory notification of measles, local authorities were permitted to make their own local