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47
child to transfer to any other person their rights and duties in respect of the said
child, subject to the approval of the Court. The Bill deals with only a portion of
the recommendations of the Departmental Committee, but if it becomes law it will
have the effect of regularising and legalising the adoption of infants.
Section 1 of the Act of 1908 sets out particulars which foster mothers must
obtain and furnish to the Council when giving notice of the reception of a nurse
infant. From time to time difficulty has arisen owing to the correct date and place
of birth of the infant not being in the possession of the foster mother. Visitors are
now instructed to insist upon foster mothers obtaining birth certificates in
all cases.
Administrative difficulty has also occurred in cases where the periodic payments
made for the maintenance of nurse infants appear to have ceased. The visitors
are now instructed to continue inspection in such cases if no objection is raised.
If, however, inspection is resented or the visitor is refused admission the visitors
are instructed to make independent enquiries as to the condition of the house and
child. They take no further action unless the result of the enquiries is unsatisfactory
or definite evidence has been obtained that payments have been resumed.
In past years arrangements have been made under which the staff of the Public
Health department undertakes the inspection at the request of local War Pension
Committees of homes in which it is proposed to board-out neglected children of
deceased or serving soldiers. During the years 1919-1921 inclusive 326 inspections
and reports were carried out on behalf of local War Pension Committees. No
new requests have been received during the present year.
The number of duly certified midwives with London addresses exceeds 5,000,
of this number 829 notified their intention to practise within the county during the
whole or part of the year. This is an increase of 71 on 1921. It is probable that about
10 per cent. of the above 5,000 are in actual independent practice in London, while
the remainder act for the most part as monthly or general nurses under medical
supervision. All practising midwives, except those working entirely within hospitals
and infirmaries, under medical supervision, are subject to inspection by the Council's
officers, in order to ensure that a proper standard of efficiency is maintained. This
work is carried out by four women medical inspectors. Special visits are paid to the
midwife if any case of a septic nature or a persistent high temperature occurs in
her practice and in all cases of inflammation of the eyes. Advice is given where
necessary to midwives on any point of difficulty which may arise in connection with
their work. The medical inspectors paid 2,366 visits during the year to midwives
or institutions employing midwives.
Midwives
and lying-in
homes.
In 95 cases there were infringements of the rules of the Central Midwives Board.
Of these 60 were slight and were dealt with by verbal caution ; 20 were of a more
serious nature and received a letter of caution from the Council. Of the remaining
15 cases, 9 midwives were interviewed and cautioned. Four prima facie cases of
negligence or misconduct were reported to the Central Midwives Board with the
following results:-(a) midwife struck off the roll; (b) charge not proved; (c)
charges adjourned sine die; (d) Council requested to report again on practice of
midwife. The two remaining cases were reported to the Board, but not by the Council.
In one case the charges were brought by a doctor and the midwife was cautioned
by the Board. In the other the husband of the patient complained that the midwife
herself applied forceps without a doctor being present. As this case was the first of
its kind to be brought before the Board, it was decided to take no action although
the charge was proved.
Two midwives were suspended from practice to prevent spread of infection
and compensation was authorised in one case. In one instance legal proceedings
were taken against the midwife by a local sanitary authority on account of her
failure to notify a case of ophthalmia neonatorum. The midwife was fined one pound
and £3 3s. costs.
Infringements
of
rules.