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Facilities for treatment by artificial light are available at various general and special
hospitals, and are not limited to tuberculous cases. The Public Health Committee
is investigating the possibility of arranging for a large scale test of artificial light
treatment under satisfactory conditions in association with the Education Committee
and in consultation with the Ministry of Health.
Midwives.
Duly certified midwives with London addresses exceed 5,000 in number, of
whom 906 gave notice of their intention to practise within the County during the
whole or part of the year, an increase of 1 on last year's figures. About 10 per
cent. of the midwives with London addresses are in actual independent practice in
the County, the remainder acting mostly as monthly or general nurses under medical
supervision. Practising midwives, other than those who work entirely in hospitals or
infirmaries under medical supervision, are subject to inspection by the Council's
officers, with a view to ensuring that a proper standard of efficiency is maintained.
This work is carried out by four women medical inspectors, who pay special visits
to midwives having cases of a septic nature or persistent high temperature or inflammation
of the eyes. Advice is also given by the inspectors on any point of difficulty
arising in connection with the work: 2,294 visits were paid by the inspectors
this year, as compared with 2,549 the previous year.
97 infringements of the rules of the Central Midwives Board were reported
during the year, of which 74 were slight, and therefore dealt with by means of a
verbal caution; 14 cases were of a more serious nature, and were dealt with by a
written caution. Of the remaining 9 cases, 6 midwives were seen by the Committee,
and 5 of them cautioned, the other one being reported to the Central Midwives
Board, as were 2 other midwives who were not so seen. In the remaining
case interviewed by the Committee, legal proceedings were instituted against the
midwife for failure to notify intention to practise, and she was fined £1 and costs.
Of the 3 cases reported to the Board, two midwives were struck off the Roll; in
the third case the Board postponed sentence and asked for periodical reports on the
midwife's conduct and methods of practice. Four midwives were suspended from
practice with a view to the prevention of the spread of infection, and in 2 cases
compensation was authorised. One midwife applied for a certificate in support of
her application to the Central Midwives Board for the restoration of her name to
the Midwives Roll. The Midwives Act, 1902 (section 1 (2)), makes it an offence
for any uncertified woman habitually and for gain to attend women in childbirth
except under the direction of a registered medical practitioner. During the year
16 inquiries were made bythe inspectors into such cases, in 7 of which it was decided
to take no further action; 8 were dealt with by a verbal or written caution, and
one woman was committed for trial for an illegal operation.
During the year there were 594 still-births reported by midwives in their practice.
The figures for previous years were: 1920, 896; 1921, 684; 1922, 720; 1923, 582.
Of these infants, 304 were males, and 281 females, and 9 not stated. Of the 594
still-births, 310 were reported macerated, and 284 not macerated.
300 cases of puerperal fever were reported during the year, as against 360 the
previous year. 70 cases proved fatal, as compared with 97 the previous year, a case
mortality of over 23 per cent, as against 27 per cent, the previous year. In addition
the Registrar-General recorded 36 deaths from puerperal sepsis, which were, however,
not notified as puerperal fever. The distribution of the notified cases was as
follows:—
Delivery conducted by
Cases.
Deaths.
(а) Medical practitioners 110 30
(b) Certified midwives 102 18
(c) Medical practitioner and certified midwife 4 2
(d) Hospitals and poor-law institutions 48 10
(e) Medical students 11 2
(f) Cases of miscarriage or abortion where no attendant was engaged 23 7
(g) Uncertified women 2 1
Total 300 70