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carried out by midwives in independent practice during the year is 32,000. This
appears to indicate that medical aid was necessary in about 21.8 per cent. of the
cases, as compared with 19.5 per cent. during 1927.
Ophthalmia
neonatorum^
In 1926 regulations came into force rendering it no longer necessary for a midwife
to notify a case of this disease to the local sanitary authority, this duty being assigned
to the medical practitioner only. This, however, did not relieve the midwife of
the necessity of sending a copy of her medical aid notice in all such cases to the
London County Council. The Ministry of Health issued a memorandum in connection
with the regulations, suggesting that the Council should consider whether
it should not refrain from exercising the power of recovery from the patient's representative
of the fee paid to a medical practitioner summoned by a midwife in a
case of ophthalmia neonatorum, and the Council agreed to adopt the suggestion.
The number of such cases during the year was 671, and the amount paid to medical
practitioners in respect of such cases was £525 6s.
Inflammation
of the eyes—
Notices.
During the year 1,421 notices were received indicating that medical aid had been
summoned for inflammation of the eyes of infants, as compared with 1,300 in 1927.
59 other cases arose in which either medical aid was not called in by the midwife
or she failed to notify the Council that she had done so. Of these 1,480 cases, 444
proved to be ophthalmia neonatorum, as compared with 488 in 1927. 283 other
cases that did not occur in midwives' practices were also notified, making a grand
total of 727 such cases during the year, the percentage occurring in the practice of
midwives being 61 per cent., as compared with about 60 per cent. in 1927. All
the midwives' cases were investigated, and it was found that 434 were completely
cured, 4 died and 2 could not be traced owing to the removal of the parents. Impairment
of the vision of one eye occurred in 4 cases. 68 cases became in-patients at
St. Margaret's Hospital, as compared with 61 during 1927.
Training of
midwives.
For some years it has been the practice of the Council to arrange classes and
demonstrations for the post-graduate instruction of midwives. The demonstrations
at institutions were well attended, and the lectures appeared to give great satisfaction.
One of the lecturers has drawn attention to the distinct improvement
observed by him with regard to ante-natal work. Ante-natal cards are being
furnished to institutions at which there are pupils, with a view to improvement in
their midwifery work. During the year the Medical Officer of the Middlesex County
Council approached the London County Council suggesting that Middlesex midwives
be admitted to the lectures on the same terms as London midwives. This was
agreed to by the Committee, on the understanding that the Middlesex County
Council would bear a proportionate share of the loss.
During the year 1 midwife was given a month's intern training at a post-certificate
school at a cost of 2 guineas a week, and in another case a midwife who desired
to obtain a teacher's certificate was paid the sum of six guineas towards her expenses.
On 22nd May, 1928, the Minister of Health appointed a Departmental Committee,
under the chairmanship of Sir Robert Bolam, O.B.E., Hon. LL.D., M.D.,
F.R.C.P., " to consider the working of the Midwives Acts, 1902-1926, with particular
reference to the training of midwives (including its relation to the instruction of
medical students in midwifery), and the conditions under which midwives are
employed." The Departmental Committee invited the London County Council
to give evidence before them, and defined the following specific matters to which
they proposed to give their attention in connection with their review of the position :
(1) Period of training of midwives; (2) Curriculum; (3) Available facilities for
teaching both theoretical and practical subjects ; (4) Desirability of differentiation
in midwifery training schools according to the type of pupil to be trained ; (5)
Qualifications for teachers of midwifery; (6) Post-certificate training; (7)
Subsequent employment of midwives; (8) Need for inducements to secure welleducated
and well-trained women in both rural and urban districts; (9) The