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317 other cases that did not occur in midwives' practices were also notified, making
a grand total of 732 such cases during the year, the percentage occurring in the
practice of midwives being 56.7 per cent., compared with 61 per cent, in 1928.
All the midwives' cases were investigated, and it was found that 407 were
completely cured, 2 died and 3 could not be traced owing to the removal of the
parents. Impairment of the vision of one eye occurred in 2 cases, and impairment
of vision of both eyes in another case; 47 cases became in-patients at St.
Margaret's Hospital, compared with 68 during 1928.
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.
Ante-natal cards are being furnished to institutions at which there are
pupils, with a view to improvement in their midwifery work.
The report of the Departmental Committee which was appointed in May, 1928,
by the Minister of Health "to consider the working of the Midwives Acts, 19201926,
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 " was published during the year.
The report received the careful attention of the Midwives Acts Committee and
the effect which the recommendations of the Departmental Committee might have
upon midwifery services in London was considered. Many of the most important
recommendations of the Departmental Committee will, however, require Parliamentary
sanction, and it is understood that the Ministry of Health is considering
the various aspects of the report. The Council, therefore, have requested the
Ministry of Health to keep them informed of any proposed legislation in the matter
so far as London is concerned.
During the year 79 cases of pemphigus neonatorum occurred, compared with
125 during the previous year.
The arrangement made at the suggestion of the Ministry of Health whereby
confidential reports are made on maternal deaths by medical officers of the Council
and are exchanged with the borough medical officers of health as described in my
last report, was continued during the year.
The Midwives Act, 1918, gave to the Council the duty of paying the medical
practitioners' fees when called in by midwives in cases of emergency. Later the
Ministry of Health laid down a scale to which local authorities must adhere. The
Midwives Act, 1926, fixed a limit of time, namely, two months from the date of the
first visit, within which a medical practitioner must submit his claim. In pursuance
of this provision 58 claims amounting to £52 7s. were refused during 1929 : 3,904
claims were submitted during the year 1929, compared with 3,737 in 1928, the
total amount involved being £4,290 8s. 6d., compared with £4,131 15s. in 1928.
About 25 per cent, of this amount will, it is believed, in due course be recoverable
from patients.
The Nursing Homes Registration Act, 1927, came into force on 1st July, 1928.
This Act repealed Part II of the Midwives and Maternity Homes Act, 1926, and also
so much of any local Acts as provide for the registration of maternity homes.
The Annual Report for 1928 (Vol. Ill, pp. 53-54) indicated fully the powers of the
Council under this Act. Three part-time assistant medical officers carry out the
work of the inspection and re-inspection of premises used as general nursing homes.
The premises used mainly for the reception of maternity patients are inspected by
the medical officers engaged in the supervision of midwives in the county of London
thus avoiding duplicate inspections. Enquiries with regard to unregistered premises
suspected of being used as nursing homes, are carried out by inspectors attached
to this department; these inspectors who are qualified sanitary inspectors also
inspect all premises in respect of which applications are received for registration as
Nursing
homep.
Payment of
medical feet.
Maternal
mortality.
Pemphigus
neonatorum.
Instruction of
midwives.