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53
and are exchanged with the borough medical officers of health as described in my
last annual report, was continued during the year.
Payment of
medical fees.
The Midwives Act, 1918, imposed upon the Council the duty of paying the
medical practitioners' fees when called in by midwives in cases of emergency. Reimbursement
by the patient except in eye cases is also provided for. The Ministry
of Health have laid down a scale of fees 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, 51 claims amounting to £49 10s. were refused during
1930 ; 4,049 valid claims were submitted during the year 1930, compared with 3,904 in
1929, the total amount involved being £4,601 14s. 6d., compared with £4,290 8s. 6d.
in 1929. Approximately 25 per cent. of the total amount of the claims was recovered
from patients during 1930.
Registration
of nursing
homes.
The Nursing Homes Registration Act, 1927, came into operation on 1st July,
1928, and repealed Part II of the Midwives and Maternity Homes Act, 1926, and also
so much of any local Acts as provides for the registration of maternity homes. The
Annual Report for 1928 (Vol. III, pp. 53-54) indicates fully the powers of the Council
under the Act.
There is no reliable information as to the number of nursing homes in London
in 1927, that is, before the Act came into operation.
The total number of applications for registration as nursing homes approved by
the Council since the Act came into operation is 372; the total number on the
register on 31st December, 1930, was 271, showing that the number of registrations
which have been cancelled since the Act came into operation is 101:35 of
these cancellations which occurred during 1930 have been analysed; the causes were
as under:—
The home removed to other premises
Use of the premises as a nursing home given up
(two of which were definitely stated to be because the
nursing home did not pay).
Change of ownership
(Death of the registered keeper was the cause in 6 of these
and her ill health in 1.)
No longer registrable
(owing to the character of the work carried on)
2
13
19
1
35
The number of applications for registration dealt with in 1930 was 42. Of these 8
were withdrawn when the Council's requirements were notified to the applicants, and
2 of the remainder were refused registration.
A nursing home is defined as "any premises used or intended to be used for the
reception of, and the providing of nursing for, persons suffering from any sickness,
injury or infirmity and includes maternity home." The definition of a maternity
home is "any premises used or intended to be used for the reception of pregnant
women or of women immediately after childbirth." Consequently such premises
require registration as a maternity home even though the women go to some other
place for the actual confinement.
In administering the Act the Council has been guided generally by the
following considerations:—
Keeper.—The keeper must not be unfit either by reason of age or otherwise.
A person under 21 years of age would be considered unfit; otherwise each case is
considered on its merits. The keeper, if not "qualified" under the Act must nominate
a person so "qualified " to superintend the nursing or to take charge of the home.
Situation.—Two particular points arise as to unsuitability, i.e., propinquity
of an offensive business or some special fire risk.
Accommodation.—A minimum standard is laid down as to size of rooms (960
cu. ft. maternity, 800 cu. ft. surgical or medical, 700 cu. ft. senile infirm, 600 cu. ft.