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60
The material provisions of the section are as follows :—
(1) It shall be the duty of every local supervising authority within the
meaning of the principal Act (in this Act referred to as an " authority ") to
secure, whether by making arrangements with welfare councils or voluntary
organisations for the employment, by those councils or organisations, of certified
midwives as whole-time servants or by itself employing such midwives, that the
number of certified midwives so employed who are available in its area for
attendance on women in their own homes as midwives, or as maternity nurses
during childbirth and from time to time thereafter during a period not less
than the lying-in period, is adequate for the needs of the area.
In this sub-section the expression " lying-in period " means the period
defined as the lying-in period by any rule for the time being in force under
section three of the principal Act.
[Under recent rules of the Central Midwives Board the lying-in period has been
extended from 10 to 14 days.]
(2) Within the period of six months from the commencement of this Act,
or such longer period as the Minister may in any particular case allow, every
authority shall submit to the Minister its proposals for carrying out its duties
under this section, after consultation :—
(a) in the case of every authority—
(i) with all the voluntary organisations which, to the knowledge of
the authority, employ or are willing to employ domiciliary midwives in
the area of the authority; and
(ii) with such local organisation (if any) of registered medical practitioners
as appears to the authority effectively to represent the opinions of
such practitioners practising in that area on the questions to be considered
in formulating the proposals ; and
(iii) with such local organisation (if any) of midwives as appears to the
authority effectively to represent the opinions of midwives practising in
that area on the questions aforesaid ; and
(c) in the case of the London County Council, with any association
or committee which appears to that Council to be representative of the
Metropolitan Borough Councils.
Careful and prolonged consideration was given to the preparation of proposals
for recommendation to the Council and submission to the Minister of Health for
carrying out the Council's duties under the Act. The problem in London was a
complex and difficult one, owing to the large area and population affected, and to the
number of voluntary hospitals, maternity homes and district nursing associations
which already provided domiciliary midwifery services. There was also the circumstance
that the City Corporation and the Metropolitan Borough Councils, who
are the authorities in London under the Maternity and Child Welfare Act, 1918
(these provisions are now incorporated in the Public Health (London) Act, 1936),
had in three cases exercised their power to appoint each a whole-time midwife, and
in about 15 cases had made contributions in respect of domiciliary midwifery services
provided by voluntary agents. There was the further point that the Council itself,
under the Maternity and Child Welfare Contributions (London) Scheme of the
Minister of Health under the Local Government Act, 1929, makes substantial payments
(replacing former grants by the Minister) to hospitals and nursing associations
in respect of domiciliary midwifery services.
The consultations prescribed in Section I (2) began immediately the Act came
into operation in July, 1936, and were continued during the early part of 1937.
In the course of the discussions, it became apparent that proposals for utilising
existing midwifery services in London could not, if they were to be capable of
efficient application in practice, be related to the county as a whole, which would
be too large an area, or to the metropolitan boroughs singly, as the activities of the