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voluntary organisations were quite independent of borough boundaries and in most
cases covered parts of the areas of several boroughs.
A solution of these difficulties was found by adopting an " area " basis, and the
proposals approved by the Council for submission to the Minister of Health provided
that London should be divided for the purposes of the Act into five areas, three north
and two south of the Thames, each composed of a convenient number of boroughs.
The following is a list of the areas :—
Area A, comprising the metropolitan boroughs of Bethnal Green, Hackney,
Poplar, Shoreditch, Stepney and Stoke Newington.
Area B, comprising the City of London and the metropolitan boroughs of
Finsbury, Holborn, Islington and St. Pancras.
Area C, comprising the metropolitan boroughs of Chelsea, Fulham, Hammersmith,
Hampstead, Paddington, and St. Marylebone, the Royal borough
of Kensington and the City of Westminster.
Area D, comprising the metropolitan boroughs of Battersea, Bermondsey,
Lambeth, Southwark and Wandsworth.
Area E, comprising the metropolitan boroughs of Camberwell, Deptford,
Greenwich, Lewisham and Woolwich.
The proposals which were submitted to the Minister of Health provided (a) for
the employment by the Council of 42 municipal midwive3 ; and (b) for the employment
by 39 voluntary organisations of 124 midwives under arrangements with the
Council. It was also proposed that, under certain conditions, the three municipal
midwives employed by Metropolitan Borough Councils should, while remaining
employees of those Councils, be included in the County Council's arrangements for
performing its duty under the Act.
In regard to the London County Council municipal midwives, it was proposed
that " relief " should be provided by the appointment of additional midwives and/or
by utilising for the purpose the services of midwives employed by voluntary organisations
with which the Council had arrangements. It was estimated that the
relief services required would be equivalent to the whole-time services of six midwives.
The Minister of Health expressed the hope that every effort would be made to
carry the Council's proposals into effect at the earliest possible date, and in any
event not later than 1st January, 1938. Arrangements were accordingly made for
the scheme to be brought into operation on 1st January, 1938.
It became necessary to make certain minor modifications in the proposals
originally submitted to the Minister of Health. Of the voluntary organisations
with which arrangements under the Act were contemplated, one decided not to enter
into agreement w th the Council and two decided to discontinue their domiciliary
midwifery service. One municipal midwife employed by a Borough Council (Bethnal
Green) surrendered her certificate and the Borough Council did not fill her position.
In the case of one of the other two boroughs (Battersea), the Borough Council
decided to continue outside the Council's scheme and in the other (Shoreditch)
negotiations were still pending at the close of the year.
These changes necessitated an increase by three in the number of midwives to
be directly appointed by the Council, and it was also decided to draw upon the
provision which had been sanctioned for " relief" purposes, by appointing two
additional midwives to act as " reliefs," making a total of 47 municipal midwives
required.
Steps were taken in accordance with the procedure laid down in the Act for the
appointment, following public advertisement, of this number of midwives, all to
commence work on 1st January, 1938. The Minister, in Circular 1569, drew attention
to the importance of absorbing into the new service as many as possible of the
independent midwives at present in practice, and in making appointments preference
was given to thoroughly competent independent midwives already practising in the
administrative area. It was also decided at the outset not to differentiate between
Municipal
midwives