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106
The staff employed in the Division as at the 31st December, 1948, numbered
687, as follows :—
Full Part-
time. time.
Doctors and dentists 12 83
Nursing, including medical auxiliaries and dental attendants 283 5
Administrative, clerical, including organisers 62 —
Domestic and miscellaneous 119 123
476 211
Much good work has been carried out despite the difficulties that have had to be
overcome in the setting up of a new organisation.
In conclusion, I would like to express my appreciation to the Medical Officers of
Health of Battersea and Wandsworth for their co-operation and assistance.
domiciliary midwifery service—historical sketch
I—Introduction
Origin
The Council's domiciliary midwifery service had its origin in the Midwives
Act, 1936, which laid on the Council the duty of securing an adequate service of
midwives for attendance on women in their own homes in London. To provide this
service the Council employed 47 salaried midwives and entered into agreements with
36 voluntary hospitals and district nursing associations employing 120 midwives.
The service commenced on 1st January, 1938. Midwives attended either as midwives
on their own responsibility or as maternity nurses under the direction of a doctor.
They were encouraged to make the fullest use of the maternity and child welfare
services provided by the metropolitan boroughs. The voluntary associations
received payment from the Council for each confinement undertaken. Every
woman attended by a midwife was charged a fee which was reduced in accordance
with the net family income, but medical aid, if summoned by the midwife, was
provided free. A choice of midwife was provided for women who desired it.
The service proved capable of development to meet increasing demands and of
adjustment to meet the difficulties of the war years. It survived the stress of the
blitz and the strain of the post-war rise in the birth rate. It underwent no fundamental
change under the National Health Service Act, except to become a free service.
Compensation
When the domiciliary midwifery service commenced, independent midwives
were given the option under the Midwives Act, 1936, of relinquishing their practices
and, subject to certain conditions, became entitled to receive compensation. Sixtyeight
midwives were so compensated, receiving £24,370. As a war-time measure
under Defence Regulation No. 33 (1) of 1939, which is still in force, some midwives
who had surrendered their certificates under the Midwives Act, 1936, were permitted
to resume midwifery for stipulated periods.
Administration
The direction of the domiciliary midwifery service was delegated by the Council
to its Hospitals and Medical Services Committee. This Committee also administered
the large hospital service which the Council inherited in 1930 from the Boards of
Guardians and the Metropolitan Asylums Board. The close association of domiciliary
midwives with a hospital service was of great value to the new service and many
valuable features of this close association are still maintained. On 5th July, 1948,
the hospitals were transferred to the Minister of Health under the National Health
Service Act and the Health Committee was set up to undertake the Council's duties
as local health authority under the same Act, including the direction of the domiciliary
midwifery service.
Areas of
practice
In planning the service in 1937, one of the main problems was that of the best
area for practice and administration. The metropolitan boroughs, who were the
M. & C.W. authorities, had claims but were too many and some were too small and the
areas of the voluntary organisations were ill-defined and often overlapped both each