London's Pulse: Medical Officer of Health reports 1848-1972
View report page
Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1948
[Report of the Medical Officer of Health for London County Council]
This page requires JavaScript
113
In 1944 the Minister of Health drew attention to the importance of the care of
premature infants as a measure to reduce neo-natal mortality. Midwives were
carefully instructed in special measures to be adopted in nursing care for infants
born at home, including the provision of warm clothing, and the establishment of
breast-feeding or, failing that, artificial feeding. Each premature birth is reported
to the supervisors who visit and advise on the care of the premature infant. If the
infant is not likely to thrive at home the midwife can arrange for immediate
admission to hospital for both infant and mother if advisable. Every care is taken
in transporting the infant—a midwife is sent and a special warm cot provided in the
ambulance. The hospital is warned to make all preparations for reception. Similarly,
newborn infants affected with haemolytic diseases, i.e., Rhesus Factor cases, are
admitted to hospital units for observation and treatment.
Special care
of Babies
One of the midwives' duties under the Rules of the Central Midwives' Board is
to call in medical aid at any time before or during labour or during the lying-in
period. The doctor's fees are paid by the Council as local supervising authority.
Medical aid is summoned on the average in 42 per cent. of midwives' cases. This
includes care of the infant.
Medical aid
There has been a great change in the clinical aspects of maternity work during
the 11 years, 1938-1948. The sulphonamide group of drugs has had a striking
effect upon the infections of the lying-in period. Puerperal infections are not now
the menace they were formerly. Ophthalmia neonatorum of a serious degree has
been reduced to a negligible figure and many of the young midwives have never had
an opportunity of seeing a case of real pemphigus neonatorum on the district.
Suspension of midwives coming into contact with serious infection has been reduced
from 124 in 1940 to 25 in 1948.
Clinical
aspects
IV—D istrict N ursing A ssociations and H ospitals
Agreements between the Council and the hospitals and district nursing associations lay down conditions under which district midwifery services are provided. The payments made by the Council have varied from time to time as follows:—
| Date | Hospitals | District nursing associations | ||||
|---|---|---|---|---|---|---|
| £ | s. | d. | £ | s. | d. | |
| 1938-9 | 2 | 6 | 10* | 2 | 14 | 0 |
| 1940-3 | 3 | 5 | 0 | 3 | 12 | 6† |
| 1943-4 | 3 | 15 | 9 | 4 | 5 | 9 |
| 1944-5 | 4 | 6 | 6 | 4 | 19 | 0 |
| 1946-7 | 4 | 18 | 0 | 5 | 7 | 3 |
| 1947-8 | 5 | 2 | 8 | 5 | 12 | 10 |
| From 5th July, 1948 | 7 | 13 | 4 | Merged in deficiency grant to cover midwifery and home nursing. | ||
Payments to
voluntary
organisations
* Reduced to £1 7s. 6d. when midwife was accompanied by pupil.
† From 1-11-40, maternity outfits have been supplied free to district nursing associations. Hospitals
were required to provide a suitable outfit to the patient.
The district midwives employed by hospitals and district nursing associations
are full-time servants of those organisations. Except that they are normally
resident in the hospital or district home and work from there, their salaries, conditions
of service and conditions of work have, on the whole, approximated to those of the
Council's midwives. This approximation was brought about, in the first instance,
by the agreements which the Council entered into with the organisations and
subsequently by the introduction of national scales and conditions of service as
recommended by the Midwives' Salaries (Rushcliffe) Committee. They have the
same responsibilities towards their patients as have been described for the Council's
midwives.
Hospital and
district
nursing
association
midwives