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obtain experience in the Council's maternity and child welfare centres. It will be
realised that this plan is essentially long-term. It has, however, been possible to
arrange for teaching hospital staff to conduct certain sessions at centres and to grant
facilities for students to attend. Extensions of these arrangements will be made
as opportunities arise. No obstetric or paediatric consultants have yet been directly
appointed by the Council to work in the maternity and child welfare centres, but, as
a preliminary measure, all the Council's ante-natal centres have been linked with
suitably placed hospitals willing to provide the services of consultants. Any expectant
mother needing specialist advice is thus able to obtain it with the minimum of delay
and inconvenience. A similar scheme for obtaining the services of consultant
paediatricians is being considered.
The Regional Hospital Boards, in conjunction with the Boards of Governors of
Teaching Hospitals, are preparing lists of consulting specialists who will visit the home
at a doctor's request.
Notification of births and deaths of children under five years of age
These were new functions for the Council, taken over from the metropolitan
borough councils. Particulars are received of all births in the County area both in
the home and in institutions. Under Section 255 of the Public Health (London) Act,
births are notifiable within thirty-six hours by the father or any other person who
was in attendance on the mother at, or within six hours of, the birth. The Council
is also under obligation (a) to supply on request a form of notification to all doctors
and midwives, and (6) to allow the registrar of births and deaths to have access to
notifications received. In practice divisional medical officers and the local registrars
exchange particulars of births which they have received. By this mutual check each
is able to prepare the most complete and accurate list available for his area.
There is no direct notification of deaths of children under five years of age to the
divisional medical officer, but he receives from the local registrars details of all such
deaths, which have been registered in the division. Under authority which goes back
to the Births and Deaths Registration Act, 1874, payment is made by the Council to
the registrars for each entry of births or deaths supplied.
A comprehensive system for transferring information between divisions and with
other health authorities has been established.
Transfer of
information
Expansion of Services
All the services provided by the Borough Councils, except those which became
the responsibility of Hospital Boards or the Executive Council, have been continued
since 5th July, 1948, and in some instances there has been reorganisation with the
object of making the best use of available staff without detriment to the public.
For example, the increase in the number of domiciliary midwives' booking and antenatal
examination sessions (see page 38), has helped to free medical staff and health
visitors for duties in other centres or in other spheres of action covered by their
enlarged responsibility. This is a matter of considerable importance in view of the
shortage of trained staff.
Joint arrangements with other local health authorities
Negotiations have been opened with the Kent County Council and with the
County Borough Councils of East Ham and West Ham for the provision of maternity
and child welfare facilities in centres which serve conveniently an area partly under
the Council and partly under one of the other authorities concerned. Other neighbouring
authorities will be approached if need arises for London residents to attend
out-county centres and the Council will continue to co-operate on a basis of mutual
assistance with any authority requesting help of this nature.
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