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47
Care of Premature Infants
The special equipment provided for use when a premature infant is being
nursed at home was reviewed in the light of experience in use, and some modifications
made. Three sets of the equipment have been provided in each of the nine
divisions, and are available on request by day or night. A deposit has to be made
for the loan of a set and is refunded in full on return of the set.
The arrangements outlined in my report for 1948 with respect to special
transport arrangements when these infants have to be removed to hospital have
operated throughout 1949. The specially heated cots carried on the ambulances
were used on 72 occasions for premature infants and on 180 for other babies
requiring removal to hospital.
Specialist Clinics
Among the services taken over from the metropolitan borough councils on the
"appointed day" were a number of specialist clinics for expectant and nursing
mothers and consultative infant welfare clinics for healthy children under 5 years
of age. It was apparent that although these had been provided under the maternity
and child welfare powers of the borough councils they were not necessarily functions
of the local health authority under the National Health Service Act. Discussions
were therefore held with the metropolitan regional hospital boards as a result of
which it was agreed that the regional hospital boards should provide and pay
specialists for consultative infant welfare clinics and should accept entire responsibility
for gynaecological clinics. Negotiations between the Council and the boards
are now proceeding with a view to the detailed implementation of these proposals.
Maternity and Child Welfare Services provided by Hospitals
Many of the former voluntary hospitals provided maternity and child welfare
services (ante- and post-natal clinics, infant welfare clinics, health visiting services,
etc.) before the " appointed day," often by arrangement with one or more of the
metropolitan borough councils, which assisted them financially in return for the
services. Two of the Council's former hospitals provided ante-natal and post-natal
facilities for metropolitan borough councils by agreement but without payment, and
others provided dental services for expectant and nursing mothers and children
under 5 years of age, payment being made on a case basis.
The question arose whether the Council had inherited under the National
Health Service Act the liability to continue the payments made by the metropolitan
borough councils and the extent, if any, to which the services could now properly
be provided by hospitals. The matter was referred to the Ministry of Health, who
ruled that hospital authorities were not empowered to provide any services which,
under Part III of the Act, were the functions of a local health authority. Such
services could be provided only by the local health authority, either directly or
through a voluntary organisation acting as its agent. It therefore appeared to the
Minister that, in the case of teaching hospitals with their special responsibilities for
the training of medical undergraduates, either the Council should take over the
Part III services being provided and, where it wished to continue them in the same
premises, should rent the accommodation from the board of governors of the
hospital; or else the committee of the medical school concerned, which could be
regarded as a "voluntary body" under Section 22 of the Act, could provide the
services with financial assistance from the Council. At hospitals under the control
of the regional hospital boards there is no medical school or other voluntary body
and consequently the only possible course is for the local health authority, if it
wishes to continue the service, to take it over and administer it direct.
This ruling has necessitated negotiations between the Council, ten of the
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