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55
of 6.7 per cent, in the birth-rate for London and also to the effect of the maternity
medical services provided under the National Health Service Act, 1946.
Where maternity medical services are provided the midwife is informed of the
result of the general practitioner's ante-natal examinations and for this purpose a
form has been brought into use. The midwife also should know whether she is to
act as a maternity nurse or as a midwife and the doctor enters his directions on the
form.
At the end of the year there were 480 General Practitioner Obstetricians on
the list of the London Executive Council. The Clerk of that Council has kindly
provided the following details of claims received from doctors during the year 1949
for maternity medical services. The figures quoted do not represent the total
number of cases attended during the year as there is no time limit for the submission
of claims for fees on maternity medical services and some claims were, therefore,
received too late for inclusion in these figures:—
Maternity
Medical
Service
Service
Provided
1949
Quarter
Claims from
General
Practitioner
Obstetricians
Claims from
General
Medical
Practitioners
Total
Full
March 482 89 571
June 428 73 501
September 582 72 654
December 990 51 1,041
2,482 285 2,767
Partial
March 203 201 404
June 500 243 743
September 700 259 959
December 745 448 1,193
2,148 1,151 3,299
Emergency
March 5 1 6
June 14 2 6
September 24 2 16
December 45 5 50
88 10 98
Full maternity medical service, for which a fee of £1 7s. 0d. is paid to general
practitioner obstetricians or £5 5s. 0d. to other medical practitioners, entails the
carrying-out of two ante-natal examinations, attendance at the confinement if
necessary and availability for emergencies, together with the care of mother and
child for fourteen days after confinement and a post-natal examination of the
mother at about six weeks after the birth. Payment is also made, according to
approved rates, for partial services, i.e. when the full maternity medical service is
not given. The London Executive Council also pay for attendances by medical
practitioners in emergency on unbooked maternity patients, where the practitioner
is not called-in by a midwife.
HEALTH VISITING
A move has been made towards greater fluidity between the health visiting,
tuberculosis visiting and school nursing staffs, which has been of great assistance,
particularly at times of pressure, and has considerably widened the interests of the
staff. This is only the first step towards undertaking the wider duties of the health
visitors envisaged in Section 24 of the Act.