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58
In 1929, a Departmental Committee on the training and employment of
midwives urged that local authorities should be encouraged to make use of their
powers under the Maternity and Child Welfare Act, 1918, to provide a home help
service. Some authorities did in fact take up their powers under the 1918 Act but
little progress was made until the passing of the Public Health Act, 1936 (in
London, the Public Health (London) Act, 1936). A number of authorities started
home help schemes but not all those commenced were successful and many
authorities did little or nothing.
Towards the end of 1944, welfare authorities were informed of the extension of
their powers under the 1936 Act by the issue of Defence Regulation 68E, whereby
domestic help could be supplied in cases of illness and infirmity as well as in
maternity cases.
In London, prior to July, 1948, all the metropolitan boroughs (but not the City
of London) operated a scheme for providing home helps for maternity cases. Every
borough (except Bethnal Green) and the City of London operated a scheme for the
provision of domestic help for sick or infirm persons who were not themselves able
to provide such assistance. The extent of the provision, however, varied considerably
from borough to borough. Generally both whole and part-time staff were
employed and in a few instances casual labour was used. This was the position
when the Council assumed responsibility for the service in Tulv. 1948.
Types of
household
attended
At present all types of household eligible for domestic assistance under Section
29 of the National Health Service Act, 1946 (namely, "any person who is ill,
lying-in, an expectant mother, mentally defective, aged, or a child not over compulsory
school age"), are served subject to the resources available. Every endeavour is made
to provide some service for all cases in need, but this is achieved only by rationing
the hours of service among the households on the books and, in some instances,
refusals have had to be made of the less urgent cases.
It has been found exceedingly difficult to grade applications for domestic help
into categories because individual circumstances vary so much, but obviously some
order of priority had to be established. After a year's experience of the service the
Health Committee agreed to the following order of priority, but decided that it
should not be rigidly applied, discretion being used in determining in which cases
help is most needed: (1) confinement cases, (2) acute or chronic illness, (3) aged
and infirm and the blind, (4) a mental defective in the household, or large families
of children under compulsory school leaving age. Each case in category (2) has to
be covered by a medical certificate before being granted help.
Statistics

(а) For the period 5th July to 31st December, 1948; because of the transfer
of powers statistics were not collected for the earlier part of the year
(б) Estimated
(c) Approximate