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66
The response from the hospitals to the offer of co-operation was varied. In one or
two instances the Council was approached by the regional hospital boards when proposals
to close or open maternity beds were under discussion, but on the whole it was
felt that there was room for co-operation to be further developed. The varied practice
of different hospitals within the same regional board area, in asking for the co-operation
of the local health authority in applying social standards for the admission of women to
maternity beds reacts unfavourably on neighbouring hospitals who loyally co-operate.
A further approach has been made to the hospital authorities to review the progress made
since the issue of the Ministry's circular and to obtain agreement on the best means for
establishing and improving mutual co-operation in the fields in which the interest of the
hospitals and the local health authority converge. The main problems on which cooperation
is desired are :
(a) Selection of maternity cases for admission to hospital, (b) co-operation between
hospital maternity departments and the Council's ante-natal clinics, (c) notification of
the discharge of maternity patients, and (d) provision of care and after-care for maternity
patients at the request of hospital almoners.
Midwives Act, 1951
The Council, as local supervising authority, has the duty to inspect midwives and
maternity nurses practising in its area in accordance with the rules of the Central Midwives
Board. Originally, these inspections were carried out by medical supervisors but
in 1939 two positions of non-medical supervisor were substituted for two of medical
supervisor. The number of non-medical supervisors employed by the Council subsequently
rose to six in 1948 but as the number of domiciliary confinements declined,
the number of non-medical supervisors employed has been reduced to four. These
supervisors maintain a 24-hour supervision of the domiciliary midwifery service. They
supervise the work of the L.C.C. midwives and supervise and inspect the district midwives
employed by hospitals and district nursing associations. They carry out the
routine inspections required by the rules of the Central Midwives Board of all independent
midwives and maternity nurses, investigate all cases of puerperal pyrexia, skin and
eye infections, neo-natal deaths and still-births occurring on district and arrange, if
necessary, for the suspension of midwives coming into contact with infection and inspect
all medical aid notices issued by midwives.
Notifications
of intention
to practise