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to cover three of the Council's ante-natal clinics and provide a night and weekend ' on
call' service. This particularly successful scheme is described by Dr. F. R. Waldron,
Divisional Medical Officer, division 6, in his report (page 132).
Plans to promote the fullest co.operation with general practitioner obstetricians are
being discussed with the London Local Medical Committee.
Hospital services
In London, 83 per cent. of births took place in hospital during 1960, a proportion in
excess of the national average of 70 per cent. recommended by the Cranbrook Committee.
Maternity beds in London are provided by teaching and non.teaching hospitals, 44
maternity units providing a total of 2,153 beds:
(i) 17 teaching hospital maternity units (894 beds) are administered by 14 Boards
of Governors.
(ii) 26 hospital units (1,249 beds) are administered by 16 Hospital Management
Committees which are responsible to the four Metropolitan Regional Hospital Boards.
(iii) One hospital (10 beds) 'disclaimed' by the Minister of Health has operated
outside the National Health Service since its inception.
The Cranbrook Committee recommend that local maternity liaison committees with a
professional membership should be formed to ensure that local provisions for maternity
care are utilised to the best advantage. These committees had been preceded by meetings
held in 1956 on the advice of the Minister of Health to discuss the Memorandum of the
Standing Maternity and Midwifery Advisory Committee on ' Ante.natal Care Related to
Toxaemia.' Local maternity liaison committees have now been set up by all Hospital
Management Committees and most Boards of Governors.
It has long been the practice in the county for health visitors or midwives to make home
visits to mothers seeking a hospital bed on social grounds, and to report on the suitability
of the home for domiciliary confinement. When requested by hospitals, health visitors also
follow up patients who fail to attend hospital ante.natal clinics.
Local maternity liaison committees have discussed means by which health education
and mothercraft training can be made available to all expectant mothers. Some hospitals
now refer mothers to the Council's centres for this purpose and display posters provided
by the Council in their own ante.natal clinics.
Some hospitals refer mothers booked for hospital delivery to the Council's clinics for
intermediate ante.natal care. The patient's personal record card, first introduced to aid
co.operation between general practitioners and midwives, is now also used as a clinical
record by the hospital and the Council's clinics.
Maternity liaison committees have also tried to improve local arrangements to ensure a
proper selection of mothers for hospital confinement. In some parts of the county, however,
in particular in the north.west, divisions 1, 2 and 3, there is a growing problem which
harasses everyone engaged in the maternity services. General practitioners, as well as
doctors and health visitors in the Council's clinics, may be unable to book a hospital bed
for women who need hospital delivery on grounds of age, parity or social conditions, if
such women attend for ante.natal care for the first time during the second half of pregnancy.
The older multiparous woman tends to seek ante.natal care late in pregnancy and is
herself often unaware that she is unsuitable for home confinement. Moreover, in Northwest
London, social conditions are often particularly unsuitable for home confinement.
A number of main line railway stations bring immigrants and temporary residents, including
unmarried mothers, to this neighbourhood, where many of them find accommodation
in lodgings or boarding houses.
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