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A procedure has been agreed with the Local Medical Committee to help such women.
The general practitioner is asked to undertake the ante-natal care of the mother and, if no
hospital bed can be found during her pregnancy, to visit her when in labour to arrange for
hospital admission through the Emergency Bed Service. If the patient's doctor does not
undertake maternity medical services and a general practitioner obstetrician cannot be
found to give these services, the mother is given ante-natal care at the Council's clinics
and a domiciliary midwife attends her when labour begins to arrange for her removal to
hospital; the Emergency Bed Service cannot remove the patient to hospital until she has
been examined by a doctor or midwife. Dr. W. G. Harding, Divisional Medical Officer,
division 3, has analysed 100 such cases arising in his area. (See page 125.)
The number of maternity cases removed by the Emergency Bed Service in 1960 was
the highest yet recorded.

Table (xii) shows the number of maternity cases admitted to hospital by the Emergency
Bed Service in each division from April to September, 1960. The cases are divided into
those admitted as emergencies and cases for whom maternity beds could not be found
during pregnancy. It will be seen that over half of the latter arose in divisions 1, 2 and 3.

This situation cannot be attributed to any single factor but is influenced by conditions
arising from the pattern of the hospital maternity services in London. In divisions 1,2 and 3
there are 1,018 hospital maternity beds of which 626 (61 per cent.) are in teaching hospitals.
The policies of these hospitals are influenced by their major function of undergraduate and
post-graduate training, and they may of course draw patients from any part of the country.
The non-teaching hospitals on the other hand primarily serve the needs of the community
in which they are situated, though in London these hospitals, too, have no responsibility
laid upon them to admit all cases requiring a hospital bed from a defined catchment area.
In these circumstances it is not possible for hospital obstetricians to decide when the needs
of all patients in priority groups have been met. Hence some of them make available a
proportion of their beds without question to mothers who attend in the early weeks of
pregnancy and only then allocate the remaining beds according to need.
In London the proportion of maternity beds compares favourably with that in many
other parts of the country. It is unlikely, therefore, that an increase of maternity beds to
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