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72
when necessary to a confinement. It is hoped that arrangements
can he made with the Essex County Council to permit of the
Medical Superintendent of their nearby institution acting in this
capacity, more particularly as it is to this hospital that emergencies
are admitted. On occasion the condition of the patient does not
admit of her removal to hospital, and one would like to see
established an emergency ambulance unit operating from an
institution by which the immediate services of a specialist and
nurses would be obtainable, ready to carry out, in the patient's
home, any desirable measures, including blood transfusion.
The desirability of abolishing the handywoman is admitted on
all sides. The difficulty in effecting this is largely on financial
grounds in that the mother is unwilling, often unable, to pay the
fees of a doctor and of a maternity nurse ; also the assistance of
the handywoman acting as a home help in helping in the management
of the home is a consideration. It would be justifiable
to assist those patients who require the attendance of a doctor
on medical grounds, by subsidising the payment of the maternity
nurse and home help. The difficulty arises in those cases where
the patient elects to have a medical attendant though a normal
confinement is expected. To endeavour to prevent home helps
developing into handywomen, the Council has decided that a
home help will not be granted to any woman unless she has engaged
a trained midwife to attend her at the confinement, or unless a
trained maternity nurse is to be present with the doctor.