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35
The Town Council may therefore comply with the requirements of the
Act either by makiug arrangements with voluntary organisations for the
provision of an adequate service of certified midwives or by itself employing
such midwives. But as there are at present no voluntary organisations
in the Borough employing midwives, the provision of a whole-time domiciliary
service of midwives should undoubtedly be undertaken by the Town Council
itself. Inasmuch as the cost of the service Will be met out of the general
rate fund (with the assistance of Exchequer grants) it would be the best
policy for the Council to retain the fullest measure of control over the new
service and thus secure the closest possible co-operation between the midwifery
service and the general scheme of maternity and child Welfare.
Consultations with voluntary organisations and other bodies.
The Council is required before submitting to the Minister of Health
its proposals for carrying out its duties under the Act, to consult with voluntary
organisations which, to the knowledge of the authority, employ or are willing
to employ domiciliary midwives in the area, and with local organisations
(if any) representing the medical profession and the midwives practising
in the area.
As no voluntary organisations at present employ midwives in Ealing
and as none are known to be willing to employ domiciliary midwives in the
area no conference With a voluntary organisation was called for.
A Conference took place on the 30th November between representatives
of the Maternity and Child Welfare Committee and the Executive Committee
of the West Middlesex Division of the British Medical Association who had
been nominated at a meeting of the local medical practitioners to put forward
the views of the medical profession.
As no local organisation was known to represent the midwives practising
in the Borough it was deemed advisable to call together all the midwives
to explain the terms of the Midwives Act and to consider any views put
forward by the midwives themselves. This conference was held on the
19th October and Was attended by the Chairman of the Maternity and
Child Welfare Committee and the Medical Officer of Health.
The various points put forward at these two conferences have been
borne in mind in formulating the suggestions in this report.
Number of whole-time salaried midwives required.
By Section 1, sub-section (3), of the Act the proposals submitted by
the Council have to include particulars of the number of midwives to be
engaged. The number required to serve the needs of the Borough is difficult
to estimate, particularly as it will not be known until after the scheme is
actually in operation how many midwives will continue in independent
practice and how many persons will be allowed under Section 6 (1) (c) of
the Act to continue to do maternity nursing, that is, to act as a nurse with
a doctor attending the confinement and being responsible for the case.
The only clue to the number of midwives required is the number of births
which occur in private houses in the Borough, allowance being made for
those to be dealt with by midwives and nurses outside the scheme.
During the year 1935, the total number of births assignable to the
Borough Was 1907. Of this number 1,008 births took place in private
houses in the district. The estimated number of births during 1936 will
be slightly in excess of this figure but it may be assumed that there will
be a little over a thousand births taking place in the homes of the patients.
A rough estimate of the number which will be dealt with by midwives and
nurses in independent practice may be taken as 280. This leaves the number
of births to be dealt with by the new service as 720 per annum.