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37
As already stated, 1,008 confinements took place in their own homes,
so that if 689 were attended by certified midwives, it means that 319 were
attended either by nurses or by handy-women, a medical practitioner being
in charge of the patient. A large proportion of these 319 must in the future
be attended by midwives, only a small number being attended by maternity
nurses holding certificates specifically approved by the Minister of Health
under Section 6 (1) (e) of the Act.
It is a requirement of the Act (Section 2) that notice of proposed appointments
to the salaried service should in addition to insertion in the local
press, be sent to every midwife who has given notice of her intention to
practice in the area.
The Minister of Health in Circular 1569 states that it is important that
as many as possible of the idependent midwives at present in practice in
the area should be absorbed into the new service and that local authorities,
when making their first appointments of salaried midwives, will naturally
desire to give preference to the most efficient of the independent it idwives
practising in the areas. No doubt the Council will accept the advice of the
Minister and will particularly consider the claims of those midwives who at
present deal with the largest number of cases and who can be deemed efficient.
Such an arrangement will provide for the least possible dislocation of the
present midwifery practice.
Scale of Salaries of Midwives appointed to Service.
The Minister of Health in his Circular states that he regards it as of the
utmost importance that the midwives employed in the service should be
adequately remunerated and expresses confidence that local authorities will
in respect of midwives appointed by them adopt scales of salaries which are
comparable With those applicable to health visitors employed in the district
together with appropriate allowances for travelling expenses. It is recommended,
therefore, that the appointed midwives should be placed on salary
scale similar to the new B1 scale applicable to Health Visitors and School Nurses
of £200, rising by £10 to £300 a year with the proviso that any increases
granted should be subject to a special recommendation of the Maternity and
Child Welfare Committee which should take into consideration the experience,
ability and personality of the midwife, her possession of the certificate of
training as a nurse and the number of cases attended in the year. It seems
undesirable to discriminate between those who have had general nursing
training and those Who have not in regard to the commencing salary in
making the first appointments but it should be accepted as a general principle
that in all appointments made after the Scheme is in operation a certificate
of training in general nursing is required.
It is essential that two of the midwives appointed to the staff should
hold a teacher's certificate which will enable them to undertake the instruction
of pupil midwives in the homes of the mothers in order to co-operate with
the training of pupils at the Maternity Hospital. New rules regarding
the training of pupil midwives are in course of preparation by the Central
Midwives Board and the position of the new Maternity Hospital will be
reviewed as a training school under one or other or both of the new categories
envisaged by the Board and it is necessary to take steps as recommended
by the Board to provide for the appropriate training of the pupils by appointing
approved teachers as part of the scheme of Whole-time midwives. In view
of the special experience and training of these approved teachers it is recommended
that they should receive £25 a year in addition to the scale already
mentioned.
To encourage midwives in the employment of the Council to improve
their status in the profession and thereby be of more value to the Council's
Scheme, an additional increment of £10 a year should be granted to any
midwife obtaining the teacher's certificate or an increment of £25 a year if
she is ultimately employed in training pupils.