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39
Fees payable for the services of the midwives.
Section 3 of the Act makes it a duty of the authority to fix a scale of
fees payable for the services of the midwives when acting either as midwives
or as maternity nurses and to recover such fees from the patient, or from
the husband or other person liable to maintain her. The authority may remit
part or the whole of the fee.
The fees charged should as far as possible be those prevailing in the
district. Enquiries among the local midwives have elicited the information
that the fees for attendance as a midwife and for attendance as a maternity
nurse are the same, but that in some instances a higher fee is charged in
respect of attendance on a woman for her first baby. The fees charged by
the midwives at present are in respect of attendance for ten days only,
Whereas from 1st January, 1937, the period of attendance will be increased
to 14 days. The fees vary from £2. 2s. Od. to £2. 5s. Od. in a multipara
and from £2. 2s. Od. to £3. 3s. Od. for a primipara, although the occasions
on Which the last fee is obtained are small in number. A uniform fee of
£2. 10s. Od. for attendance in all cases Would therefore appear to be equitable.
There are certainly advantages in having a uniform fee for both the primipara
and the multipara.
It is suggested that the fees charged should be reduced according to the
following scale of family income after deducting rent, rates, insurances and
travelling expenses of the worker, but not taking account of maternity
benefit :
Average weekly income per
member of family after excluding
rent, rates, etc. Proportion of Fee.
Under 10/- No charge.
10/- to 15/- One-third.
15/- to 20/- Two-thirds.
Over 20/- Full charge.
This scale for recovery of fees is based more or less upon others used in
connection with various benefits obtained through the Maternity and Child
Welfare Scheme. The other scales, however, should, in view of past experience,
be reconsidered.
Cases will arise in which the midwife will not render the full period of
service and it is recommended that the Medical Officer of Health be authorised
to reduce the fee to meet the circumstances of each case.
To prevent patients cancelling the services of a midwife without any
adequate reason it is recommended that a proportion of the fee, say 5/-,
should be payable at the time of booking. The booking fee Would not be
refunded except where the cancellation is not the fault of the patient.
While the Council will not be able to insist on prepayment of the whole
fee due, as is done in connection with patients admitted to the Maternity
Hospital, steps will be taker to encourage payment during the expectant
period.
Booking of Patients.
It will be an integral part of the new service to give the patient as free
a choice of midwife as is practicable ; the midwife will be booked direct by
the patient and not through any intermediate agency.
To facilitate the sending for medical aid it is intended to circularise
medical men practising in the Borough and to compile a list of those who
express their willingness to respond to calls made by the midwives. It is
provided in the rules of the Central Midwives Board that the midwife must
call in the doctor named by the patient and it is only proposed that the list
of doctors shall be used to submit to patients wTho are unable to name a doctor
themselves.