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further steps at the moment in this direction.
The Maternity and Child Welfare Committee gave very careful
consideration to the question of obtaining consultants for doctors
needing assistance in difficult and complicated confinement cases.
The distance of Enfield from London makes it extremely
difficult, if not impossible, for local practitioners to call an Obstetric
Specialist from London during the course of a confinement unless
his patient is at least well-to-do. The alternative has been to obtain
admission to the North Middlesex County Hospital or the Enfield
War Memorial Hospital. This must have meant the admission to
hospital of some cases that could have been adequately treated
with Specialist advice at home. Moreover, the Committee had the
fear that in view of the difficulties of obtaining a second opinion
there was a tendency for doctors to deal with difficult cases themselves,
when they would have been far happier had they been able
to obtain a second opinion.
I accordingly was instructed to confer with Doctor Tate, the
County Medical Officer, and see if steps could be taken to obtain the
services of the Obstetric Specialists at the North Middlesex County
Hospital for complicated midwifery cases.
Doctor Tate gave me a most kind and sympathetic hearing, and
the County have now agreed to make the services of their Obstetric
Specialists at the North Middlesex County Hospital available for
complicated midwifery cases in the district.
The scheme will work very simply.
Any practitioner attending an Enfield resident during her
confinement and desiring a second opinion can telephone the
Medical Superintendent at the North Middlesex County Hospital
and consult him concerning the case. If it appears that immediate
admission to hospital is necessary in the interest of the patient,
arrangements will be made at once for such admission. In other
cases, however, where the danger is not so urgent, one of the
Obstetric Specialists at the Hospital will visit the case, together
with the general practitioner in charge, and will advise and help him.
Each time a consultant attends on an Enfield resident the Enfield
Council will pay the Middlesex County Council a sum of £2 2s.,
and the Enfield Council will recover from the patient as much of
that sum as the patient can reasonably afford to pay.
I look upon this as one of the most important steps the Council
has made in connection with maternity and child welfare, and I feel
that I shall have the whole-hearted support of every practitioner in
Enfield in making this scheme a success.