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apparently healthy women only and no examination, apart from the cervical smear,
is carried out. The patient and her family doctor are informed of the result, and
any treatment which is necessary is arranged or carried out by the family doctor.
Women are at present recommended to have this test at five-yearly intervals.
Two thousand eight hundred and forty cervical smears were taken during antenatal
sessions and at the 135 special clinic sessions. Cancer cells were found in
thirteen cases, a higher proportion than previous years. All were married women
between 28 and 56 years of age. Treatment in each case was arranged by their
general medical practitioners at local hospitals.
There were eight doubtful cases requiring further examination and 973 other
findings of a non-cancerous nature. Of the eight doubtful smears three were found
to be non-malignant on repeat examination, and five are still being followed up.
Thus, since the service began a total of 7,892 smears have been taken and
twenty positive cases found, i.e. 2.5 per 1,000 examinations.
The increase in the number of smears taken in 1968 was partly due to special
arrangements which were made with certain factories by which almost 300 women
were examined, and to special general publicity in the early part of the year.
(See Statistical Tables 10, 11 and 12)
MIDWIFERY
Under Section 23 of the National Health Service Act, 1946, it is the duty of
every local health authority to provide a domiciliary midwifery service. The local
health authority is also the local supervising authority for the purposes of the
Midwives Act, 1951.
Ministry of Health Circular 31/68 drew attention to Section 10 of the Health
Services and Public Health Act, 1968, and indicated that it enabled local health
authorities to make provision for midwives to attend women elsewhere than in
their own homes or in hospitals vested in the Minister, the aim being to obtain
greater flexibility on the deployment of midwives and promote greater co-operation
between the local authority midwifery service and general practice. The section
also provides for arrangements between local health authorities for the services of
midwives employed by one authority to be used by another authority on agreed
terms and conditions. Similar arrangements can be made between a local health
authority and a hospital authority. The Circular also stated that the reference to
the "lying in period" in the 1946 Act has not been renewed in the new Act in
order to remove any doubt as to the propriety of a local health authority sending
in a health visitor or home nurse rather than a midwife if the latter is not required
in a particular case.
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