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any patient who has engaged a doctor for her confinement, but
is unable, in addition, to afford the services of a trained nursing
attendant.
3. That a salaried midwives' service should be established
under the appropriate local authority in all areas not already
served by salaried midwives. It is not intended to interfere
with the continuance in practice of independent midwives.
4. That it should be the duty of every appropriate local
authority to provide, or secure the provision of, an adequate
domiciliary service of midwives in its area , and for this purpose :
(«) to employ the requisite number of whole-time midwives at
adequate salaries; and/or (b) to aid approved voluntary
organisations (including provident societies) that employ
salaried midwives for service in its area.
5. That the local supervising authority (Midwives Acts)
should be the unit of administration for the proposed service.
0. That the cost of the service should so far as practicable
be met by the fees charged by, and payable to, the authority or
the voluntary organisation for the services of the midwife.
The remaining recommendations doal with
(a) The steps which should be taken by the local supervising
authority before initiating a scheme in its area ;
(b) The status, salary and appointment of midwives
entering municipal service ;
(c) The compensation of midwives not accepted for
service ;
(d) The necessity for refresher courses .of study by
practising midwives ;
(e) The right of appeal by midwives ;
(f) The freedom of choice of midwife bv the patient.
After consideration of the above report, the Maternity and
Child Welfare Authority expressed general approval of the proposals
contained in the Report of the Joint Council.