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Willesden Council in all necessitous cases for which they assume responsibility. The suggestions in
this paragraph are that it should extend to all cases, and the Local Authority should make up any
difference in the fees payable. In order to do this the co-operation of the doctors practising in the
district is required, as stated in the paragraph. If the Council agree to this suggestion, practising
doctors should be informed accordingly, and prior applications should be received from the patients
concerned.
(3) Reasonable Facilities for Effective Medical Care.
All facilities, including the services of a Consultant, are available in Willesden for the medical
care of the expectant mother and at her confinement.
The number of beds at the Willesden Maternity Hospital (for 500 cases per annum) is not
more than sufficient to meet the present requirements, and the present demand under the conditions
of admission which have been laid down by the Council. The numbers booked for confinement
have shown a steady rise during the last few years, as follows
No. of Cases Booked for
Year Confinement in Hospital
1924 99
1925146
1926 220
1927 221
1928 272
1929 334
1930 402
In addition to the above cases a number were admitted on account of complications of pregnancy
or arising after confinement.
Under Section 4 (hospital beds) on p. 6 of Memo. 156/M.C.W., it is suggested that the practicability
of offering facilities for private practitioners to attend their own cases in maternity institutions
should be considered.
With regard to Section 5 on p. 6 (Provision of Ancillaries), all the items there mentioned are
provided in Willesden. In respect of sub-section 3, however (Supply of milk for expectant and nursing
mothers) this is only available for women who attend the Health Centres, if recommended by the
doctor at the Centre.
(4) Better Attention by the Patient to the Medical Advice offered.
This can only be secured by the education of the patient as to the importance of care during
pregnancy and at confinement. A step towards this education would be taken if the public generally
were aware of the services the Council considered desirable in connection with maternity.
It is suggested that a booklet should be issued to doctors and midwives stating the facilities
available. Emphasis might be put on the importance of the utilisation by the patient of the various
services. It might also be represented that the co-operation of patient, midwife and doctor, one with
the other and all with the Local Authority, is highly desirable in the best interests of the community,
and that each has a part to play.
Recommendations.
1. That a booklet be prepared giving full information as to the facilities which exist in respect
of Maternity (and Child Welfare).
2. That such booklet be given to all Doctors and Midwives.
3. That the booklet or similar information be given to such others of the public as may be
considered desirable.
4. That arrangements be made for doctors, if they so desire, to examine at the Health Centres,
patients—either those who directly engage the doctor or those in respect of whom the doctor may be
called in by the midwife in an emergency.
5. That if it is so desired, the Council will be prepared to make up the deficit in cases where
midwives are employed as Maternity Nurses whenever a Maternity Nurse is required. It may be
that in some cases Home Helps would be employed with Midwives.
6. That steps be taken to secure the recognition of Willesden Maternity Hospital as a Training
Centre for Midwives.
7. That all practising Midwives be afforded the opportunity of attending lectures and refresher
courses from time to time.
8. That the Committee consider the question of the supply of milk for expectant and nursing
mothers attending Allied Centres on the same terms as this supply is given at the Municipal Centres.
GEORGE F. BUCHAN,
10th February, 1931. Medical Officer of Health.