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103
APPENDIX G.
MIDWIVES ACT, 1936.
I.—SPECIAL REPORT OF HOSPITAL VISITING COMMITTEE.
(.Adopted by the Willesden Town Council on the 2&h January, 1937.)
1.—The Midwives Act, 1936, places large responsibilities upon the Willesden Borough Council.
The Minister of Health has issued Circular 1569 and Memo. 200/M.C.W. explanatory of the Act. In
paragraph 1 of the Circular he states that the principal object of the Act is to secure the organisation
throughout the country of a domiciliary service of salaried midwives under the control of local supervising
authorities as an important step in the improvement of the maternity services and in the
campaign for reducing maternal mortality. Your Committee have kept this object before them
throughout the prolonged consideration they have given to the many problems that have arisen during
their discussions.
2.—Your Committee have received communications from and have had consultations with all
voluntary organisations known to them as employing or willing to employ domiciliary midwives and
organisations representing midwives and medical men practising in Willesden, namely, Queen
Charlotte's Maternity Hospital, Kilburn and West Hampstead District Nursing Association, the
North West Middlesex Branch of the Midwives' Institute, the Willesden District Nursing Association
and the Willesden Division of the British Medical Association.
3.-—The scheme which is now submitted for carrying out the Act has been prepared by your
Committee in accordance with the requirements of the Act and embraces provision for the employment
of whole-time salaried midwives and maternity nurses. For the information of the Council it should
be stated that a midwife is a midwife when she is engaged to deliver a woman and that a midwife
is a maternity nurse when she is employed to assist a medical practitioner who has been so engaged.
4.—As regards midwifery your Committee are of opinion that the arrangements to be made
under the Act should be such as to secure for the mothers of Willesden the best possible midwifery
in their homes properly linked up with complete arrangements for dealing with any emergency that
may arise. They have accordingly divided Willesden into two areas, namely (1) the South Kilburn
area, i.e., the area bounded on the North by L.M.S. Railway, on the West by and including Claremont
Road and on the South and East by the Boundaries of Willesden ; and (2) the rest of Willesden.
Your Committee propose that the South Kilburn area be allotted to Queen Charlotte's Maternity
Hospital with its home situate at 40, Princess Road in that area and that midwifery in the rest of
Willesden be provided for directly by the Council by the establishment of a midwives' home linked
up with the maternity service of the Council and the Willesden Maternity Hospital. It will be
observed that both the areas are thus ultimately dependent on first-class maternity hospitals.
5.—WTith regard to maternity nursing your Committee propose that the maternity nursing for
the whole of Willesden should be carried out by the Willesden District Nursing Association.
6.'—Paragraph 4 of Circular 1569 states that "one of the main objects of the Act is to improve
the status of the midwifery profession. Accordingly the Minister regards it as of the utmost importance
that the midwives employed in the new service should be adequately remunerated. The work to be
carried out by them is in his view at least as important as the work carried out by health visitors, and
he feels confident that local authorities will in respect of the midwives appointed by them adopt
scales of salaries which are comparable with those applicable to health visitors employed in the same
district, together with appropriate allowances for travelling expenses, and that their contributions
to voluntary organisations will be sufficient to enable those organisations to pay adequate salaries to
all the midwives they employ." Your Committee accept this view and are of opinion that the
midwives employed directly by the Council and by Queen Charlotte's Maternity Hospital and the
maternity nurses employed by the Willesden District Nursing Association should possess the same
qualifications and have as nearly as possible the same conditions of service. The bodies concerned
have agreed that the domiciliary midwives to be employed by them will be fully trained general
nurses holding the C.M.B. Certificate, subject to the condition that in the case of Queen Charlotte's
Hospital this will not apply until the present midwives employed by Queen Charlotte's Hospital
District Home, Kilburn, come to be replaced. With regard to salaries your Committee propose that
the midwives directl_v employed by the Council shall receive salaries at the same rate as those of Health
Visitors with a deduction of £150 per annum for board, lodging, washing and other emoluments.
Queen Charlotte's Maternity Hospital have also agreed to this scale of salaries. The Willesden
District Nursing Association refuse to pay this scale of salaries to the midwives employed by them on
behalf of the Council on the grounds that the salaries of their nurses are fixed by the Queen's Institute
to which the Willesden District Nursing Association are affiliated. Your Committee are unable to
accept this refusal as they feel strongly that all persons similarly employed under the auspices of the
Authority should receive similar rates of pay. Your Committee have accordingly included in the
estimates for Maternity Nursing submitted in this report an additional provisional sum of £100,
subject to final revision, so that the Willesden District Nursing Association may be able to pay the
salaries as required by the Authority.
7.—Your Committee have considered a scale of fees applicable on an income basis for persons
using the midwifery or maternity services provided under the Act. This scale of fees is attached to