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12.—Arrangements proposed under the Act.—Paragraph 16 of Memo. 200/M.C.W. of the Minister
of Health states that the Act requires that the proposal submitted by the Authority to the Minister
should include particulars of the parts of the area to be served by the midwives to be employed. It
is accordingly proposed that the nine whole-time salaried midwives required be employed as under :—
By arrangement with Queen Charlotte's Maternity 3 midwives for approximately
Hospital for the South Kilburn area as defined 200 cases.
Employed directly by the Local Authority for the 6 midwives for approximately
rest of Willesden 400 cases.
13.—Queen Charlotte's District Home, Kilburn.—This is a midwives' home maintained by Queen
Charlotte's Maternity Hospital for district midwifery and the training of pupil midwives. Your
Committee desire to state that the proposals now submitted will not in any way restrict this valuable
work of training. Queen Charlotte's Maternity Hospital have not hitherto been paid any sums by the
Council in respect of any necessitous cases of district midwifery which they may have undertaken.
An agreement has been reached by your Committee by which Queen Charlotte's Maternity Hospital
agree to employ three whole-time salaried midwives at the Queen Charlotte's Hospital District Home,
Kilburn, and carry out the whole of the midwifery in the South Kilburn area as defined, the local
authority on their part paying to Queen Charlotte's Hospital a sum of £1,180, being the estimated
cost for the first year of working. The details of the agreement which it is proposed to enter into with
Queen Charlotte's Maternity Hospital will be found in Appendix I.
14.—Kilburn and West Hampstead District Nursing Association.—The Kilburn and West Hampstead
District Nursing Association does comparatively little midwifery work in Willesden over a wide
area on the borders of Willesden from Kilburn Park Road to Cricklewood Broadway, a distance of
over two miles and about half a mile westward. The number of cases with which this Association
deals has only recently increased, apparently by reason of the payments which the Council have been
making to the Association since May, 1933. The following table gives particulars of the total number
of cases dealt with by the Association in Willesden since 1931 together with the approximate number
of cases paid for by the Willesden Borough Council:—
Approximate No.
of cases paid for
Total Cases. by Willesden.
in Willesden. Borough Council.
1931 27 0
1932 23 0
1933 31 5
1934 35 18
1935 51 48
1936 (Jan. 1st to Dec. 17th) 70 59
Having regard to the wide area in which this Association does few cases and to the other facts
mentioned above, it does not appear to be practicable or desirable to enter into any formal agreement
with this Association and your Committee do not propose that any arrangements shall be made with
them under the Act.
15.—Willesden District Nursing Association.—Your Committee have received communications
from this Association to the effect that they are willing to undertake midwifery in Willesden. The
Willesden District Nursing Association have not hitherto done any midwifery work and your Committee
think it undesirable to encourage any new agency in connection with midwifery—a subject to which
the Council have given great attention over a number of years and with the difficulties and emergencies
in relation to which they have become familiar as the result of their experience of ante-natal work and
the admission of cases to their Maternity Hospital. In these circumstances it is not proposed that
any arrangements be made with the Willesden District Nursing Association for midwifery work.
16.—Employment of Midwives by the Local Authority.—With regard to the number of midwives
to be employed by the Council, it is stated above that six would be required for the annual number of
midwifery cases with which it is estimated the Council would be called upon to deal. Apart from the
favourable position in which the Council find themselves for undertaking midwifery work with their
very complete ante-natal clinics and Maternity Hospital as supporting institutions, it should be remembered
that with a district midwifery service such pupil midwives in training at the Willesden Maternity
Hospital as may require district training will be able to obtain it at the Council's own district home.
17.—Scale of Fees for Midwifery.—Under the Act the Council is required to fix a scale of fees payable
for the attendance of midwives and to recover the fees except in cases in which the Council remit the
fees in whole or in part on account of the financial circumstances of the patient. It is proposed that
the economic circumstances scale should be one-half that for confinement in hospital, and that assessment
and collection be carried out by the Borough Council for all cases in the same way as for Hospital
confinements and other services.