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payment has usually been made at the rate of 25s. per case, being approximately the same rate as
the Council pay in respect of home helps.
No. of cases
No. of cases in which payment
of Maternity was made by
Year. Nursing. the Council.
1931 183 11
1932 205 11
1933 158 9
1934 188 19
1935 188 16
In addition, the Council pay to this Association per annum a sum of £300 in respect of nursing of
expectant mothers, maternity nursing, nursing in puerperal fever and any complications of pregnancy
and nursing of children under five years.
21.—Arrangements to be made under the Act.—It is proposed by your Committee that arrangements
be made with this Association to undertake the whole of maternity nursing in Willesden.
22.—Scale of Fees for Maternity Nursing.—The Council are required to fix a scale of fees for
maternity nursing subject to the remission of such fees in cases unable to pay. It is proposed that
the scale of fees for maternity nursing be the same as for midwifery or where a maternity nurse is
not engaged at the confinement, a daily attendance fee of half that of the daily fee chargeable to a
hospital midwifery case as indicated on the Council's economic circumstances scale. Your Committee
further propose that the assessment and collection of these fees be undertaken by the Council
in the same way as for cases of midwifery.
23.—Estimated costs of Maternity Nursing.—Your Committee provisionally recommend that the
Willesden District Nursing Association be paid a sum of £1,715 (this figure is subject to final revision
—vide paragraph 6 of this report) for the year 1937-38 in respect of the maternity nursing to be
carried out by them in the whole of Willesden under the Act. The payments hitherto made to the
Willesden District Nursing Association for nursing have been as follows :—
(a) Fixed Annual Contributions.—£200 from the Block Grant and £100 by way of voluntary
Grant from Council in respect of the following nursing :—
1934. Cases. Visits.
Maternity, Pregnancy and Miscarriage 295 4,743
Children under five years 266 3,134
1935.
Maternity, Pregnancy and Miscarriage 270 4,790
Children under five years 273 3,050
From the above figures it would be fair to say that this Association already receives £180 per
annum in respect of maternity nursing (i.e., maternity and pregnancy and miscarriage in the
above table).
(b) Payments on case basis.
1934 £22 3s. Od.
1935 £20 10s. Od.
It would, therefore, appear that while the Local Authority will pay the Willesden District Nursing
Association a total sum of £1,715 (subject to final revision—vide paragraph 6 of this report) the actual
additional payment which will rank for Government Grant under the Act will be that sum less approximately
£200 already paid by the Council to the Willesden District Nursing Association. The details
of the agreement which it is proposed should be entered into with the Willesden District Nursing
Association showing the salaries to be paid to the maternity nurses to be employed by them appear in
Appendix II to this report.
24.—Government Grant in respect of midwifery and maternity nursing.—The Ministry's Memo.
200/M.C.W. states that the ad hoc grant (i.e., grant payable other than for compensation) is payable
in respect of estimated additional expenditure as compared with the year 1935-36 during each year
of the third fixed grant period (1937-42) and will be one half, scaled up or down in proportion to the
extent to which the relative needs of the area, as measured by the grant formula for weighted population
at present used for the calculation of grants under the Local Government Act, 1929, are relatively
greater or less than the average of all Counties and County Boroughs in England and Wales as determined
by that grant formula. Memo. 200/M.C.W. states further that: "In order to minimize
detailed control and examination, and to simplify the grant arrangements in respect of local authorities'
direct expenditure, the grant in respect of the cost of the employment of midwives by local supervising
authorities themselves will be calculated on a "unit" basis, this unit representing the estimated
average annual cost for the country as a whole of the salary and expenses of a municipal midwife, less
the estimated average annual receipts from fees."