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25.—The Grant is also payable in respect of contributions paid by the Council to Voluntary
Associations and will be reckoned on the same formula. Memo. 200/M.C.W. states: "As regards
midwives employed by voluntary organisations, the additional expenditure to be taken into
account for the purposes of grant will be the excess of the amount of the annual contributions made by
each authority to such organisation for domiciliary midwifery and maternity nursing over the contributions
which were made to them by the authority during the financial year 1935-36 in respect of those
services in the area of the authority."
SUMMARY OF ESTIMATED COSTS OF OPERATING THE MIDWIVES ACT, 1936.
From 31st July, 1937, to 30th July, 1938.
Midwifery.
£
Contribution to Queen Charlotte's Hospital 1,180
Cost of Midwifery Service of Council 3,117
4,297
Less Income. 600 midwifery cases. Payments by patients at, say, £1 per case... 600
3,697
Deduct Government Grant on £3,697, estimated at 25% 924
Net cost chargeable to rates £2,773
Maternity Nursing.
Contribution to Willesden District Nursing Association. £1,615 as per letter
of the Association dated 17/12/36. Add *£100 for adjustment of salaries ... 1,715
Less Income. 400 maternity nursing cases. Payments by patients at, say,
£1 per case 400
1,315
Deduct Government Grant on £1,315 less £200, being the sum already paid to
this Association for maternity nursing, estimated at 25% 279
Net cost chargeable to rates £1,036
Total net cost chargeable to rates in respect of midwifery and maternity nursing
as above £3,809
*Subject to final revision—vide paragraph 6 of this report.
Compensation.
27.—The Act does not prohibit the continuance of independent practising midwives but for all
practical purposes it is unlikely that such midwives will get much work to do after the Act is in
operation. The Act has accordingly made provision for independent midwives who cease practice
either voluntarily or compulsorily. The whole-time salaried midwives to be employed under the
Act may be recruited from existing practising independent midwives in the area. None of these
independent practising midwives in Willesden, however, are fully trained general nurses, although all
of them have the C.M.B. Certificate. In the opinion of your Committee it is highly desirable that all
midwives employed in the whole-time salaried service established by the Council under the Act should
be fully trained general nurses as well as certified midwives.
28.—Voluntary Surrender.—If a midwife has given notice of her intention to practise between
the 1st January, 1935, and 18th March, 1936, she may voluntarily surrender her certificate before
31st July, 1939, and be compensated by a sum equal to three times the average net annual emoluments
derived from her practice as midwife or maternity nurse.
29.—Compulsory Surrender.—If a midwife has given notice of her intention to practise on or
after the 1st January, 1936, and the Council is of opinion that by reason of age or infirmityof m ir.d
or body, she is incapable efficiently to discharge her duties as a midwife, then the Council may require
her to surrender her certificate at a compensation valuation of five times the net annual emoluments
derived from her practice as midwife or maternity nurse. Where the Council requires a midwife to
surrender her certificate by reason of age or infirmity as aforesaid, the midwife has the right to appeal
to the Minister.
30.—If as a result of the passing of the Act the present independent district midwives obtain
compensation on the above basis, your Committee estimate that the total compensation to be paid
will be in the neighbourhood of £2,500.
31.—Government Grant in respect of Compensation.—The Act provides for the payment to local
supervising authorities by the Exchequer pf one half of their actual expenditure on payment of
compensation to midwives.