View report page

104
LETTER TO MINISTRY OF HEALTH, DATED 25th FEBRUARY, 1938.
Sir,
Payment of Doctors' Fees in Midwifery Cases.
I am directed by the Willesden Town Council to apply to the Minister of Health for approval
of the following scheme for the payment of fees to doctors called to cases of confinement in circumstances
other than calls for medical aid by the midwives under the Midwives Acts, 1902 to 1936.
The following is a copy of the resolution of the Council in the matter:—
"The Midwives Acts, 1902 to 1936, provide that where a midwife calls in to her assistance
a registered medical practitioner, the Council, as the local supervising authority, shall pay
the doctor's fee according to a scale laid down in pursuance of the Act, and arising out of a
case reported to us at our last meeting, we have considered the desirability of the Council's
undertaking to pay the fees of doctors called into midwifery emergencies otherwise than
by midwives.
Apart from cases in which a midwife requests professional assistance, a doctor could
be called in the following circumstances:—
(a) Where a pregnant woman or a woman in labour or during the puerperium has made
no arrangements whatsoever for her care and where an emergency arises;
(b) Where a pregnant woman or a woman in labour or during the puerperium has made
arrangements for her care, but for some reason or other these arrangements are
not available.
We are of opinion that on application by the patient or doctor, financial assistance
should be provided to the benefit of patients in cases of this kind, and we therefore recommend
that the scale of fees operating under the Medical Practitioners (Fees) Regulations, 1936,
be adopted for the payment of fees to doctors called in as above.
In view of the lack of definition of the Council's powers to institute such a scheme, we
recommend that it be made conditional upon the prior approval of the Minister of Health."
I shall be glad to receive, in due course, the sanction of the Minister so far as this may be necessary
under Section 204 of the Public Health Act, 1936, or any other enactment authorising the Council
to make such arrangements.
I am, Sir,
Your obedient Servant,
(Signed) E. A. PRATT,
Town Clerk.
LETTER FROM MINISTRY OF HEALTH TO THE TOWN CLERK, DATED 30th
MARCH, 1938.
Sir,
I am directed by the Minister of Health to refer to your letter of the 25th February (JG/ENJ)
requesting the approval of the Minister to the payment of fees to doctors called in to attend women
during pregnancy, labour, or the puerperium in certain circumstances other than those provided
for by Section 14 of the Midwives Act, 1918.
The Minister does not consider, having regard to the proviso of Sub-section (1) of Section 204
of the Public Health Act, 1936, that it is open to him to give approval under that Section to arrangements
of the nature proposed, nor is he aware of any other powers for the purpose. Moreover, it appears
to him that the institution by the Council of general arrangements of this kind would tend to encourage
expectant mothers to neglect the making of proper arrangements in advance for their confinements,
for which the Council's institutional and domiciliary midwifery service is provided.
If, in an exceptional case, a woman has made arrangements to enter an institution for her
confinement, or for a midwife to attend her in her home, but owing to quite special circumstances
the arrangement breaks down and the summoning of a doctor by relatives is found to have been
justifiable, it might be possible for the Minister in a necessitous case to consider granting a special
sanction under the proviso to Sub-section (1) of Section 228 of the Local Government Act, 1933, to
the payment by the Council of part or the whole of the doctor's fees, but it appears to the Minister
that occasion for such an application should be rare.
I am, Sir,
Your obedient Servant,
(Signed) J. N. DARK.