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The Local Supervising Authority is responsible for payment
of the fee to the doctor called in, according to a fixed scale of
fees under statute. These fees are recoverable either in whole
or in part, or may be remitted in whole or in part according
to the circumstances of the patient.
ADMINISTRATION OF ANALGESICS.
The Local Authority provides apparatus for administration of
gas and air analgesia, which are held at the disposal of midwives
qualified to administer. Training for qualifying in administration
is provided by the Authority, the course occupying two
weeks. Shortage of midwives present difficulty in release for
training, but co-operation amongst the profession usually mitigates
this drawback.
Gas/air apparatus supplies at the present time would not
allow us to furnish each so trained midwife in domiciliary
practice with apparatus. Only 8 administrations were given in
1946 due mainly to scarcity of cylinders available. The difficulty
of transporting the heavy apparatus is a factor militating against
its more frequent use, except in the case where the midwife has
transport by car.
The number of midwives practising in the area qualified in
analgesia administration is (a) domiciliary midwives 3, and (b)
in institutions 18.
MATERNITY HOSPITAL PROVISION.
Under agreements with the County Hospital, Farnborough, 231
patients were admitted through the Local Authority's maternity
service, and an additional arrangement with the Bromley and
District Hospital commenced during the year and 9 cases were
admitted up to the end of the year. Only environment and/or
medical necessity qualifies applicants for hospital in-patient
treatment so far as cases passing through the local service are
concerned. Many beds in the Bromley and District Hospital,