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93
as a public health measure by an extension of its hospital
service, or be provided by the several local District Councils
under their maternity and child welfare schemes, by the
creation of a number of relatively small ad hoc maternity
hospitals.
the provision in public hospitals for between 30 per
cent. and 40 per cent., should be considered reasonably
adequate for the average social conditions obtaining in
Middlesex.
the population of the County is increasing very
rapidly and it is apparent, therefore, that further beds will be
needed in order to provide public accommodation for 30 per
cent. to 40 per cent. of all births. The extent of this additional
accommodation, however, should not be very great. Probably
a further maternity block of some 60 beds would go far to
meeting the justifiable needs of the County for some time to
come.
The question that was discussed with the officers ot the
Ministry of Health was whether this additional provision
should be met by Local Borough and District Councils or by
the County Council. Whilst no absolute ruling was given
it was understood that the Ministry of Health's present policy
was based upon the final report of the Department Committee
on Maternal Mortality and Morbidity, which stressed
the advantages of maternity provision being made in conjunction
with general hospitals, and therefore the Ministry favoured
the undertaking of this work by the County Council. On the
other hand the actual existing number of beds in the County
was patently inadequate and the time was considered a most
important factor; therefore, if prolonged delay was likely to
result in awaiting the County Council's development of its
schemes, the Ministry might find it hard to resist pressure
from any Local Authority who urged the immediate needs of
their area and gave proof that they were in a position to provide
the accommodation at a much earlier date than the
County Council.
The position may be summarised by stating that the
Ministry of Health deprecated the provision of new maternity
accommodation by a Borough or District Council and considered
that public interest was best served by the County
Council, as the hospital authority of the area, adding such
maternity accommodation to its general hospitals as would
adequately meet the legitimate needs of the County. On the
other hand, where a Borough or District Council has already
established a maternity hospital the Ministry considers that
it is a matter for every Council's own discretion as to whether
this hospital shall continue. In the case of Harrow and