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It was decided, however, that after December 31st midwifery grants
and assistance under the Council's maternity assistance scheme,
grants by way of home helps and maternity outfits and other similar
assistance be made only to women attended by midwives employed
by the Council. In 359 cases the Council paid, or contributed to,
the fee of the midwife, in 70 a home help was provided, and 43
maternity sets were issued.
Consultant services: Medical practitioners are now authorised
to summon the consultant obstetrician without first communicating
with the Medical Officer of Health, but both the consultant and
practitioner are required subsequently to furnish the Medical Officer
of Health with details of the case.
No call was made by the consultants for the use of the emergency
maternity outfit housed at the Fire Station, nor was it found
necessary to arrange for the blood transfusion service. No claims
were made under the arrangement by which the Council accepts
responsibility for the payment of the fee of one guinea to a medical
practitioner called in to give an anaesthetic at a confinement.
When the consultants are summoned to a case of difficult labour
and an operation is necessary, the Council accepts responsibility for
the payment of the surgeon's fee if an operation is done at the
patient's home. During the year it was agreed to accept similar
responsibility if the surgeon operates at a nursing-home or hospital
to which the patient is removed.
The following scale of charges is to be applied for recovery of
the fees of the consultant whether for consultation or operation:
no claim to be made where the family income does not exceed £250
per annum ; one-third of the sum to be claimed where it is between
£250 and £350 ; two-thirds where it is between £350 and £450;
and full cost to be recovered where the family income exceeds £450.
During the year a consultant was summoned on 14 occasions.
Two of these were ante-natal cases of pyelitis of pregnancy which
were taken into hospital for investigation and treatment. Two
cases of delayed second stage ultimately had natural deliveries, one
of the patients being admitted to hospital. In three cases of
abnormal presentation the patients were removed to hospital and
were delivered by Caesarian section, each resulting in a living child.
Another patient with an extended breech and a slightly contracted
pelvis was removed to hospital and a living child delivered by
Caesarian section ; and a patient in whom a trial of labour had
been advised was delivered by low forceps. The other conditions
for which the consultants were summoned were complications in
the puerperium. One patient was suffering from puerperal pyrexia,
another required currettage in the puerperium, a third suffering
from post-partum haemorrhage required ligature to an artery ; one
patient was suffering from pyosalpinx which followed on a miscarriage,
and in the other case the aid of the consultant was invoked
to recover a portion of needle which had broken while the perineum
was being repaired.