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Though the local authority is responsible in the first instance
for the payment of the medical practitioners' fees for attendance
on cases to which they have been summoned by midwives' medical
aid notices, in regard to 64 out of the 292 summonses no claim was
made on the authority. Of those made about 33 per cent. were
for sums of 1 guinea, 25 per cent. for sums of 2 guineas and about
15 per cent, for sums of 5s., the average being about 25s. The
authority is entitled to recover all or part of the fee paid out from
those responsible for the care of the patient. It has been decided
that no claim should be made in respect of attendances on cases of
any discharge from an infant's eye, of which there were 26 cases
during the year. By the operation of the scale adopted the full
charge was claimed from about 70 per cent. of the remaining cases,
from about 20 per cent. one-half of the charge was claimed,
and in about 10 per cent. of the cases no claim was made.
MIDWIVES ACT, 1936.
The approval of the Minister of Health was obtained to the
Council's proposals regarding the putting into operation of the
Midwives Act, 1936. The references in the proposals as to staff
were "no arrangement is suggested for the employment of midwives
by voluntary organisations, but nothing herein shall prevent the
continuance by the Pinner Nursing Association and the Stanmore
Nursing Association of the services now rendered by them, but no
contribution shall be made thereto by the Council. The Council
will themselves employ as whole-time servants, one superintendent
midwife and eighteen other midwives, and will from time to time
employ such other number of midwives as may be adequate for
the needs of the area for the purposes of Section 1 of the Midwives
Act, 1936."
The number of eighteen was arrived at in the light of particulars
regarding the places in which confinements took place in 1935, and
in anticipation of the continued growth of the population being
maintained to 1937 which would give about 2,900 births in 1936
and 3,300 in 1937. Applying the ratio of home to total confinements,
namely, 1,377 to 2,523 which occurred in 1935, to the 3,300 anticipated
births for 1937 gave an estimate of 1,800 births to occur in
the patients' own homes in 1937. Because of the high proportion
of confinements in this district attended by medical practitioners
either with imported midwives or other attendants, the ratio of
midwives to be appointed to the number of domiciliary confinements
was accepted as one per 100, the difference between this and the
number of 80 cases which it is anticipated a midwife can deal with
being off-set by the number of cases in which the services of the
Council's midwives would not be used. On the basis of one midwife
per 100 domiciliary confinements per annum, therefore, it appeared
that eighteen midwives would be required to deal with the 1,800
domiciliary confinements. The figures of 1936, however, were a