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92
so that it is at times difficult enough to arrange even for one midwife
to attend each session. By the operation of the schedule of off-duty
time coupled with the necessity for fourteen days' attendance on
each patient, it follows that a patient has in attendance on her at
least two and sometimes three midwives. While there are, perhaps,
some who point to this as one of the disadvantages of the local
authority's service, it seems that many more definitely favour the
scheme as under it they feel that in no circumstances will they be
left without the care of a midwife, a point which apparently used
to be a source of worry to some who had only independent midwives
and who could not be sure that they would be at their service when
required. The fifteen midwives work in five teams of three. This
arrangement permits of there ordinarily being one stand-by for calls.
Between July 19th and December 31st, 437 patients were
attended to by the Council's midwives. Of the 294 attended by
the midwives in their capacity as midwife 126 were brought over
by the staff on their engagement, 36 were attended at full cost,
to 99 some rebate on the charges was made and 33 were attended
free. Of the 143 attended by the midwives in their capacity as
maternity nurse 90 were brought over, 42 were attended at full cost,
to ten some rebate was made and one was attended free.
This 437 as the number of cases is less than the number that
could have been taken in the time by the staff appointed. This
fact, however, does not indicate that too many were appointed.
In the first place it was necessary to move a few of the staff to other
addresses and these, naturally, would take some time to become
known in their new districts. Then the surrender of the certificates
by some under the provisions of the Act will reduce the number of
cases dealt with by those other than the Council's staff. Actually
in the month of December 102 patients were attended to, the
monthly potential of the staff of fifteen at an average of eighty
cases per year being one hundred.
There are those who are disposed to criticise the Act, maintaining
that merely to provide better salaries, more off-duty time and
fewer cases to be cared for will not effect the aims of the Act,
namely, an improved midwifery service. There is, however, some
immediate benefit accruing from the operation of the Act, namely,
the elimination of the pin-money midwife who is unable, because
of the small number of cases she attends, to maintain the skill she
acquired in training, and the bringing into the health service of
those carrying out the practice of midwifery. Also, the restriction
in the number of cases to be attended will avoid that hurrying
which must inevitably have occurred at times in the life of an independent
midwife carrying on a successful practice where a number of
confinements occur within a short interval of time. It is hoped,
however, that theu altimate benefits from the operation of the Act will
be more far-reaching than these immediate effects. What is required
is the general raising of the standard of the profession of midwifery
so that it will prove attractive as a profession. If it is made