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practice the Minister could in any district, were he satisfied that the
authority had in pursuance of the Midwives Act provided a service of
domiciliary midwives adequate to the needs of the district, by order
apply the provisions of section 6 of the Act, after which the employment
of unqualified persons acting as maternity nurses for gain was prohibited.
An order of the Minister of Health dated 6th April, 1938, applied section
6 of the Act to this district, operating from the 1st June, 1938.
One of the less satisfactory features of to-day's service, is its impersonal
aspect. Under the older arrangements an expectant mother booked
the midwife she wanted, even though that midwife was not the nearest
to her. She booked her, too, with a fair assurance that she would be
attended at the confinement by her, and also be nursed by her throughout
the puerperium. To-day the mother has usually allotted to her, the
midwife living nearest to her. Having got to know one who up to that
might have been a complete stranger, she then finds she has no assurance
that she will be attended by her at the confinement, because the delivery
might occur at a time when that midwife is off duty. Even though she
might have been fortunate enough to be delivered by her, she cannot have
her, and her only, for the nursings, because the midwife must be off duty
sometime in the next fourteen days. It has happened that a mother has
been attended in that period by as many as four midwives. However
competent as midwives each of these might be, from the mother's point
of view it must seem the service lacks something present under the older
arrangements.
Home Helps : For many years before the war the Council provided
a home help service in connection with their maternity arrangements.
Suitable women were recruited, usually by the health visitors, and their
names entered on the panel of home helps. The mother selected her
help from a number offered, and the Council contributed towards the
charges in accordance with an approved scale. Owing to the difficulty
that some helps experienced in obtaining their remuneration, with the
result that suitable people declined to remain on the panel, the Council
decided to be responsible for the remuneration of the helps, paying them
direct, and recovering the appropriate amount from the patients. Payment
was not made to near relatives assisting in the home. Up to the
outbreak of the war, it was usually possible to find a suitable help for any
particular patient. With the competing demand of labour, though, and
probably too, because of the higher remuneration offered, it was found
some time after the beginning of the war it was much more difficult to
find helps. To retain those on the panel and, if possible, recruit others,
the remuneration was raised to £5 5s. Od. for the 14 days' attendance.
This step apparently achieved little more than resulting in a higher
charge having to be made to the patients. Shortage of help necessitated
payment being made to near relatives, if these gave up remunerative
employment to act as helps, while contributions to the charge of the
occasional help not on the panel were made, if the midwife was able to
report that her services had been satisfactory.
During the year 119 cases were attended by home helps under the
Council's scheme. During the financial year 67 cases were attended by