View report page

9
hensive about their status, as they feared that the arrangements by
which mothers could obtain the services of medical practitioners might
result in their becoming, to an increasing extent, maternity nurses.
Again, too, they feared an extension of the practice by which mothers
were admitted to hospital for their confinements and, because of limited
accommodation, were discharged home early, to be nursed at home by
the midwives. It was intended that only those medical practitioners
with special experience in midwifery should be recognised as General
Practitioner Obstetricians, although later, the only distinction to be
made between those recognised and those not, was to be a difference in
the fee payable by the Executive Council for their services. It was
anticipated that only those recognised as General Practitioner Obstetricians
would be allowed to answer the midwives' medical aid notices.
There seems to have been difficulty, however, in deciding on those
entitled to be recognised and, as far as is known, no special list for this
district has been compiled. Included in the Part III Services provided
by the County Council, as the local health authority, are the
arrangements for vaccinating members of the public against smallpox,
and immunising them against diphtheria. The very much
greater extent to which infants were being immunised against diphtheria
under a voluntary arrangement as compared with the numbers
of infants vaccinated against smallpox, although the law required
these to be done unless the necessary steps to obtain exemption had
been carried out, led some to suppose that vaccination would be
carried out on a greater scale if the compulsory element were removed.
So far from this being the case, throughout the country it
seems that, small as was the proportion of the vaccinated in the years
before 1948, the numbers are now only about half what they were.
There is, of course, now no person whose special responsibility it is to
see that infants are vaccinated. In this district, the new arrangements
by which immunisation against diphtheria is carried out largely by the
general medical practitioners, as required under the Act, brought about
no great change as many of those in this district who had been treated,
were dealt with under similar arrangements. Information as to the
extent to which children are vaccinated or immunized is obtained only
on receipt, by the Area Medical Officer, of the records completed by the
medical practitioners doing the work. As there was such a delay in an
agreement being reached as to the basis of payment for this work, it
is quite possible that many records were not and possibly never will be sent,
so that to some extent, the official returns will be an understatement
of the actual position. As to the workings of the ambulance service,
little is known, as it seems it is not possible to separate local figures from
those of the County as a whole.
Although the report follows on much the usual lines of its predecessors
there are certain features to which special attention might be
drawn. During the year under review, the district, in common with the
rest of the country, suffered another invasion by acute anterior poliomyelitis.
This was not on the scale of the outbreak of 1947, but apart
from that year, is the highest incidence to which the district had been
subjected. These two outbreaks and the fact that the incidence in the