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in connection with the Ministry of Health Circular 1167 and
Memorandum 156/MCW. The matter has been deferred for the
time being.
The following is the Report presented to the Committee:—
MATERNAL MORTALITY.
I have to report as follows on the Memorandum issued by the
Ministry of Health. The Memorandum deals with the subject under
six sections, viz.:—
Section I.—Ante-Natal Services.
During the year 1930 the number of cases attended by midwives
was 284. Of this number 57 attended the Ante-Natal Clinic.
It is suggested by the Ministry of Health that a list might be
prepared by the Authority of those doctors practising in the area
willing to undertake the examination of uninsured women who
engage midwives and who are not willing to attend an ante-natal
centre, and that the midwives, where the women are unwilling to
attend the centre, encourage them to select one of the doctors on
the list as being the doctor to be called in by the midwife if any
emergency should arise.
The Ministry of Health informed me in a letter dated 17th
April, 1931, that the Ministry would agree to the doctor being
paid a fee of five shillings for each examination.
Section II.— Supply of Midwives.
It is suggested in the Memorandum that local authorities should
encourage the employment of midwives instead of a handy woman
in cases attended by a doctor and a handywoman by contributing
to the fee of the midwife. In 1930, 850 cases were attended in
Ilford by a doctor and a woman who was not a certified midwife,
but in some cases she was a partly-trained monthly nurse.
Section III.—Consultants.
The Ministry consider it is desirable that a consultant should
be available for any doctor who needs assistance in difficulties or
complications arising during pregnancy, or at or after confinement .
There is no such provision in Ilford. In January, 1929, it was
found that 22 districts in and around London had arranged for the
services of such a consultant. The district in which the services
of a consultant was utilised during 1928 on the greatest number of
occasions was Shoreditch, and in this district he was called in on
seven occasions The Borough of Hampstead first instituted this
system, and in 1929 consultants were called in for five cases for
difficult labour, incurring a cost of £16 16s. to the Council.
(£5 5s. per case is the fee for which the Council is responsible to
the Consultant.)
I am not satisfied that any very substantial improvement
would be effected by such a scheme until the beds are available at
the Maternity Home for the admission of difficult cases. It will be
remembered that the plans of the scheme for the provision of such
beds are before the Ministry of Health.