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33
Personal Health Services
MIDWIFERY SERVICE 1969
This year has been an interesting one for domiciliary midwifery. Domiciliary midwives booked
1,377 expectant mothers for home confinement, and of these 878 were delivered at home, 240 were
admitted to hospital of whom 159 were discharged soon after delivery and nursed at home. The
remainder moved to other areas in the country during their pregnancy. Of the mothers booked for
hospital delivery, 125 were discharged early for various reasons, and were nursed at home.
The development of the scheme for hospital delivery of selected cases by domiciliary midwives
mentioned in my 1968 report, commenced on 1st July for a six months trial period. From that date
a delivery unit in the Duchess of Kent Maternity Wing was set aside for the use of the domiciliary
midwives, and by the end of the year 17 patients were delivered. In the next three months 15 cases
were delivered, and all the indications are, from the number of bookings now made, that the numbers
will continue to increase.
The scheme is intended to provide hospital facilities for those patients who do not qualify for
hospital booking on medical or social grounds, but nevertheless wish to have their confinement in
hospital and still be looked after by their own general practitioner and domiciliary midwife. Basically
the scheme merely arranges that the confinement shall take place in hospital instead of at home. The
patients are taken to hospital by ambulance accompanied by their midwife and discharged home as
soon as possible after the delivery. This scheme could not have progressed at all but for the full
co-operation of the Ambulance Service, the general practitioners concerned and the hospital maternity
unit, and I would like to place on record my appreciation of their very great help.
This midwifery scheme is the first step in bringing about integration in the maternity service,
which is not only most desirable from the patient's point of view, but is also very convenient administratively,
as it brings the three branches of the Health service together into one unit.
The midwifery establishment consists of the Non-medical Supervisor of Midwives, her deputy
and 22 full-time midwives. Newly appointed midwives serve five days in hospital in order to become
familiar with local methods and routine. Equipment is kept up to date and discussions at all levels
take place to improve knowledge and co-operation. The Statutory refresher courses under Central
Midwives Board rules are undertaken when due.
Education and training take up a considerable amount of time and effort; 34 pupil midwives
completed Part II training and all were successful in the examination for the State Certificate. In
addition 37 Obstetric Nurse Students were given practical experience in domiciliary midwifery.
HEALTH VISITING
Staff
Establishment—57 (including Superintendent Health Visitor and Deputy).
In post at end of year:
Superintendent 1
Deputy 1
Group Advisor 1
Health Visitors—full-time 23
Health Visitors—part-time 14
Tuberculosis visitor 1
Clinic nurses—full-time for mobile clinic 1
Clinic nurses—part-time 15
Health Assistants (miscellaneous grade whose duties are
specifically allocated to schools and clinics) 4
The health visiting service, with a reduction of full-time staff due to retirements, has been maintained
although not without some difficulty.
Ante-natal teaching to expectant mothers, and talks to some groups of husbands of these women,
are well established additional services offered by health visitors at all the main clinics.
Other agencies are gradually becoming aware and appreciative of their skills, not only in the
work with mothers, young children and school children, which is well known, but to all persons in
the community, particularly the elderly.