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sory refresher courses arranged by the Royal College
of Midwives under the rules of the Central Midwives
Board.
Care of Premature Babies
The necessary equipment for the care of premature
infants born at home is always available on loan.
Although the Council's midwives, family doctors and
consultant obstetricians are able to deal with
premature infants at home it is sometimes necessary
to transfer such babies to hospital. In these cases a
special portable oxygenated incubator is immediately
brought to the home by the Ambulance Service by
arrangement with the Greater London Council.
Co-operation with Family Doctors
The close co-operation and communication firmly
established between family doctors and the midwifery
staff was maintained.
Domiciliary midwives attend ante-natal sessions
conducted by certain family doctors at their own
surgeries. One doctor holds an ante-natal session each
week at one of the borough clinics for his own
patients and is assisted by the Council's midwives.
Emergency Obstetric Units
Units are kept at Hillingdon Hospital and West
Middlesex Hospital and were required on four
occasions only during 1965.
Analgesic Apparatus
The Central Midwives Board has approved the use
of Entonox analgesic machines by midwives. The
apparatus produces an analgesic comprised of nitrous
oxide and oxygen in equal parts and is considered the
safest form of anaesthetic for domiciliary deliveries.
As the present Minnett and Trilene sets wear out
they will be replaced by Entonox machines.
Maternity Medical Services Co-operation Card
A standard co-operation record card for maternity
patients has been prepared in consultation with the
representatives of the profession and other interested
bodies and has been endorsed by the Standing
Maternity and Midwifery Advisory Committee.
The main purpose of the card is to ensure that
each member of the obstetric team is aware of the
attention given by the other members.
It is intended that the card shall be given to the
patient by the doctor or midwife who first sees her in
connection with her pregnancy. Entries on the card
would be made by any family doctor, local health
authority or hospital doctor, or midwife who is
concerned with the patient's care. The card should be
kept by the patient until the final post-natal examination
when it should be passed to her family doctor
and kept with her medical record.
The Council has approved the use of the card and
consultation with the two other branches of the
maternity services have continued but no decision
has yet been made on its adoption.
Maternity Services Liaison Committee
The committee meets approximately every three
months, and consists of members representing the
Regional Hospital Board, the South-West Middlesex
Hospital Management Committee, the Tottenham
Group Hospital Management Committee, Hammersmith
Hospital, Queen Charlotte's Hospital, West
Middlesex Hospital, Bearsted Hospital, the London
Boroughs of Hounslow, Ealing, Hammersmith and
Richmond-upon-Thames, the Middlesex Executive
Committee, the Middlesex Local Medical Committee,
and the Local Medical Committee for the County of
London.
Among the items reported and discussed were the
booking procedures to ensure an equitable distribution
of cases, planning of early discharge cases,
heating of ambulances, a standard co-operation card
for use by family doctors, hospital doctors, and local
authority doctors and midwives.
Health Visiting Section 24
The National Health Service Act 1946 laid upon
local authorities a duty to provide a complete health
visiting service for the whole family. The primary
function of the health visitor is to provide social
advice and health education for the family and to
recognise any departure from normal at an early
stage when help can be most effective.
Recruitment of health visitors remains difficult and
to relieve them, the duties of school nurse, usually
combined with those of health visitor, are now largely
carried out by clinic nurses who are state registered
but do not hold the health visitor's certificate. The
clinic nurses carry out duties at school, immunisation,
eye and other clinics, enabling the health visitors to
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