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Contrasting the figures in Columns 3 and 4 above, it is
obvious that several factors must be considered before finally
assessing the number of whole-time midwives to be allotted to
this service by each organisation in agreement with the Council's
Schcme.
(1) A certain number of women will still continue to use the
services of private midwives; this may be estimated as
about 150 cases per year.
(2) Although definite districts will be allotted to each Organisation,
there will be "free choice" of midwife by the
mothers. Clinic Medical Officers, Health Visitors, and
all whose work brings them in contact with expectant
mothers, will be made conversant with the districts, and
will endeavour to secure the utilisation of the services as
arranged and approved by the Council. But, for some
considerable time, there is bound to be overlapping of
the work of one association into adjacent areas.
(3) In an area such as West Ham, the facilities provided for
confinement in hospital will always prove popular, and
the number of confinements in hospital may reasonably
be expected to increase.
Bearing all these factors in mind, upon the adoption of the
scheme it will be advisable to provide for a revision of this service
at the expiry of a definite period (e.g. from 30th July, 1937, to
30th September, 1938) when necessary re-adjustments of the
several agreements may be made in the light of further experience.