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24
MIDWIFERY
The number of home confinements in 1970 was virtually the same as the 1969;
the number of early discharges showed a slight increase. The total home confinements
numbered 271 and in all but two cases a doctor was booked (137 women
were given analgesia). The number of mothers discharged from hospital before
the tenth day totalled 266 as against 233 the previous year.
Under the extended agency arrangement which came into effect on 1st April,
1970, the domiciliary midwifery service for the whole borough is provided by the
Mothers' Hospital (Salvation Army). Three midwives directly employed by the
Health Department at the transfer date were retained on the Council's payroll to
sageguard superannuation rights and conditions of service. However for practical
purposes they work on one duty rota with the hospital district midwives.
A revised method of payment was agreed with the hospital for part-cases,
i.e. those where the hospital midwives undertake part but not all of a patient's
care at home, e. g. the baby is born in hospital.
During the year, 211 state certified midwives notified this Council, as
local supervising authority, of their intention to practise within the area.
In view of the extended agency arrangement the practical training of Pupil
Midwives taking Part II of their Midwifery Training Course is now dealt with in
its entirety by the Mothers' Hospital within the Agency Service. A total of 59
pupils underwent their district training in the year.
DAY CARE OF CHILDREN
Child Minders
The current procedure for inspection and registration of child minders was
described in the Annual Report for 1969. As soon as an enquiry or request for
registration is received the applicant is visited by the Senior Nursing Officer
who was specially appointed for this part of the work. The rooms to be used are
inspected and arrangements for children's care discussed. A report is compiled
and a recommendation made as to the applicant's suitability for registration and
the maximum number of children she may take.
Routine checks are made for any previous record in the Health Department
concerning mental health, notified cases of tuberculosis in the household or
information about the premises. The Children's Department are also asked for
any information known to them about the applicant or her family.
The arrangements for inspection by the Public Health Inspectors of heating
appliances and fire prevention arrangements in the homes of child minders have
continued and have proved very satisfactory. One more re-visits may be needed
to ensure that the applicant has carried out the advice given, e. g. to fix fireguards;
each visit is followed up with a letter stating the items still requiring
attention.
The standard procedure which has to be followed even where only one child
is to be minded is complex but this is unavoidable in view of the statutory
requirements to be applied.
Registration allows supervision and an improvement in standards in the home
and child care has been observed together with easier communication between
minder and Health Department staff.
The number of applicants coming forward for registration shows no sign of
falling-off. At 31st December 1970 the total number of registered child minders
was 230 with places for 480 children.