Report of the Departmental Committee appointed by the Lord President of the Council to consider the working of the Midwives Act, 1902.
- Great Britain. Midwives Act Committee.
- Date:
- [1909]
Licence: In copyright
Credit: Report of the Departmental Committee appointed by the Lord President of the Council to consider the working of the Midwives Act, 1902. Source: Wellcome Collection.
Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.
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![19 May 1909.] Mr. E. P. Toung. [Co7itiimed. Mr. E. Paeker Young called and examined. 6685. (Chairman.) Tou represent the Society of Apothecaries upon the Central Midwives Board, do you not ?—I do. 6686. That Society represents the general prac- titioners in this country to a great extent ?—-Tes. It is not all composed of general practitioners. For instance, one gave evidence here the other day, Sir Shirley Murphy, and there are several others, but the majority are general practitioners. 6687. The majority of the general practitioners are adequately represented in the Society of Apothecaries, are they not ?—ISTo; not adequately represented, I think. I do not think there is suf&cient representation of the general i^ractitioners upon the Central Midwives Board. 6688. But that is not my point. What I want to know is, whether the Society of Apothecaries may be considered an adequate mouthpiece of the general practitioner?—Yes, I fancy so. We have something like 10,000 members, I think.* 6689. The main point on which you wish to give evidence is the payment of medical practitioners when called in by midwives ?—Yes. 6690. That, you think, should be provided for at every birth ?—Yes, certainly. 6691. You believe that under the present system there has been a very general failure to comply with the admonitions of the Local Government Board on the subject ?—Decidedly. 6692. With, of course, very considerable friction in the relations of the general practitioner to the working of the Midwives Act ?—Yes. 6693. You, as a member of the Central Midwives Board, are aware of that ?—Quite so; and v/e have passed resolutions frequently on it. 6694. You believe that it has been an obstacle to the working of the Midwives Act ?—Decidedly. 6695. Then will you kindly explain how you think this payment should be made ?—^Of course it is hardly for me to say, but I think it is for the Departmental Committee to arrange for the payment. 6696. What would be, in your opinion, the best way of making that arrangement ?—The coimty councils or the borough councils, rather than the poor law authority should do it, although they have the machinery in the poor law. 6697. The comity councils can do so now, I believe. The city councils of some of the big places, like Man- chester and Liverpool, have done so ?—Yes. 6698. Do you not think that the board of guardians or the destitution authority, or whatever it may be called, is the best authority to make the payment ?— I do not care whom it is put under, so long as it is put under some authoi'ity. 6699. What authority would exercise the power with the least friction, is rather the point, is it not ?— I think the poor law authority might carry out these duties. 6700. The poor law authorities have in a large number of cases the best information, I suppose, to enable them to determine whether the condition of the patients is such that they ought to be assisted in that way ?—Yes. It is something like the Notification Act. The borough councils receive the notification and pay the fee, and then recover it from the poor law after- wards. 6701. You would wish to see the payment recovered wherever j)ossible ?—Yes; I think it is immaterial whether it is done through the borough councils, or the county coimcils, or the boards of guardians. 6702. So long as it is done?—Yes, so long as it is done, and it is most important that it should be done. 6703. Do you believe that, if that were done, all the suspicion that is at present in the minds of medical men with regard to the Midwives Act would disappear ? —To a great extent it would. 6704. Do you believe that their remuneration has been diminished owing to midwives taking cases which * The number of licsntiates of the Society appears to be about 6,000. (See Question No. .5543 and the footnote appended thereto.) U 2240. doctors or medical practitioners used to take ?—I should say so. . 6705. Would you say that that has been the general effect ?—I should think so. 6706. But you have no facts before you to enable you to state it as your convinced opinion, have you ?—■ Cases that would have been taken by members of the medical profession are now taken by midwives. 6707. There is no doubt that is so in some cases ? —Yes. 6708. But then they have got compensation in other directions, have they not?—I am afraid the genera, practitioner does not get much compensation in any direction. 6709. In the event of no provision being made, do you think there would be a general refusal to attend ? —They refuse to attend these cases sometimes. Of course you have heard, no doubt, of the case of the medical mission in Kensal Green, where the midwife sent for eight doctors before she could get one to attend. 6710. Had there been any organised refusal to attend, or was it independent action ?—No, I think it was independent action on the part of the doctors. When you are sent for you do not know whether you are going to be paid or not. 6711. Your practice is in London, is it?—Yes. 6712. Do you believe the position has been more acute in London than elsewhere ?—No, I do not know that it has been more so in London. Not only is it bad for the medical practitioners, but it is also bad for the midwives. I had two cases only this last week, where two women who are on the roll of the Central Midwives Board have been practising in London, and they said that they had to pay the general practitioner, whom they called in, out of their own pocket, but they found that it was a losing game, and they gave it up. 6713. Do you mean to say they undertook to pay the doctors' fees ?—They were compelled to. They said there was no provision in any way, and they further said they were making nothing out of it. 6714. Was that in order to get the doctor's attend- ance ?—Yes. The doctor would want to know who was going to pay him. 6715. Is there no system in London by which, through any provident or insurance scheme, women may provide for the charges incident to childbirth ?— Some dispensaries have such an ai-rangement, but when women can get attended for nothing, they do it. 6716. But thei-e is no reason to suppose they will get attended for nothing, is there ?—Candidates have been wanting to get cases to make up their number. 6717. But surely the Midwives Act has not assisted to give women the impression that they are entitled to attendance for nothing ?—I think it has a little. 6718. How ?—In this way, that the candidates who are going in for the examination of the Central Midwives Board must get their 20 cases. 6719. But that surely does not affect the question to any great extent, does it ?—Perhaps not. 6720. How does it create in the minds of the patients the impression that they are entitled to mid- wifery attendance free?—Different institutions have midwives attached to them, and they have to supply 20 cases for the training of each candidate for the examuiation of the Central Midwives Board, and some- times there is great difiiculty in getting these 20 cases. Consequently they get them from other areas that originally were used for medical students. 6721. But then how does that produce in the minds of any section of the public the impression that they are entitled to medical attendance free ?—They do get it free. I will give you an instance of a poor woman in my own neighbourhood. The husband asked me if I would attend her. I said, No. I am afraid you coiild not pay my fee, but the gentleman who is helping me will take your case, and he said I have a difiiculty in getting a letter; I had no difficulty before with all my children. The husband was earning a very fair wage and was able to pay, but he had always had a letter before. r](https://iiif.wellcomecollection.org/image/b21361113_0301.jp2/full/800%2C/0/default.jpg)
