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. B. P. Young. [Continued. in a minority of one, sometimes you are in a difEcult position. 6766. But the same would be the case if you are in a minority of two. The position would not be im- proved. Would you suggest that the Board should be wholly composed of general practitioners ?—No, I would not; but I do not think they are adequately represented. 6767. From what point of view do you suggest that they should have one more representative ?—I think it woidd be important in regard to voting power, for one thing. 6768. But for what purpose are they to use that voting power, or in what sense are the interests of the general practitioners affected by the composition of the Central Midwives Board ?—For instance, general prac- titioners are not put on as lecturers or teachers so often as they might otherwise be. 6769. As examiners ? — No, I was speaking of teachers. 6770. Who puts them on; do the Board appoint lecturers ?—We appoint teachers and examiners. 6771. Tou mean recognised teachers ?—Yes. 6772. But surely a general medical practitioner's claims to be recognised are considered with as much care as anybody else's ?—Yes, but they are not so generally put on as you believe. 6773. I suppose the Central Midwives Board, in the exercise of their wisdom, do not think some persons are as well qualified as others ?—Sometimes. We do not put them on suf&ciently. 6774. You think their claims to be put on are neglected owing to the fact that you are the only advocate of their interest on the Board ?—Yes ; I think they would be better looked after if we had another representative or two. 6775. Do you distrust your own powers of repre- senting their case adequately ?—I should like to be supported by someone else. I will give one instance to you of this in the case of Newbm-y. A gentleman applied to be put on as a recognised teacher. He said he thought he could form a class. It was put to the Board, and I was in a minority of one. 6776. Would yovi be happier if you were in a minority of two?—But then the women at Newbury were told they must go to Reading. A class was to be formed there. These poor women woiild have had to put their hands in their pockets, and travel from New- t)ury to Reading and come back again. Newbury is a straggling village, a mile long. The end of it was this, that the gentleman at Reading could not form his class, and then the Board unanimously voted for this teacher whom they had previously refused. 6777. Am I to understand that the other medical practitioners on the Central Midwives Board are un- sympathetic towards the interests of the general practitioner ? — I think they look more after the intei'ests of the specialist or consultant. We have three specialists or consultants on the Board,— Dr. Champneys, Sir William Sinclair, and Dr. Ward Cousins,—and though, of course, they might possibly imdertake other cases than those coming under their peculiar sphere, they could not properly be regarded as representatives of the general practitioners. 6778. (JkTrs. Hohhouse.) You consider that the pay- ment of medical practitioners should be guaranteed by some oiitside body ?—Yes. 6779. But have you never thought at all of the amount of fee that it would be fair to pay ?—In the poor law they give generally half a guinea or 10s. for an ordinary case, and 21. if it is an instriimental case. 6780. Do you consider that would be adequate remuneration ?—I should fancy it would. 6781. Do you refer to the country or to urban districts ?—I am speaking of London more especially. 6782. Do you consider the same fees should be paid in both cases ?—I think when there is a long distance to go, that is, if jou have to go six miles or more, it might be different, and if you have to continue the case afterwards, the fee would have to be adequate. 6783. Would you suggest some sort of mileage fee ? ■—I think there ought to be something of that kind. 6784. For rural districts only? — Yes, for rural districts. I think that in towns the difficulty is easily got over. 6785. You say in your precis, as regards the distri- bution of midwives, there are now too many in some districts like Paddington, Oxford, &c., &c., and in others too few. Do you think that by some method they could be more evenly distributed ?—Yes, I suppose simply by vokmtary associations distributing them. 6786. You would not siiggest that the power of distribution should lie in the hands of the Central Midwives Board ?—No, I thinlc we have got quite enough to do. 6787. Or in the hands of local authorities, such as boards of guardians ?—Yes, local authorities might do it. 6788. Or county councils ?—Yes. 6789. But you have not thought out any definite scheme, have you?—But then comes in the question with regard to subsidising in the rural districts if you are not able to keep a woman there. Take a small place like, for instance, Chilthome, three miles from Yeovil. They have no midwife there and they have to send three or four miles for a midwife, but they gene- rally send for the poor law medical officer. 6790. The only way you can see of adequately dis- tributing the midwives would be by means of voluntary associations ?—Yes, by means of voluntary associations and the poor law. I think that would be so. 6791. Including general nursing as well as mid- wifery ?—No, I was thinking more of the midwife. 6792. You think there should be voluntary associa- tions for the provision of midwives only?—No, I do not think that. I think they might use their time advantageously otherwise. 6793. In general nursing ? — Yes. certainly. They would starve upon midvrifery cases. 6794. Then where would you recommend that mid- wives should be subsidised ?—Where you could not get them in these out of the way places. 6795. Where it would be impossible to have a voluntai-y nursing association?—Yes, or almost im- possible. 6796. By what means would you judge of where the absolute necessity occuri-ed. In what authority or in whose hands would you put that judgment? It would be an extremely difficult matter, would it not ? —Yes, extremely difficiilt. 6797. You have not considered that question, have you?—It must be done from some centre, some town near at hand, or something like-that. 6798. Then you suggest further that classes should be formed where instruction would be given. Do you mean to apply that to women who have passed the Central Midwives Board examination ? — I certainly think that a good many of those who are on the roll are thoroughly inefficient. 6799. Then you mean to apply it to keep them up to the mark ?—To the bond fide women mostly. 6800. Not to those who have passed the exami- nation?—No, I do not think they would want it so much as the others. 6801. I did not know whether you meant it to be applied to keeping the standard efficient ?—Yes, I think it would be a very good and desirable thing. 6802. For both purposes, for the bond fide women and for the trained ?—The bond fide women, I suppose, will rapidly disappear next year. 6803. But they will not be all off then ?—No, but some of them are wi-etchedly ignorant. 6804. You have not considered really whether it should apply to both classes of midwives or not ?—I think it should apply to both. 6805. (Mr. Davy.) I take it the gi-ievance of the medical profession is partly cash and partly the feeling that they are being subjected to compulsion?—Yes, but I think it is mainly cash. 6806. You think they would be satisfied with an aiTangement whereby any medical man who has been summoned by a midwife and has failed to obtain his fee should make a statement that he had been summoned, and that he had attempted to get his remimeration, and had failed, and on the receipt of that statement the public authority, or whoever it might be, would pay](https://iiif.wellcomecollection.org/image/b21361113_0303.jp2/full/800%2C/0/default.jpg)
