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. Toting. [Continued. him one sovereign, say ?—It all depends on what the case is. 6807. Some cases would be only worth 20s. ?— Quite so. 6808. —And some cases more than a sovereign?— Take a case of turning; I had such a case the other day, where I was called in and got a guinea, but it was worth certainly a couple of guineas. 6809. An all-round sum has been suggested as being a fair sum ?—We should hke a guinea better than a sovereign. 6810. It is more gentlemanly ?—It has been the custom generally. 6811. Would a guinea satisfy the profession P—^No I do not think so. 6812. What would satisfy them ?—I prefer to stay in my bed, except as an act of charity, to going out and performing a case of turning, with the uncertainty of getting paid. 6813 I make the suggestion of a uniform fee taking one case with another. What do you say to that ?—If you make it general all-roimd, do you mean ? 6814. Yes ; would it meet it ?—I think it would be a very good suggestion. 6815. As to the penal jurisdiction of the Central Midwives Board, would you go so far as to approve of leaving all the penal work to the local authorities subject to an appeal to the Central Midwives Board ?— I think they might do a great deal more than they do 6816. Tou go so far as that ?—Certainly. 6817. Then as to representation on the Central Midwives Board, do you suggest that everybody who is interested in the matter pecuniarily should be repre- sented, or that consultants should be represented ?— They are well represented as it is. 6818. And midwives ?—They are represented. 6819. And rural midwives and superintendent nurses?—The nm-ses are represented on the Central Midwives Board at the present time. 6820. Do you thinlc it is making a good adminis- trative body if every person interested is represented ?— Yes, I do. 6821. Do you think it would be a good thing to have the county councils represented?—Yes, and we have got them on the Board. 6822. And Government departments should be represented ?—Yes, certainly. 6823. Everybody except perhaps mothers and babies ?—Mothers should be represented. 6824. {Dr. Ghampneys.) With regard to the question of recognised teachers not being general practitioners, you do not mean to say that there are no recognised teachers who are general practitioners, do you ?—No, we have some on the Board's list. 6825. But do you really think that the Board are prejiidioed against general practitioners; that is to say, supposing the Central Midwives Board come to the conclusion that a person would be competent if he were not a general practitioner, he would be debarred, in virtue of being a general practitioner, frorn being recognised ?—I have had a feeling rather in that direc- tion, that there has been rather a leaning to give it elsewhere than to the general practitioner. 6826. The Central Midwives Board issue, do they not, a long series of questions to be answered by applicants ?—Yes. 6827. Speaking from memory, they go into what previous appointments the man has held ?—Yes. 6828. Whether he has had any experience of teach- ing ?—Yes. 6829. And whether he has had any experience of midwifery or lying-in hospitals or lying-in institutions, and details like that; is that not so ?—Yes. 6830. And on those particulars the Central Mid- wives Board come to their conclusion ?—Yes. 6831. Then, so far as possible, the Board come to their decision upon plain questions put to the candidate to show his or her efficiency for the post, quite irre- spective of the line of practice ? There is no question about the line of practice in that paper, is there ?—No ; your question would be answered in the affirmative with regard to London and the gi-eat towns, but it is impossible to carry it out in the counti-y. 6832. But in the country do we not have general practitioners as teachers?—Yes. because you have to do it nolens volens ; because there is no one else there. 6833. But, generally speaking, is it not the Board's view that we must have the best material to be got ?— Certainly. But you cannot get it in the countiy. You cannot get men practising pure gynecology. 6834. Therefore you take the best you can get ?— Yes. A preference, of coui-se, is given to the best, but I think sometimes general practitioners have been excluded, as in the case of Newbury. 6835. But that is capable of another intei-pretation, namely, that the Central Midwives Board thought there was an efficient teacher in the neighbourhood, and that people had better go to him, and when they foimd he could not form a class they said to the women you had better go to the other man, whom they did not think so good?—Yes, but there was 36 mUes to go. 6836. You rather suggested that my feeling was in favour of consultants as against general practi- tioners, but are you aware of any case of that kind ?— There is that case I gave. 6837. But that was because the Central Midwives Board thought with me ?—But that man was practising as a general practitioner, and he had had possibly more training in midwifery. 6838. Then that is all right, and in those circum- stances we tried to get the best person we could ?— Yes, but you could not get him. 6839. But we did our best ?—Yes, and then you fell back upon the poor general practitioner afterwards. 6840. Naturally; so that it is capable of two inter- pretations ?—Certainly. 6841. You will bear me out that I have never said anything about its being inadvisable to use general practitioners as teachers or in any other capacity if they were efficient ?—No. 6842. (Chairman.) Sometimes it is impossible to get any others ?—Yes. 6843. (Dr. Downes.) You spoke of women tending to regard themselves as entitled to free medical attend- ance in their confinements ?—Yes. 6844. Would that arise from the fact of institutions and midwives taking pupils ?—Yes. 6845. These pupils pay considerable fees to the institutions for the instruction they get, do they not ?— Yes, they do. 6846. So that it has come to be a money question? —Yes, certainly. 6847. I am referring to the certificates required under the Rules of the Central Midwives Board, Rule C. 1, paragraphs (1) and (2) ?—Yes. 6848. With regard to the question of fees it was suggested to you that one fee of 11. or one guinea, or whatever it might be, to cover all cases, taking the rough with the smooth, might be acceptable ?—Yes. 6849. Would your preference be for one uniform fee as compared with a scale of payment ?—It would be almost immaterial. General practitioners would do better with a uniform fee of one gmnea than with a variable fee of 10s. or 21. 6850. It would be much better from an administra- tive point of view to have a uniform fee ?—Yes. 6851. If there were a uniform fee would you take the duties of the practitioner called in in compart- ments; for instance, if called in under the head of Labour in the Rules, what he might have to do would be different from what he would have to do if called in the case of Pregnancy ?—Certainly. 6852. So that it might be necessary to consider it in compartments ?—Certainly it might. I think a guinea would be almost too much if a man were called in just once to see a case. You could get a man to do it for a less fee than that, but it would pay all right, taking the rough with the smooth. 6853. Taking the rough with the smooth, would a uniform fee of a guinea be acceptable in cases of labour ? —I fancy so. 6854. And the after-attendance ?—Yes, I fancy so. But it is a little more now, because in London the](https://iiif.wellcomecollection.org/image/b21361113_0304.jp2/full/800%2C/0/default.jpg)
