Government Grants.
Government grants for maternity and child welfare work are now made, and half the cost of the whole or any part of schemes, approved by the Local Government Board, is now paid.
A sum of £50,000 has been voted this year (1915) for England and Wales, and no doubt corresponding sums will be available for Scotland and Ireland.
NATIONAL SCHEME
PROPOSED BY THE WOMEN’S CO-OPERATIVE GUILD
To insure effective care of Maternity and Infancy, it would be necessary to combine the administration of benefits under the Insurance Act with the services organised by the Public Health Authority.
Maternity and Pregnancy Sickness Benefits.—These should be taken out of the Insurance Act, extended to all women (under the income-tax limit), and increased in amount. In addition to the 30s. maternity benefit, every mother should receive £3 10s. in weekly payments of 10s. for three weeks before and four weeks after confinement (or for longer periods if she prefers smaller weekly payments). During pregnancy she should be entitled to benefit varying according to her condition, from 2s. 6d. to 7s. 6d. a week, if her health requires it, subject to the recommendation of a maternity centre or a doctor.
Public Health Authorities should be empowered to administer these benefits through women health officers and maternity centres.
Notification of Births.—Notification of births and still-births is now compulsory throughout the country, and in order to make it effective, an adequate number of Health Visitors should be appointed in every area.
Women Health Officers.—The status of Health Visitors should be raised, their salaries being increased, and three qualifications being required—i.e., midwifery, sanitary, and nursing certificates.
Midwifery and Nursing.—These services should be organised by the Public Health Authorities, which already supervise midwives. Longer training for midwives should be required, and an adequate salary secured to them by the Public Health Authorities. A charge of 10s. might be made to mothers employing them, to be remitted if the circumstances require it. This is the only method of meeting the present shortage of midwives, which is particularly serious in rural districts. It is also the only way of securing skilled attention for the women at a charge within their reach, and at the same time of securing adequate payment for midwives. Municipal midwives could be employed with a doctor.
The administration of the Treasury grant for nursing should also be placed under the Public Health Authority.
Maternity and Infant Centres.—These centres should be places where expectant and nursing mothers and children up to school age can come for advice and treatment, so that they may be kept well and made well. Their organisation will depend on local circumstances, but it will be found desirable in most cases to open several centres, so that they may be near the people’s homes and serve the different classes of women in different localities.
Advice to expectant mothers might be given either at local maternity centres or at centres at hospitals.
It is important that treatment of a simple nature should be given with advice at maternity centres. Nourishment being often the treatment mothers most need, provision should be made for dinners for expectant and nursing mothers when ordered by the doctor. Simple talks on personal hygiene, infants’ clothing, etc., should be arranged, and saving-clubs organised.
Medical Service.—It is desirable to appoint women doctors as municipal officers of the centres, but local practitioners may in some cases be advantageously worked into a municipal scheme. The provision of a doctor called in under the Midwives Act should be part of the scheme.
Maternity Hospitals or Beds.—The dearth of such hospitals for abnormal cases is calamitous. The need for their existence is also pressing from the point of view of research, and they could be used as training schools for doctors and midwives.
Maternity Homes.—These are required for normal cases. The few voluntary homes in existence in England are most valuable, and the experience of New Zealand shows that municipal homes could be made self-supporting. Private doctors might attend their patients in the homes.
Milk Depots.—The difficulties of securing pure milk make it desirable to establish municipal depots for the supply of milk to expectant and nursing mothers and children. While every precaution should be taken not to undermine the practice of breast-feeding, there are cases where specially prescribed bottles would be useful.
Household Helps.—The need for help in the home before, at, and after confinement is urgent, but in order to prevent untrained women doing midwifery work, careful supervision and an organised service under the public health authority are necessary. The experiments made by relief committees show the value of such a service.
Women as Councillors.—Working women should be elected on to councils and serve on public health committees.
Public Health Maternity Sub-Committees.—These committees should be largely composed of representatives of the women concerned. Such representation should be secured whenever possible through the following industrial women’s organisations: the Women’s Co-operative Guild, Women’s Trade Unions, the Women’s Labour League, and the Railway Women’s Guild.
Any parts of this scheme not at first taken over by Public Health Committees—e.g., Dinners, Household Helps—might be organised experimentally by the sub-committees with a view to ultimate inclusion in a municipal scheme.
Ministry of Health.—In the future it will probably be advantageous to establish a Ministry of Health, with a Maternity and Infant Life Department, partly staffed by women.
It is essential that Government departments and Public Health Committees should be in constant communication with organised working-women, and be ready to welcome their co-operation, so that their needs and wishes may be freely consulted. It is by a partnership between the women who are themselves concerned, the medical profession, and the State that the best results of democratic government can be secured for the mothers and infants of the country.
To be obtained from the Women’s Co-operative Guild, 28, Church Row, Hampstead, London, N.W.:
The National Care of Maternity (leaflets for town and country), ½d. each, or 3s. a hundred.
Hints to Expectant Mothers, by Dr. J. W. Ballantyne, price 1d., or 6s. a hundred.
Household Helps, ½d. each, or 3s. a hundred.
BILLING AND SONS, LTD., PRINTERS, GUILDFORD, ENGLAND