It will be seen, therefore, that the Act definitely contemplates that the powers of sanitary authorities will be used to promote the care of mothers and young children.
The Board are anxious to insist on the importance of linking up this work with the other medical and sanitary services provided by local authorities under the Public Health and other Acts. They have already in their circular letter of the 30th July, 1914, on the subject of Maternity and Infant Welfare, indicated generally the scope of the work which they consider should be undertaken, and an additional copy of that letter is enclosed.
As indicated above, the Act contemplates that arrangements for attending to mothers and young children may be made either by County Councils or by sanitary authorities. The Board recognise that the organisation must vary to some extent with local conditions, and that a considerable degree of elasticity is necessary. They are, however, of opinion that it will generally be desirable to formulate comprehensive schemes for counties and county boroughs, although in some cases portions of the services may be undertaken by the larger District Councils with advantage. The councils of counties and county boroughs are the local supervising authorities under the Midwives Act, 1902, and they are also entrusted with the initiation and execution of schemes for the treatment of tuberculosis; if the organisation of a maternity and infant welfare scheme is also undertaken by them, it will be practicable to secure the unification of home visiting for a number of different purposes.
In all cases, however, in which a general scheme is organised for the county, the work should be carried on in close co-operation with the sanitary authority, and any insanitary conditions found by health visitors should at once be reported to the sanitary authority. Although the Board consider that general schemes should be organised for the county as a whole, and that the County Council should, as a general rule, provide for health visiting, they are prepared, in suitable cases, to recognise the sanitary district as a proper area for a scheme.
Co-operation with Medical Practitioners and Voluntary Agencies.
In the development of general schemes the Board desire that the services of hospitals and other efficient voluntary agencies should be fully utilised. They are also anxious that the co-operation of medical practitioners should be secured. The value of a Maternity Centre will be much increased by obtaining the co-operation of the medical practitioners in the area to be served by it, and in organising the arrangements it is desirable that they should be consulted.
London.
In London the Act contemplates that schemes should be organised by the Metropolitan Borough Councils. Many of the services required can be provided by the various London hospitals and the numerous voluntary agencies now at work, and in some cases the chief need is to secure that such services are properly linked up with the work of the Borough Council. In other areas existing medical services will require supplementing and extending, and it will be for the Borough Councils to consider how this can best be done.