Domicilliary midwifery and maternity bed needs : report of the Sub-Committee.

  • Great Britain. Standing Maternity and Midwifery Advisory Committee
Date:
1970
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Licence: Public Domain Mark

Credit: Domicilliary midwifery and maternity bed needs : report of the Sub-Committee. Source: Wellcome Collection.

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    INTRODUCTION 6. The next following chapter reviews in some detail the developments in the maternity services both before and since the Report of the Maternity Services Committee (hereinafter referred to as the Cranbrook Committee) in 1959. The Sub-Committee have, however, been aware that changes necessary, or already evident, in the field of maternity services cannot be isolated from other more general changes in the health services as a whole. Some of these relevant, but more general, trends and developments are briefly considered in the following paragraphs. 7. Within general practice the tendency towards group working is accelerating, and group practices in their turn afford opportunities for specialisation which were denied to the single handed practitioner and difficult to achieve even by doctors working in partnership. Added to this, the last year or two has seen an upsurge in the planning and building of health centres. Both these developments are likely to continue and may be seen as offering to general practitioners an opportunity to reconsider the part they should play in the provision of maternity services; we are aware that experiments in this field have already met with some success. 8. Concurrently with the trend towards group practices there has been steady progress in the development of schemes of attachment of local health authority nursing staff to general practices. Following the issue by the Department of Health and Social Security of Circular 13/69 this progress may well be acceler- ated. It has, however, been worthy of note that of the three local health authority services, health visiting, home nursing and domiciliary midwifery, the last has lagged far behind the other two in this development, and the possibility that mid- wifery does not so readily lend itself to this form of organisation cannot be discounted. 9. In the hospital and specialist services plans are going ahead for the provision of district general hospitals which will provide the focal points hitherto lacking, and the concentration of services which this concept implies must have a radical effect upon the diffuse geographical distribution of the present hospital maternity services. Quite apart from those aspects of existing small maternity units with which the Sub-Committee are directly concerned, it is clear that the maternity services of the future will be affected by the rationalisation already under way. 10. Overriding developments within the existing tripartite structure of the health service, the Green Paper issued by the Minister of Health in 1968 has given rise to wide discussion of possible future changes in the administrative structure of the service as a whole. The Sub-Committee have taken the view that the broad administrative structure is outside their terms of reference, and that their con- cern with the ways in which maternity services are provided need not be
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