The minority report in its relation to public health and the medical profession / by Mrs Sidney Webb.

  • Beatrice Webb
Date:
1910
Catalogue details

Licence: In copyright

Credit: The minority report in its relation to public health and the medical profession / by Mrs Sidney Webb. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    10/24 page 10
    of birth (including the virtual abolition of ophthalmia neonatorum), and an almost incredible diminution of the mortality among new-born infants and children under 5, together with a most beneficent increase in the consciousness of parental obligation and in the performance of parental duties on the part of the mothers, and a far more general enforcement of pecuniary responsibility against the fathers— the whole at a cost to the community that would be more than saved in the diminution of the expense now so unwillingly incurred over the defective, the blind, the crippled and the diseased who result from our present neglect.* The Treatment of the Sick. In no branch of the subject is the question of overlapping of work and duplication of machinery between the Poor Law Medical Service and the Public Health Department becoming more acute than in the actual clinical treatment of sick patients; and yet there exists, at the same time, a disastrous amount of untreated disease. There are, I believe, still some people, * An interesting example of the hopeless tangle into which we are getting through the overlapping and competition between the Poor Law and the Public Health Service is afforded by the position in England of the medical practitioner under the Midwives Act, administered by the Town or County Council. The medical man whom the law requires the midwife to send for in cases of difficulty is held by public opinion to be under a moral obligation to go ; and yet there is still, after a whole year’s delay, no provision for the payment of his fee. The Departmental Committee to which the question was referred could, under the inspiration of the Poor Law Division of the Local Government Board, find no better solution than to recommend the Board of Guardians to pay. Yet the Board of Guardians admittedly need not pay, and, indeed, cannot legally pay, unless upon inquiry they come to the conclusion that the woman (or rather the woman’s husband if living with her) was at the time “ destitute,” or at any rate “ poor,” according to the meaning of an obscure statute of 1848, which has never yet been construed by the High Court. At the same time, it is recommended that the Local Health Authority should be responsible for preventing collusion between midwives and doctors. Thus, the best arrangement the Local Govern- ment Board can suggest is that the doctor should go whenever he is called, but that his chance of getting his fee from the Poor Law Authority is to depend, not on the gravity of the case, or even on the absence of a fraudulent collusion between the midwife and himself, but on whether the Board of Guardians may subsequently choose, without possibility of appeal, to class the woman as desti- tute. Under the proposals of the Minority Report, both the control of the certified midwives and the payment of fees to medical men whom they are required to call in, would be in the hands of the Health Committee of the Town or County Council, and its chief medical officer; whilst the recovery of the cost from the patient or her husband, in case of ability to pay according to (lie statutory scale, would be enforced by the special department of the Town or County Council entrusted with this duty. IO
    digitised image 1
    digitised image 2
    digitised image 3