14.
MAJORITY REPORT.
(3) Provision of medical services if and when called
in by a registered. midwife who has been engaged to
attend the confinement.
(4) Consultant service.
(5) Institutional treatment.
The payment of the cash benefit should be distributed over
several weeks before and after the confinement and not be
paid over in one lump sum. The Association are of opinion
that the Medical and Maternity Benefits Services should be
regarded as a health service and be grouped with other such
services for administrative purposes ; that is, under the Public
Health Authority *’ (App. CXXIV, 9 and 10).
112. The Ministry of Health representative, in answer to
questions on the subject, gave the following reply : ‘ This is a
matter that has been discussed several times with the medical
profession in 1919 and since, and I think that the general feeling
is that, if the requisite financial arrangements could be made,
it would be very desirable to end the present system under which
you have the general practitioner responsible for treatment before
labour but having no responsibility during labour, the midwife,
under an entirely independent authority, giving attendance in
labour and calling in a practitioner to attend in labour, if
necessary, who would be paid by the local authority ; then you
have the maternity and ante-natal centre giving assistance in
the early stages. There is a great deal of overlapping and
probably a good dedl of waste, and it would be most desirable,
if it could be arranged, to have a scheme that brought the
family doctor, the midwife, the specialist, if necessary, and all
the services that are available at the maternity centre, under
& common scheme and a common control, so that they each
played their proper part and were brought into proper relation
with each other, helping one another instead of acting at a
distance as they do now.” (Smith Whitaker, Q. 23,896.)
113. Closing this summary of the evidence on this important
question, we note that the National Conference of Friendly
Societies, to whose advocacy of a radically reformed Health
Service we have elsewhere referred, include all the maternity
work of the various agencies as part of the material to be in-
corporated in their proposed unified scheme (App. XXVI, 30-41).
Ea
SEPARATION OF MONEY PROVISION AND TREATMENT.
114. On a review of all the evidence we have heard we have
come to the conclusion that the present elements of maternity
benefit should be ultimately dissociated from each other,
that is to say, any cash payment made on confinement
should be separated from the medical, nursing and institutional
services. of all kinds provided in connexion with the condition
of pregnancy. The former should, we think, continue to be