History of medical administration in NSW
A History of Medical Administration in New South Wales 1788-1973 contains the valuable insights of Dr C.J. Cummins, who was Director-General of Public Health from 1959 to 1975.
The republished version has been updated with photographs and imagery from that period, including A4-sized posters that you can download.
You can see the full contents of the publication OR highlights. All links are to PDF documents.
Full contents
Go to the publication's table of contents and select a chapter.
Highlights
- The colonial surgeons
After the arrival of the First Fleet in 1788, six naval surgeons established the Colonial Medical Service. As Dr. Cummins states, "The Colonial surgeons serviced the Colony in an era wherein jealousies, frustrations and thwarted ambitions were resolved in vitriolic words and even with pistols".
- Convict hospitals
A series of tents was erected on the west side of Sydney Cove near the present Maritime Services Building to serve as a makeshift hospital. This was soon replaced by a timber building with dirt floors. So the General Hospital was established, to be replaced in 1790 by a wooden prefabricated hospital which was transported to the Colony in the Transport Lady Juliana.
- Lunacy and idiocy
Lunacy was regarded as an extension of benevolence in the early years of the Colony, and it was not until some 70 years later that its medical significance was recognised by Government.
- The lunatic asylums
The asylum system of containment of lunatics and idiots was forced upon the administration by the growth of population, which by 1810 had increased to 11,566.
- The Norton Manning Report
The Norton Manning Report became the "magna carta" of the care of the insane, and the proposals were incorporated into the Lunacy Act of 1879.
- State and voluntary hospitals
In 1855, the Government constituted a Board to enquire into the operation and general management of the Benevolent Society, and to determine the position which the Government should adopt regarding the continuation of subsidies from public funds.
Voluntary hospitals were founded by private enterprise on the principle of mutual self-help, divorced from Government interference. They provided a complete medical service to the poor through their outpatient and inpatient facilities.
- The Board of Advice
"I think it desirable that a number of gentlemen should be appointed as a Board of Advice or Board of Health to advise with and assist the Government in preventing the spread of smallpox..." So began Sir Henry Parkes' memo in July 1881, in his capacity as Premier, in an attempt to address and combat the outbreak of smallpox.
- Smallpox outbreak of 1881
The story of the establishment of public health administration begins in 1881 with the outbreak of a major smallpox epidemic in Sydney.
On Chong lived at 223 Lower George Street, Sydney. In 1881, his young son was taken to the North Head Quarantine Station. He had the dreaded smallpox.
- Chief Medical Officer and Director-General of Health
The process of consolidation of the two medical administrations of the Board of Health under the Colonial Treasury and the Medical Department within the Colonial Secretary's Department was initiated by the creation in 1899 of the position of Chief Medical Officer to the Government.
- Districts, Divisons and Branches
The development of public health administration is reflected in the growth of Public Health Divisions and Branches, each catering for specific components of service.
- Administration of mental health
"In the institution of a Lunatic Asylum there is this singularity, that the interests of the rich and poor are equally and immediately united ..."
So began James Currie's description of lunatic asylums in 1789. As Cummins comments, "With few exceptions, the mental hospitals as I knew them in 1961 still conformed to the functions ... as described by James Currie".
- The Ministry of Health
One gets the impression that unofficially [ the portfolio of Health ] was not regarded as a prestige Ministry, although some occupants later achieved higher political posts, and others personally had strong political influence within their parties.
- Administration of hospitals and charities
It cannot be stressed too frequently that general hospitals developed as voluntary charities for the indigent poor, survived essentially on the subscriber system, with irregular Government assistance, during the nineteenth century.
- Organisation Charts 1913-1941 Chart 1
Organisation Charts 1913-1941 Chart 2
- From Department to Commission
In the mid-1960s, health services were at a crossroads. Old and tried values were being challenged, and new values were novel and untested. Some method of review was inevitable.