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A History of Medical Administration in NSW 1788-1973

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A History of Medical Administration in NSW 1788-1973 A History of Medical Administration in NSW 1788-1973 by CJ Cummins Director-General of Public Health, NSW (1959-1975) 2nd edition Photographic acknowledgments Images of St. Vincents Hospital, Benevolent Asylum and Scenes of Gladesville Hospital courtesy of the Mitchell Library, State Library of New South Wales. Images of Lunatic Reception House – Darlinghurst, Department of Health Office, Broughton Hall Hairdressing Salon, Callan Park Recreation Grounds, Dr Morris, Dr Balmain and Garrawarra Hospital courtesy of the Bicentennial Copying Project, State Library of New South Wales. Image of The ‘Aorangi’ in quarantine courtesy of the Sam Hood collection, State Library of New South Wales. Image of Polio Ward – Prince Henry Hospital courtesy of photographer Don McPhedran and the Australian Photographic Agency collection, State Library of New South Wales. Image of John White (Principal Surgeon), George Woran (Surgeon of the ‘Sirius’), and Governor Phillip and young Aboriginal woman courtesy of Rare Books Collection, State Library of Victoria. NSW DEPARTMENT OF HEALTH 73 Miller Street NORTH SYDNEY NSW 2060 Tel. (02) 9391 9000 Fax. (02) 9391 9101 TTY. (02) 9391 9900 www.health.nsw.gov.au This work is copyright. It may be reproduced in whole or in part for study training purposes subject to the inclusion of an acknowledgement of the source. It may not be reproduced for commercial usage or sale. Reproduction for purposes other than those indicated above, requires written permission from the NSW Department of Health. © NSW Department of Health 1979 First edition printed 1979 Second edition redesigned and printed October 2003 SHPN (COM) 030271 ISBN 0 7347 3621 5 Further copies of this document can be downloaded from the NSW Health website: www.health.nsw.gov.au October 2003 Preface This new preface is the result of a request from the NSW Department of Health to republish the original A history of medical administration in New South Wales, 1788-1973 Report. During my tenure as Director-General of Public Health from 1959 to 1975, there were incredible advances in medical sciences and technology following World War II. These changes rendered obsolete the concept of a Central Health Authority with its own legal capacity through the Public Health Act and the Board of Health. There was a shift towards greater involvement of community agencies and charities. This underlies the system now in operation, and the Report of 1979 provides the background and details of this change. It remains a valuable document which aids in the understanding of the historical development of health services in this state. C.J. Cummins M.B., B.S., D.P.H.,F.A.C.M.A Sydney July 2003 i A History of Medical Administration in NSW St. George Nursing Home Nurses 1928 Foreword The administration of health services in NSW has a rich heritage. Conceived in the harsh realities of a struggling penal colony, growing through the challenges of epidemics and regular social upheaval, state health services developed into an organised system which catered to the ongoing medical needs of generations of residents. These days, with new research published daily and as models of health care adapt to incorporate new diseases, treatments, and community demographic changes, the public health system continues to evolve to meet the challenges of the 21st century. In looking to the future, it is also important to learn from the past. As the Director General of Public Health for sixteen years, Dr CJ Cummins was in a unique position to lead health care providers through an era of emerging technology, a burgeoning and culturally diverse new population and changing social expectations. Sadly, Dr Cummins passed away earlier this year.A modest man, he was nonetheless flattered when NSW Health approached him to obtain permission to republish his significant work. This republished volume, A History of Medical Administration in New South Wales 1788-1973, contains his valuable insights as a top administrator into almost two centuries of how the best available health care was provided to the people of NSW. Updated with photographs and imagery from that period, this document is an important historical record of the times, from which future health administrators can draw insight and inspiration. Robyn Kruk Director General NSW Department of Health October 2003 iii A History of Medical Administration in NSW Prospective Recruits for the RAAF receive a thorough medical examination A recruit having his ears examined 1940’s Foreword and Preface 1st edition 1979 Preface This study of the historical development of health administration in New South Wales was commissioned by the Health Commission of New South Wales in January 1977. The development of the topic is a logical extension of my earlier studies up to the period of self-government, and I am presenting the present study in two parts, before and after 1881, ie of the period when the conduct and rules of health administration were ill defined and pragmatic, as contrasted with the period subsequently when it was based on legislation and departmental organisation. There will be areas of opinion and interpretation, especially in the second episode, when there may be personal and official differences to my expression of views. I emphasise that any views or opinions expressed are personal to myself, and in no way reflect the attitude of the Health Commission or its Officers, who may have assisted me in this study. To the latter I wish to express my personal thank for their help and courtesy despite my demands, which, at times, were inconvenient and no doubt irritating. In particular I thank Mr. K. Brown, Secretary of the Health Commission; Mr. D. Hunt, Librarian, and Miss M. Petrich, Reference Librarian, of the Health Commission Library; and Miss Bruni Torreblanca who is responsible for the precise and accurate typing of the study. C.J. Cummins m.b., b.s., d.p.h., f.a.c.m.a, Sydney, June 1979. Foreword In November 1976, Dr C.J. Cummins, M.B.B.S., D.P.H., F.A.C.M.A. accepted an invitation by the Health Commission of NSW to write an historical account of the development of Government health services in NSW, from the foundation of the colony in 1788 to the establishment of the Health Commission in 1973. Dr Cummins has had an eminent career in public health administration and has obvious ability as an historian. He is thus well qualified to compile this history. The positions which he held gave him intimate knowledge of events in NSW related to health services administration in the quarter century prior to the formation of the commission. These positions included the following: Director, Division of Industrial Hygiene, Department of Public Health . 1950-52 Deputy Director-General of Public Health . 1952-59 Director-General of Public Health . 1959-75 President, Board of Health . 1959-75 The commission considers the history will be a valuable addition to other literature related to the health services of this state. Roderick McEwin, Chairman, Health Commission of NSW, June 1979 v A History of Medical Administration in NSW Contents Part I. 1788-1880 Page Introduction ................................................................................................................................................................................3 The foundation of the Colony of NSW ..........................................................................................................................................3 Medical practice and welfare in Great Britain in the eighteenth century .......................................................................................4 Medical practice ..........................................................................................................................................................................4 Physicians...............................................................................................................................................................................4 Surgeons ...............................................................................................................................................................................4 Army and Navy surgeons .......................................................................................................................................................5 Apothecaries .........................................................................................................................................................................5 Medical schools and voluntary hospitals ................................................................................................................................6 Accreditation .........................................................................................................................................................................6 Welfare and benevolence .......................................................................................................................................................6 The poor laws ........................................................................................................................................................................7 Poorhouses and workhouses ..................................................................................................................................................8 Care of orphans......................................................................................................................................................................8
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