Detail showing the Sydney Infirmary from 'Bird's eye view of Sydney Harbour' by FC Terry, c 1856 courtesy National Library of Australia ( PIC Drawer 2407 #S1997)

This week on 2ser Breakfast, Nic and our Dictionary of Sydney special guest Dr Peter Hobbins looked at the early history of public health and hospitals in Sydney. 

You can listen to their entertaining and informative conversation here: 

Listen now 

Until the late 1830s, hospitals in Sydney were provided by the government only for convicts, who they saw as a source of free labour, and government personnel like the military, employed to supervise the convicts and maintain the security of colony. This wasn't unreasonable in terms of what people thought about healthcare and hospitals at the time.  If you were sick, you called in a doctor to visit you at home, or relied on family and friends for care, or you might make use of herbal and traditional remedies. If you were poor or indigent, you were dependent on the small number of charitable institutions who might be able to take you in. Hospitals were more like a convalescent home or hospice for the dying than we think of them today.  Even into the 1870s, hospitals were still not places one would attend in anticipation of a full and rapid cure. If you were sick in the 19th century, the hospital was an option of last resort.

New South Wales Government Gazette 12 January 1847, p46 via Trove

From the 1830s though, a new sense of what a government might be, and its responsibility for the welfare of its citizens, began to develop as the colony began to move towards self government. From 1836 the Governor and  Legislative Council began making limited funds available to the Sydney Dispensary (a charitable institution established in 1826) to provide some medicines and advice for free settler, and then in 1840, when convict transportation had effectively ended and some of the resources used to maintain the system could be redistributed, a section of the 'Rum Hospital' on Macquarie Street was handed over to the organisation to become the Sydney Infirmary and Dispensary - the first to specifically offer beds for free settlers. St Vincents Hospital in Darlinghurst, founded by the Sisters of Charity in 1857, was the second hospital to serve Sydney's general population. The establishment of more institutions like Royal Prince Alfred, North Shore and Prince Henry hospitals followed over the next few decades, until now we have over 220 public hospitals and health services in New South Wales. Another important related facility also opened in 1847: the Vaccine Institution. Located in the Barracks next door to the Mint and the Rum Hospital, its task was to provide vaccination against smallpox for all of the city's residents, especially children of  'humble classes', a task made more difficult by the fact that New South Wales never made vaccination compulsory. In the 19th century the only effective vaccine available was that for smallpox, and this had been around since 1804. Most of the other Australian colonies and New Zealand had made vaccination compulsory, in particular to protect children born in the colony who had had no exposure to the disease and were therefore particularly vulnerable to an outbreak. As the proportion of the population born in the colonies increased, so too did the risk of devastating epidemics unless vaccination was implemented widely. The well to do and aspiring colonists who lobbied for the establishments of institutions like these and others, like the Benevolent Asylum, were charitably minded people who saw their philanthropy as a form of social duty, one which also served to increase their personal standing in the colony. Many of them had genuinely benevolent motives of course, but there was also a strong sense that these institutions, set up to corral the sick poor provided a 'moral and charitable quarantine' between themselves and the 'humble classes'. (1)

A bed in the Infirmary was by no means a given, even by the 1860s. Sydney Punch, 4 September 1869, p128

These developments in public health through the economic depression of the 1840s also suggest that Sydney's residents were willing to trade off some of their colonial liberties in return for a growing role of the state in tending to their medical and political needs.     (1) The Fifteenth Report of the Committee of the Sydney Dispensary (Sydney: Kemp and Fairfax, 1844), 9. Further reading: Dictionary of Sydney Stephen Garton, Health and Welfare Judith Gooden, Hospitals: and Nursing Laila Ellmoos, Sydney Hospital Gary Wotherspoon, Epidemics Raelene Allen, Smallpox Epidemic of 1881 Terri McCormack, Benevolent Society and Asylum Other reading: Peter Hobbins. 'Tending the Body Politic: Health Governance, Benevolence, and Betterment in Sydney, 1835–55.' Health and History 19, no. 2 (2017): 90-115. doi:10.5401/healthhist.19.2.0090 State Archives and Records NSW 'An Unexpected Discovery: Vaccine sample from 1841 found in the archives'     Peter Hobbins is an historian of science, technology and medicine at the University of Sydney. Much of his work has explored the meanings and boundaries of 'scientific medicine', in both nineteenth- and twentieth-century Australia. He is the author of a book on snakes and snakebite in colonial Australia, and co-author with Ursula K Frederick and Anne Clarke of 'Stories from the Sandstone: Quarantine inscriptions from Australia's immigrant past', winner of the 2017 NSW Community and Regional History Prize at the Premier's History Awards. In 2016 Peter was the Merewether Fellow at the State Library of New South Wales, researching Sydney-based amateur naturalist, James Samuel Bray. He appears on 2SER for the DIctionary in a voluntary capacity. Thanks Peter! Listen to the podcast with Peter & Nic here, and tune in to 2SER Breakfast with Nic Healey on 107.3 every Wednesday morning at 8:15-8:20am to hear more from the Dictionary of Sydney.  The Dictionary of Sydney has no ongoing funding and needs your help. Make a donation to the Dictionary of Sydney and claim a tax deduction!