An Account of the English Colony in New South Wales, Volume 2
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In the early s, the BMA NSW stated that two features of contract practice had to be immediately eradicated: membership for those able to afford private fees; and the excessive number of patients to be serviced. In , the BMA federal committee decided a model agreement should apply in all states. In Victoria, also, the profession recommenced hostilities in the s. In , the BMA Victoria announced it would withdraw from contract practice in In , three large societies plus a few smaller ones still held out against BMA demands; but by , the last of the recalcitrants, Manchester Unity, was brought to heel.
Unlike in Britain, where the existence of a traditional professional hierarchy delayed the unification of the profession, the small populations and penal colony status of NSW and Tasmania meant that, in registration terms, a unified profession was inescapable from the outset. Only in the second half of the 19th century, when economic, social and demographic development had progressed enough, did private practice, the force behind professionalisation in Australia and comparable countries, become significant.
Moreover, in the face of major scientific advances in medicine and the community's growing appreciation of the positive role of science in their lives, public scepticism about the regulars' claims to reliable knowledge and therapeutic effectiveness began to disappear. This external boost to status went along with the internal boost in corporate strength after the arrival of the militant BMA.
The medical schools were producing a small but growing number of graduates who, despite increasing specialisation, were intended to fit the locally appropriate role of the omnicompetent general practitioner. Further, a few local researchers were also producing knowledge of international significance: Joseph Bancroft on the mature parasite in filariasis ; John Davies Thomas on hydatid disease ; and John Ashburton Thompson on the rat flea as a vector in plague In medical politics and health policy, the legacy was of a well organised and politically sophisticated profession that was committed to the ideals of fee for service and exclusivity of the doctor—patient relationship.
Yet, while gaining control of the conditions of contract practice, the BMA had to accept it was the only way to fund private practice for a large part of the population well into the 20th century.
Medicine in colonial Australia, 1788-1900
State or other third-party involvement in organisation and funding of medical care would always have to be on terms the organised profession found acceptable. The next great struggle was to begin in the early s when a federal Labor government, committed to social reconstruction, contemplated but did not ultimately introduce a national salaried medical service as the answer to the problem of equitable access to increasingly complex and costly care. Provenance: Commissioned; externally peer reviewed.
Publication of your online response is subject to the Medical Journal of Australia 's editorial discretion. You will be notified by email within five working days should your response be accepted. Basic Search Advanced search search. Use the Advanced search for more specific terms. Title contains. Body contains. Date range from. Date range to. Article type. Author's surname.
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The Colonial Period, 1788-1900
Medical education. Volume Issue 1 Suppl. Medicine in colonial Australia, Med J Aust ; 1 : S5-S Topics History and humanities. Summary For the first five decades of European settlement in Australia, medical care for convicts and free settlers was provided by the Colonial Medical Service.
After about , as population and wealth grew markedly, there was significant professional development based on private practice. Except in Victoria, medical societies and journals did not become solidly established until late in the 19th century. The advent of local British Medical Association branches was an important factor in this consolidation.
In the first few years of the colony, mortality was very high, but the common childhood infections were absent until the s. From the s, there was a sustained decline in mortality from communicable diseases, and therefore in aggregate mortality, while maternal mortality remained high. Australian practitioners quickly took up advances in practice from overseas, such as antisepsis and diphtheria antitoxin. They shared in the international growth in the status of medicine, which was conferred by the achievements of bacteriology in particular.
From , students were apprenticed in Sydney and Hobart and then travelled to Britain to obtain corporate qualifications. Medical schools were ultimately opened in the new universities in Melbourne in , Sydney and Adelaide The first female student was admitted to medicine in Sydney in Medical politics were intense. The outlawing of practice by unorthodox practitioners proved to be an unattainable goal. In the latter half of the 19th century, doctors saw chemists as unfair competitors for patients.
The main medicopolitical struggle was with the mutual-aid friendly societies, which funded basic medical care for a significant proportion of the population until well into the 20th century. The organised profession set out to overcome the power of the lay-controlled societies in imposing an unacceptable contract system on doctors, even if, historically, the guaranteed income was a sine qua non of practice in poorer areas. Medical education From an early date, colonial students often starting at 14 years of age were being trained under the traditional apprenticeship system.
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Medical politics In Australia, as in Britain, doctors often dispensed drugs, and chemists provided medical advice as well as drugs. View this article on Wiley Online Library.
Competing interests:. Garton S. Medicine and madness: a social history of insanity in New South Wales, — Lewis MJ. Managing madness: psychiatry and society in Australia, — Canberra: Australian Government Publishing Service, Coleborne C. Madness in the family: insanity and institutions in the Australasian colonial world, — Basingstoke, UK: Palgrave Macmillan, The people's health: public health in Australia, — Westport, Conn: Praeger, The people's health: public health in Australia, to the present.
An Account of the English Colony in New South Wales, Volume 1 on Apple Books
A companion of the history of medicine in Australia — Canberra: AJ Proust, Gandevia B. The pattern of Australian medical history. Proc R Soc Med ; Lewis M, MacLeod R. Medical politics and the professionalisation of medicine in New South Wales, — J Aust Stud ; Porter R.
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