Medicine in colonial Australia, 1788-1900.

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 1850, 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 1830s. From the 1880s, 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 1813, 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 1862), Sydney (1883) and Adelaide (1885). The first female student was admitted to medicine in Sydney in 1885. 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.