HEALTHCARE IN NEWCASTLE 1817-1860
Presented at The Hunter Postgraduate Medical Institute one-day seminar at HMRI on 11 November, 2017. Dr Ann Hardy
Newcastle hospital is one of the oldest hospitals in Australia, founded in 1817, however limited primary sources have survived relating to healthcare. To commemorate 200 years of the Newcastle Hospital a secondary written source “The Newcastle Hospital 1817-1915 by Ben Champion (1950) held in Cultural Collection at UON has been digitised and made freely available to the community.
Many thanks to Karen Moller for digitising these records.
Royal Newcastle Hospital 1817-1915 – Vol.1 – DOWNLOAD HERE
Royal Newcastle Hospital 1817-1915 – Vol. 2 – DOWNLOAD HERE
Royal Newcastle Hospital 1817-1915 – Vol. 3 – DOWNLOAD HERE
Royal Newcastle Hospital 1817-1915 – Vol. 4 – DOWNLOAD HERE
Prior to the Colonial Hospital a temporary hospital provided care in a hut – in the house of ‘Sir Henry Browne Hayes’ an Irish convict, this likely east of the later Pacific street site.
The first permanent hospital was a converted gaol (built of stone and weatherboard), and thought to have been built some time before 1816 when Commandant Thompson and built by convict mason James Clohesy.
This hospital mainly treated convicts, it had wonderful views and fresh sea breezes, and was described by JT Campbell to Governor Macquarie in 1818 as ‘an excellent hospital, well aired and well situated, with suitable paling”.
The building reflected British architecture, and similar structures were seen in India, the style was not intended for public use, but for convicts, as well as military and admin staff – it certainly was not decorative or ornate –and was typical of many military style buildings.
East Newcastle in the ‘Sandhill ’ – Hospital was close to industrial sites such as coal mines and the salt pans.
The Hospital measured 70 x 35 feet, it had two large wards, five small rooms and shaded by verandas, it held 25 patients, had 2 smaller rooms, one for females, and the other for grinding rations of wheat for use at the hospital,- prior to the later windmill on Prospect Hill (known today as Obelisk Hill).
The surgeons House was near the Colonial hospital as shown in above Plan of Newcastle (Items 4 & 5).
Who was treated at the hospital?
The General public, government workers, convicts from stockade were treated at the colonial hospital. The general public had to pay for care, on one occasion a man who had a ‘ticket of leave’ was unable to pay for treatment, his ticket cancelled and he was required to work as a hospital attendant – unskilled labour.
Convicts often escaped from the hospital, and a sentry was installed to stand guard at the main door, however other convict patients were less likely to escape as they’d been admitted after being flogged and needed treatment for their lacerations– apparently these convicts were in need of respite – time for their wounds to heal. Or was it respite for authorities?
Another group treated at the hospital were the military men, some from a detachment of troops who had remained in Newcastle after the penal settlement closed in 1823.
Lt Coke described in 1827 that many of his men were admitted to the hospital with incurable diseases, with dysentery, and many young men died there.
During the 1830s the Australian Agricultural Company employed workers and along with assigned servants this put increasing pressure on the hospital. – Convicts turned workers – the population relatively unchanged.
However, Newcastle began to gradually change from being an active convict outpost, to an outdoor asylum of ageing men- remembering that many of these people had no extended family to care for them – it was a much different situation to Britain.
1830s – Only a few convict women were admitted to the hospital, it is noted that unlike the men few of the women had health problems and required hospitalisation – does this says something about the resilience of women?
There was another hospital in Newcastle during the 1830s
Newcastle was seen by British authorities as a coal emporium – that needed to be protected. The British ordnance built a large military complex, today the site is known as the James Fletcher hospital.
Aboriginal people also often required healthcare, many lived on the fringe of town, they were a marginalised group, some were cared for at the hospital.
Relationship between colonial authorities and aboriginal people.
Medicine & Conditions at the Hospital
NOTE- as mentioned minimal hospital records exist from this period, and it is very difficult to get accurate details about what medicines were used.
Medicines shipped from Britain was often in short supply, even scarcer in Newcastle, therefore practices and treatments were likely primitive.
In 1819 complaints from Surgeon Evans state that there were ‘insufficient medicine and other necessaries in the dispensary at the settlement’. As a result there were high rates of illness and mortality. Even bedding and blankets were in very short supply. – England- Sydney
The Hospital was also seen as an unofficial asylum – with both sick in mind and body admitted- duty of care applied
In 1820 assistant Colonial Surgeon Evans advised Bigge who was reporting on conditions in the Colony, that
“there were 74 patients with general disease under his care. Most were outpatients, 21 men and one women in the hospital and 10 at the gaol hospital in the stockade – Convict Lumber Yard. A convict woman acts as a nurse.”
Many died of bacterial infection prior to antiseptic and antibiotics- hospitalisation was a last resort- usually a place where people went to die.
Making life even more stressful was the prevalence of plagues, and diseases such as measles and other epidemics- again incurable and the cause of many deaths. It was noted that ‘bilious and fever’ were common during autumn and spring; ‘dysentery’ during summer; and ‘ophthalmia and pulmonary disease’ prevalent all seasons. Also dropsy.
Blight was also a common disease, many people were in a poor state of health, often there was no other refuge, other than being sent to hospital.
- Calomel for treating dysentery
- Use of Blistering plaster
Lt Coke ” I never touch spirits but take perhaps 5 glasses of wine during the day, the doctors say it is absolutely necessary” 1827
Also contributing to the prevalence of illness were environmental/industrial factors, for example coal mining caused black lung- industrial accidents. Illness was caused by general filth – poor sanitation, water supply. Often Miasma (an unpleasant or unhealthy smell or vapour) was often referred to as the cause of sickness. There were many deaths during the 1850s, death rates declined after cemetery moved to Sandgate and improvements to drainage. Dr Richard Bowker government medical officer, and Medical Officer to the Regiment of Artillery, magistrate and coroner. He was a strong voice for reform for mental health patients and passionate about public health.
Newcastle cemetery on the hill he was concerned about seepage from graves would pollute the ground water and the wells, he agitated for cemetery to be relocated to Sandgate. Also for proper drainage in the city. NSW legislative assembly introduced two bills to raise the standards for medical registration. Later Bowker became one of first eye surgeons in Australia, practicing from Sydney.
The hospital lacked flow of fresh air, staff were often forced to close windows due the sand blowing into the building- as noted in earlier image of sand drift.
In later decades Newcastle hospital cared for sick and ageing convicts and was a general hospital for poor people who lived throughout the entire Hunter Region.
There were many poor and disadvantaged people in the region and admissions occurred due to social and economic reasons- there was no government welfare and minimal family support.
It soon become apparent that a larger hospital was needed due to the growth of city, and remembering that government gangs remained in Newcastle until 1846 to build the breakwater (Macquarie Pier) – and many of these workers had families that required healthcare.
By the late 1840s there was a change in the way that colonial hospitals were funded and managed. imperial funds were withdrawn (British Military) leaving communities vulnerable financially and unsupported. NSW gained responsible government and the colonial hospital was handed to communities and given a yearly grant of 200 pounds, providing the community raised the same amount of funds to maintain it.
There was not a lot of funding from charitable organisations during the 19th Century for hospitals, and funding would very much depend very much on government in the future– this was much different to Britain where charitable organisations were the primary funding bodies.
In 1848 the Newcastle community was handed the colonial hospital, and needed to take control of their own healthcare.
Miners organised their first Union in 1856 to improve the welfare conditions of miners and their families. The Australia Agricultural Company subsidised miner’s contributions to the union’s accident and sickness fund and this was Australia’s first owner subsidised workers benefits fund. These unions also employing doctors. Dr Richard Bowker was invited to Newcastle by the Royal Unions Lodge in 1842.
Time for Change
There were meant Problems with the state of the hospital and its location in the Sandhills. There was need for a new hospital. In 1836 the hospital was impassable, stuck in the sand hills, the surgeon had to lay wooden planks and use wheelbarrows to cart water , and in 1839 the morgue was completely covered by a sand drift.
By the 1860s Newcastle desperately needed a new hospital. The earlier hospital had remained in use for over 50 years, and at times struggled due to its size and lack of resources, it is quite remarkable considering it hadn’t been purpose built as a hospital.
In 1861 a special building committee (including Mayor James Hannell and Mortimer Lewis Jnr) was established to plan for a new two story hospital.
Communities, including miners, iron workers, companies, bankers and lodges, churches collectively made financial contributions to build the new hospital.
Fortunately in 1863, a bequeath of 800 pound from former convict Henry Usher went towards building a new hospital.
The Old hospital was eventually demolished in 1865 and a new hospital built as shown in image below (see two story building on left).
1866 Second Hospital – beginning of modern institutions
The second hospital opened on the same site in 1866, a true community hospital that reflected the beginning of modern health care that would eventually become government funded and regulated- a tradition that continues today.
The architect of the new hospital was Thomas Rowe, his new two story, Gothic designed hospital had four wards and many verandas. The Foundation stone was laid by the John Williams, the provincial Grand Master of Freemasons of NSW.
This Second hospital was built in two stages (1866 and 1884) and reflected the Florence Nightingale method of nursing – cleanliness and fresh air. Although she rejected Pasteur’s germ theory. There were positive elements to her philosophy including, specific training of nurses.
A third hospital begun in 1913, as well as other new buildings including the North Wing that was also influenced by Florence Nightingale, it was an impressive four-story building in the Federation free style.
Who were the Doctors and other staff?
Many of the surgeon superintendents at the Hospital started their medical careers at convict and military hospitals.
Colonial surgeons were paid, whereas medical officers often in an involuntary role in England, many of these medical officers who had experience in voluntary hospitals became government medical officers and were paid in NSW.
Newcastle hospital was shaped by the needs of the community and medical personnel who brought to the colony skills and knowledge that was at the time contemporary and modern.
Healthcare was also shaped by the many accidents, injuries and disasters (such as shipwrecks) that occurred in the region, the communities, and people who advocated for what they knew was best for Newcastle people – a resilience that is still very evident in Newcastle today.
200 years of medicine in Newcastle goes back to our convict days By Damon Cronshaw November 9, 2017.
Also see blog post Healthcare in Newcastle 1817-2017 – hosted by Hunter Postgraduate Medical Institute, 11 November, 2017