In The Beginning: Western Australia
Probably the first doctor to work in the new colony was Dr Isaac Scott Nind. He was the surgeon with the Lockyer expedition of 1826 to the King George Sound area, though he was less well known for his work as a doctor than for his vocabulary of words and placenames of the Nyungar people and his anthropological research for the Royal Geographical Society in London. Dr Nind left the colony after only a few years, in any case, returning to practise in New South Wales where he died in 1868. In the first 40 to 50 years of the new society, doctors (as in all the other settlements) were prominent not just in medicine but also in exploration, public service and private commerce.
Governor John Hampton was a doctor, though not a practising one, being exclusively involved in improving the fragile local economy and managing the convict system in his three years of office. The first doctor in private practice in the new colony is said to have been a Dr Thomas Harrison who worked in the Fremantle area. Dr Alexander Collie explored the Cockburn Sound area with the Preston expedition in 1829 and then practised in the Albany area before coming to Perth where he established the first hospital tent and became Colonial Surgeon. Dr Thomas Lovegrove practised at Bunbury and became Resident Medical Officer there before his appointment as Government Resident and Warden in the Kimberley goldfields. He was also Acting Colonial Surgeon for about a year in the absence in England of Dr Alfred Waylen. Dr Waylen’s doctorate in medicine from St Andrews University in Scotland was the first medical qualification granted to a West Australian-born person. He practised at Guildford before his 30-odd years in government service as Colonial Surgeon, member of the Medical Board, chairman of the Aborigines Protection Board and Superintendent of Vaccination. Acting Colonial Surgeon Dr William Milligan, who in Perth’s early days offered his services out of a tent near Barrack Street and later in a former stables, was one of the leading citizens depicted along with Governor Stirling and Captain Fremantle in George Pitt Morison’s famous painting, The Foundation of Perth. Dr Charles Simmons also treated the sick among the first white settlers out of a marquee on Garden Island.
Conditions were especially hard in Perth in those days; it was far from being the progressive city envisaged by Governor Stirling. The first permanent hospital building did not open until the mid-1850s. At the beginning of the 1830s, when the population was still only about 1,500, nearly everybody was still living and working in tents and other makeshift accommodation. (Even in Stirling’s official residence, the leaks were so bad when it rained that letters had to be written under an umbrella.) The tents in which the first doctors treated their patients (and even the loftiest families lived) were surrounded by deep ditches to keep out snakes and “unfamiliar animals”.
There was a major difference between the environment in which doctors practised in the new colony and that in the settlements elsewhere in Australia: the absence of the traditional discord. Harmony was not disrupted until much later, when the local newspaper was used to air criticisms of the way patients were treated in the smallpox and typhoid epidemics in the early 1890s. At the centre of it was the cantankerous English-born Dr Edward Haynes, who had already had the odd clash with Perth colleagues. Dr Haynes, citing his record in England of dealing with epidemics, had asked the Board of Health to appoint him medical officer (salary £200) in charge of a smallpox epidemic in Perth in 1893. Whether or not the Board had in mind Dr Haynes’ disputatious reputation, it appointed instead Dr Michael O’Connor, a young up-and-coming Western-Australian-born doctor who was already helping to deal with the epidemic. Dr Haynes was not pleased.
The Board already had its internal problems in dealing with the epidemic. Mr William Traylen, a lay Board member who was also on Perth City Council, was leading a noisy public campaign against the Board’s compulsory vaccination policy and for the use as an alternative treatment a medicine composed of cream of tartar dissolved in water. Then, when the Board set up an emergency infectious diseases hospital at Subiaco, Dr Haynes set up his own nearby with his own method of treatment. He claimed to be persecuted when, after he had been called out to a patient with smallpox symptoms, the police refused to let him breach the quarantine regulations by entering the patient’s house and he was left out in the street shouting out his instructions to the patient’s family. Dr Haynes did work with Dr Waylen and other colleagues in a free vaccination campaign at Perth Town Hall, but his criticisms of the Board’s handling of the epidemic did not stop. The dispute degenerated again when Dr Haynes interrupted a public inquiry into a smallpox fatality and had to be reprimanded for interfering with witnesses. He ran out of friends finally when it was discovered that he had sent a telegram to the colonial government in Sydney calling for it to intervene in handling the epidemic because the local authorities were incompetent and then when he scandalised his colleagues by getting the Australasian Medical Gazette to publish his version of the way the epidemic was handled.
All this did not go down well in what was then a small and isolated society, and at a time when secession was in the air. Nor did it later that year, when his view of the Board of Health fuelled a brutal offensive against it in the Parliament. Whatever their reason, his fellow doctors rejected him some years later when honoraries were up for election to the Perth Hospital and, 10 years after that, some members of the newly-formed branch of the BMA even tried to expel him for his “scandalous publications”.
The Haynes incident is recorded at some length because it almost certainly influenced – if not delayed – the development of medical organisation later in the colony.
Already, by the mid-1850s, doctors in Western Australia had been discussing their need to organise, though the matter had not gone much further than that. Nothing much had changed until the Victorian branch of the BMA, reportedly encouraged by the Victorian Government Botanist Baron Ferdinand von Mueller, sent a request to the South Australian branch in 1886 to help round up support among doctors in Western Australia for an organisation for medical professionals. The Baron had no medical qualifications (he was trained as a botanist and chemist). But he had a number of medical contacts in Western Australia and elsewhere because of his research into the medical qualities of the flora he had discovered while with the Gregory North Australian Exploring Expedition in 1855. But, despite the Baron’s influence and contacts, the Victorian-South Australian initiative petered out.
A Medical Union operated at Coolgardie on the goldfields for a while but it was very localised and attracted few members. The issue of organisation was not resurrected until 1895, in Victoria rather than Western Australia and – unfortunately, because by then he was running so short of people who wanted to have any dealings with him – via an initiative of the unpopular Dr Haynes who had written in the Australasian Medical Gazette that doctors needed to form an organisation in Western Australia to protect their interests.
Still, the Victorians maintained interest, encouraged by contact from a Dr George McWilliams offering the Victorian branch his support. The Victorians were encouraged. Dr McWilliams, though young, was a prominent (and very busy) Perth character: head of out-patients at Perth Hospital, founder-president of the St John’s Ambulance Society, head of an organisation that looked after poor sick children, president of the Perth Cycling Club and honorary surgeon to the Western Australian Turf Club. But, perhaps because he had so many other things to do, Dr McWilliams was missing in action when a group of his colleagues formed a WA Medical Association in 1897 and the new group languished. It was not until a year after that that another group of doctors met in the Perth Hospital boardroom to discuss forming a branch of the BMA in Western Australia. This time, the notion of organisation was about to take off.
The prime movers were relatively new to Australia and very possibly had witnessed what an active and committed organisation like the BMA had achieved in the UK. Dr Herbert Horrocks had only recently arrived from England, though he had already been appointed to the Dental Board. His co-actors were the Stewarts. Dr Mitchell Stewart and his brother Fergusson had arrived from Scotland in the late 1880s and their sister Roberta in 1896, and the three of them had a group practice at Guildford. Their initiative led to 27 doctors setting up a branch of the BMA in Perth. Dr Waylen was elected President. Dr Mitchell Stewart was on the Council. His sister Roberta was an active and influential member.
In fact, Roberta, the first woman to practise medicine in Perth, came to have an enormous influence on the health system and the society of Western Australia as a whole until she died aged nearly 90 in 1961. In 1898, she married Martin Jull, with whom she had one child, the writer-historian Henrietta Drake-Brockman. With Edith Cowan and others, Dr Jull was heavily involved in social reform, especially (as a foundation member of the Children’s Protection Society) in activities aimed at reducing the high rate of infant mortality in Perth and rural areas of the State. She was a member of Convocation and the Senate of the new University of Western Australia and the first medical officer of schools in the Public Health Department.
Dr Jull and her brothers had much to do with the mark that the new BMA branch was quickly making on development of the WA health system, particularly in helping develop programs to reduce infant mortality. New regulation had been drawn up to deal with infectious diseases, enforced by a Central Board of Health. A Principal Medical Officer had been appointed to control standards in the goldfields hospitals, where conditions were atrocious. The BMA was being consulted on a range of matters, including school health and food safety.
In 1911, when the branch was finally incorporated, a report to the Council had complained that most of its work was still being done by only “a willing few” and that the others displayed what could only be described as “enthusiastic apathy”. Dr Jull herself had suggested that so much administrative work had had to be done by the Council and the honorary secretary that the new branch needed to employ clerical staff, part-time to start with. But the branch had achieved a huge amount in its first years.
It had developed a code of ethics, supervised by a committee, and prepared a paper on ethics and medico-politics for the Australasian Medical Congress. It had prepared ideas for a doctors’ organisation at the national level, such as a federated BMA. A committee had drawn up fair contracts for members who worked for friendly societies. It had worked with the Government on a system of medical inspection of schools, legislation to deal with workers’ compensation and the operations of midwives and the appointment of a Commissioner of Public Health to replace the Central Board of Health and with much greater powers. It had helped set up a maternity hospital in Perth.
With the developments in Perth, medical organisation had now been accomplished over most of the country, but there was little evidence of cooperation among the different branches in the different jurisdictions. In the new Commonwealth, and especially in the aftermath of World War I, a national government began considering ideas for the structure and elements of a national health service. The new organisation, operating as separate entities in different systems and often with different agendas, had to prepare itself for these developments, especially for their ramifications for its members.