Staff in the operating theatre of the Zeehan Hospital, c 1890 (Tasmaniana Library, SLT)
Doctors arrived with Bowen in 1803 and Collins in 1804 when Hobart was settled, and at Port Dalrymple in 1804. Many were employed to look after convicts and free settlers in conditions of hardship, for both patient and doctor. Regiments often had their own surgeon, and hospitals were built in Hobart and Launceston, poorly funded and with minimal competent nursing staff.
The Medical Council of Tasmania was established in 1837, 21 years before the General Medical Council of Britain. It regulated the medical profession in Van Diemen's Land, and continues to check qualifications of doctors registered in Tasmania. The number of doctors in private practice gradually increased, although it was difficult for doctors to make a living in rural districts, and several were appointed as District Assistant Surgeons and paid by the government, such as Dr Coverdale, appointed to Richmond in 1840. These surgeons were the forerunners of District Medical Officers, who were the mainstay of rural general practice from the 1920s until the 1980s. By the 1840s there were small private hospitals in both Hobart and Launceston, run by doctors. At St John's Hospital in Launceston, in 1847 Dr W Pugh administered the first recorded general anaesthetic in Australia. Later Dr John Ramsay established St Margaret's Hospital (now St Vincent's) in Launceston, and St Helen's Hospital in Hobart was owned by Dr V Ratten.
Less affluent patients were treated at general hospitals, with specialists providing services free of charge. There was always tension between public and private practice, notably in the doctors' strike of 1917–30. The honorary system in public hospitals ceased in the 1970s as it did around Australia, with the employment of staff specialists and sessional payments for visiting specialists.
The 1950s and 1960s saw the expansion of public hospitals in Hobart, Launceston, Devonport and Burnie, with many country hospitals also equipped for surgery and obstetrics. Immunisation programmes reduced the incidence of childhood infectious diseases. Doctors concentrated in urban areas. Rural medical services were often inadequate. Country doctors are now all fee-for-service, and are mostly overseas trained graduates.
In Hobart in the 1840s an attempt was made to establish a medical school, but this was not approved by London as it was felt there would not be enough patients or teachers. A medical school was finally founded in 1965, and over forty years it has developed a reputation for the high standard of its graduates. Tasmanian-trained doctors mostly choose to specialise, with only small numbers entering general practice.
Further reading: A Proust, A companion of the history of medicine in Australia, 1788–1939, Canberra, c 2003; W Crowther, 'The medical history of the early days of the settlement at Hobart Town, 1803–1821', 1938, TL; and A background to medical practice..., Melbourne, 1952.