The first ships to South Australia carried a surgeon-superintendent to care for migrants onboard and a colonial surgeon responsible for the health of government officers and settlers in the new colony. These men, who were the nucleus of the colony’s medical workforce, were soon joined by other medical colonists.
At this time British medical qualifications were not standardised. The new colony did not attract the medical elite, and some of the first practitioners were poorly qualified, even by contemporary standards. Thomas Cotter, the first colonial surgeon, had only a London Society of Apothecaries’ licence, which did not imply surgical competence, and the first inspector of hospitals, John Litchfield, had allegedly purchased his qualifications. Some medical colonists were very capable, but some were quacks, with or without medical diplomas. Aware of this, in 1844 Governor George Grey set up a medical register with provision for assessing credentials. Later legislation defined the status of a legally qualified medical practitioner, but left those South Australians who preferred alternative medicine to do so – at their own risk.
In 1861 there were 120 practitioners, not all in active practice, for a European population of 126 830. They were largely trained in Britain, although a few had German qualifications. From 1875 several highly qualified young men staffed the Adelaide Hospital, hitherto an unremarkable institution, making it a leader in Australian medicine, especially the prevention and surgical treatment of hydatid disease. In 1879 a branch of the British Medical Association (BMA) was formed, the first in Australia, which raised the level of scientific discussion. In 1887 this branch convened in Adelaide the first Intercolonial Medical Congress, a landmark in Australian medical history.
In 1885 the University of Adelaide opened a medical school, the third in Australia. This was chiefly the achievement of Edward Stirling, a Cambridge graduate who had taught physiology in London. The medical faculty had some outstanding teachers, notably Stirling and Archibald Watson, who for all his legendary eccentricities was a brilliant surgical anatomist. William Bragg, later a Nobel Laureate, taught physics. The clinical teachers included some very gifted surgeons, and teaching in other parts of the course was adequate. Women were admitted with no fuss; in 1891 Laura Fowler became one of Australia’s first female medical graduates. Others followed, and by 1910, 19 women had entered the Adelaide Medical School, of whom 16 eventually qualified.
The new medical school shaped the South Australian medical profession. By 1915, of the 296 registered medical practitioners, 109 (36.8%) were Adelaide graduates. In 1950, with 758 medical practitioners (100 per 100 000 population), nearly 80% had graduated locally. Teaching was focused on general practice, especially country practice; those who wished to specialise or to do research usually went to England. This produced a relatively homogeneous and competent but perhaps parochial medical profession. Many served in both world wars; among these Henry Simpson Newland made notable contributions in the surgery of facial mutilations.
In the 1950s a new generation of medical teachers broadened horizons, promoted research and encouraged postgraduates to go to the United States as well as to the United Kingdom. In 1975 the state’s second university founded the Flinders Medical School under the deanship of GJ Fraenkel, an experienced medical statesman from Oxford. His innovative thinking stimulated the Adelaide Medical School to modernise its goals and methods. Globalisation also enriched the medical profession, and by 2000, with more than 5000 registered medical practitioners (330 per 100 000 population), more than 25% came from elsewhere – many from universities in Asia and continental Europe. Women made up some 32% of the workforce, though the proportion was smaller in many of the specialties.
From the nineteenth century members of the South Australian medical profession have given leadership in public health, notably Helen Mayo (infant health), HK Fry and Charles Duguid (Aboriginal welfare), and JS Robertson (road accident research). South Australians have also pioneered in the management of craniofacial deformities.
Except in the memorable Adelaide Hospital Row, the South Australian medical profession has not been very combative. Even the nineteenth-century jihads against quacks and homeopaths were mild by contemporary standards, and government attempts to introduce universal health insurance were made with civilised courtesy. The profession has usually been represented by the BMA, which became the Australian Medical Association in 1962, and the South Australian Salaried Medical Officers’ Association which formed in 1974.
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