Health and the state : the development of collective responsibility for health care in Australia in the first half of the twentieth century

Abstract

The state in Australia was only minimally involved in health matters at the beginning of the twentieth century, its concern being al­ most entirely limited to environmental control. But advances in medical science particularly in the field of preventive medicine, an increasing awareness of the problems of ill-health and unfitness within the community, and the experience of the first world war forced the state to become far more concerned to preserve the health of its citizens. The first part of the thesis examines these developments up to the formation of the Commonwealth Health Department in 1921. The second part outlines the structure of health administration in the various States and follows the development of health controls over persons suffering from communicable diseases, of the provision of treatment facilities , and of mass preventive programmes. These themes are discussed in relation to acute infectious fevers including quarantinable diseases, scarlet fever, poliomyelitis, typhoid and diphtheria, and in relation to tuberculosis and venereal diseases. Having established controls over persons whose ill-health constituted a specific threat to the welfare of the nation, the state began to be concerned to preserve the health of groups of persons whose fitness was of particular value. The third part of the thesis commons with a discussion of the problems of the falling birth rate and the preoccupation with racial standards and then examines the maternal and child welfare movements which over a period of two decades succeeded in convincing women that they needed constant medical supervision. during pregnancy, they should be confined not at home but in hospital, and that they should seek regular expert advice on the rearing of their children. The role of the medical profession is emphasised in relation to maternal welfare. where services were retained within the private sector: on the other hand the profession was only minimally involved in infant welfare which became, ultimately, the area in which collective responsibility was most successful Finally, the thesis is concerned with health standards in general in the community and with the personal medical and hospital services available to the mass of the population. The section dealing with the expansion of hospital services and of the role of the state in the provision of institutional care culminates with the short-lived Commonwealth with personal medical services follows the conflict between the and the medical profession over the provision of hit}l quality, equitable health care to all sections of the community until 1949 when the profession defeated the Commonwealth Labor government's attempts to establish collective responsibility for all health care in Australia. Show more