Australia’s first hospital, completed 200 years ago, was a pragmatic deal between politicians and opportunistic rum-dealers

AUSTRALIA’S first hospital was completed 200 years today in a pragmatic deal between can-do Governor Lachlan Macquarie and alcohol merchants.

An 1850s sketch of the Sydney Infirmary later known as the Sydney Hospital showing the original centre wing (later demolished) along with the north wing, now State Parliament, and the south wing, now the Sydney Mint building. Courtesy of Sydney Hospital.

CORRUPTION accusations that stalk the hallowed halls of NSW government likely all come down to the single hall linking the state’s Legislative Assembly and Legislative Council chambers.

That hall, after all, is the remnant of Australia’s first hospital, completed 200 years ago in a pragmatic deal between can-do Governor Lachlan Macquarie and opportunistic rum-dealers. Poorly constructed over five years in return for excise discounts on more than 60,000 gallons of rum, contractors Garnham Blaxcell, Alexander Riley and surgeon D’Arcy Wentworth advised Macquarie on March 3, 1816, that the long-awaited project was completed.

Macquarie commissioned three Crown officials to inspect the work, already aware the central block was 60cm lower than planned, while the front verandas did not extend to a large flight of steps in the middle of the building, as first intended.

An 1850s sketch of the Sydney Infirmary (centre) later known as the Sydney Hospital along with the north wing (left), now State Parliament, and the south wing (right), now the Sydney Mint.

Macquarie’s inspectors were also unsatisfied, making severe criticisms and ordering alterations that delayed transfer of the first patients from Dawes Point infirmary until at least April 8, 1816, and possibly until an unspecified date in July.

Despite shortcomings, the Sydney Infirmary and Dispensary was a step up from Dawes Point, where tents were erected to treat First Fleeters in 1788. The Second Fleet delivered a portable hospital in July 1790, and another 486 patients, bedded in up to 100 surrounding tents. Each tent held four patients on grass beds, with one blanket per tent, invariably seized by the strongest patient. Five surgeons and convict-nurses provided meagre treatment as patients, most covered with filth, vermin, and suffering “scurvy, fevers, violent purging, and flux”, treated each other brutally.

Rations of bread or balled flour and water for dying convict patients were seized by others, who argued food was useless to those who were dying anyway. Mortality was almost 10 per cent of the colonial population, while medical staff were also required to witness frequent public floggings of up to 500 lashes.

Portrait of NSW Governor Lachlan Macquarie, 1822, by Richard Read Sr.

Liberal quantities of rum likely eased physical suffering and proved lucrative for colonial entrepreneurs in the delay between first governor Arthur Phillip’s departure in 1792 and his successor John Hunter’s arrival in 1795.

Government was then effectively run by senior corps officers Major Francis Grose, followed by Captain William Paterson, who allowed poorly paid subordinates to boost their pay through trade and speculation on necessities.

As the product in highest demand, rum became a defacto currency. Whenever ships arrived with a cargo of rum, the spirit was divided between officers according to rank, at the government cost price of about 3s 3d a gallon, to retail at 40s to 50s a gallon. Although unable to curtail the rum trade, Hunter demolished then had the colonial hospital re-erected on a stone foundation near the present Argyle Cut. Governor Philip Gidley King upgraded the hospital and increased medical salaries before Macquarie arrived in December, 1809.

State Parliament House in Macquarie Street, Sydney, 2000, was formerly the north wing of the Rum Hospital.

Macquarie advised British Minister for the Colonies Viscount Castlereagh in March 1810 that a new hospital was an “absolute necessity” as the present one was in “a most ruinous state, and very unfit for the reception of the sick”, which averaged 70 to 80 men, women and children. Refused funding from Britain, Macquarie negotiated a building contract. Blaxcell was active in the rebellion against Governor William Bligh, when he was appointed magistrate and became the colony’s sole auctioneer. As one of Sydney’s richest merchants, he had a farm at Petersham, a windmill at Pyrmont, a warehouse in George St, and a “fine house”.

Riley, who migrated in June 1804, became friendly with Paterson, who also supported the insurrection against Bligh. Granted land near Liverpool, he launched a trading business with spirit importer Richard Jones in 1815, helped by Riley’s brother Edward in Calcutta.

The Mint in Macquarie St, Sydney, which was once the south wing of the Rum Hospital.

Wentworth had arrived in NSW in 1790 with meagre professional qualifications but experience in London hospitals. After assisting in medical duties he was officially appointed to the colonial medical staff in 1796. Seniority secured his appointment as principal surgeon, when he was also a magistrate and police superintendent.

Although Wentworth oversaw medical staff treating the infirmary’s first 40 patients, assistant surgeon William Redfern made daily rounds from 8am to noon, when a poorly educated convict clerk noted prescriptions. Female nurses often came on duty intoxicated, despite frequent punishments, while convict constables patrolled to stop patients escaping over the 2m hospital wall.

Three wards in use until 1819 were soon overcrowded, holding up to 120 patients, while an oversight in providing a mortuary meant one kitchen was converted to a “deadhouse”. The other kitchen housed the overseer and attendant, leaving patients to cook for themselves in the wards.

Medications were often given to the wrong patients. A patient suffering brain fever had “2lb of blood removed in the morning and 3lb in the evening; he was then allowed to get up, and died”.

And despite the apparently generous rum deal, Riley’s losses on the contract left him disillusioned with business, while Blaxcell fled in April 1817 owing £1000 and £2385 in government import duties. His death at Batavia in October 1817 was apparently “hastened by drink”.

Originally published as Australia’s first hospital, completed 200 years ago, was a pragmatic deal between politicians and opportunistic rum-dealers