PubMed1996
Surgeon-superintendents on the convict ships transporting convicted men, women and youths to Australia played a key role in the evolution of medical standards in Australia. The British Transportation Acts of 1717 and 1825 added the punishment of exile and banishment to the prevailing penology of the era, that of retribution and deterrence. The surgeon-superintendents formed a bulwark during the sea voyages (between 88 and 258 days), protecting the convicts against the potential abuses of the time. Between 1787 and 1868, some 160 000 convicts were transported to the open air gaols at Sydney, Norfolk Island, Van Diemen's Land (Hobart, Macquarie Harbour, Maria Island and Port Arthur), Moreton Bay, Melville Island and Fremantle. Seventeen convict ships left England for Australia in 1823 alone. The surgeon-superintendent's role on the high seas evolved over this time from one of amateur casualness with a primary responsibility to the system rather than to individual convicts, to that of a highly efficient, courageous professionalism. It became a new specialty discipline in its own right. Mortality on the convict transportation voyages fell from one in three convicts embarked in 1790 to zero mortality in the convicts transported on the Sultana in 1859. The key role of the surgeon-superintendent, in the context of preventive medicine, is developed in the present paper. Historical nodes in the evolution of the new discipline of prison doctor were the 1814 Report of Redfern (himself a former convict), and the evolution from the 1820s of doctors who became the pioneers of the specialty discipline of the Prison Medical Service in Australia. The experiences and influences of surgeon-superintendents on convict transportation vessels formed the catalyst for the Passenger Act (UK) of 1855 which, for the remaining decades of the 19th century, regulated the lives of millions of immigrants to Australia and New Zealand.