|Description of this FunctionDescription of this Function|
Medical Establishment and Public Hospitals 1837-1854
The earliest manifestations of the public health function in Victoria occurred with the appointment of an Assistant Colonial Surgeon in 1837 and the establishment of the first public hospital in 1839. Between 1837 and 1854 the medical establishment grew considerably to comprise a Chief Medical Officer, district surgeons to the police and gaols, medical staff at Pentridge and at hospitals on the goldfields, a dispenser, and a health officer at Queenscliff. A temporary seven bed hospital and dispensary provided the only facilities until the establishment of a small general hospital in Melbourne in 1841. The hospital initially occupied a rented cottage until building was completed in Lonsdale Street in 1848. Hospitals were later established on the goldfields at Castlemaine, Sandhurst and Ballarat (The Australian Encyclopaedia, Volume V, p.2; see also Historical Records of Victoria, Volume 3).
The medical establishment and public hospitals were primarily concerned with providing medical services to Government employees (police, military, Gold Commissioners) as well as to people under Government care (such as immigrants, prisoners, lunatics). The Chief Medical Officers Health Report for the half year ending 30 June 1854 indicates that the medical establishment in Melbourne was responsible for immigrants from the time of their landing until they left the Immigration Depot and for the police and the officers and prisoners in the gaols and stockades. The immigrants were attended by the Chief Medical Officer and the more serious cases were taken to the Colonial Hospital at Batman's Hill. In the seaport towns the medical officers were responsible for the health of immigrants, police, military and prisoners and on the goldfields they were responsible for police, military, gold commission and prisoners (see Votes and Proceedings of the Legislative Council, Session 1854-5, Volume 2, p.89).
Concern for the prevention of infectious and contagious disease appears to have initially been handled by regulation of vessels entering Port Phillip (see the quarantine function).
Patrick Edward Cussen was appointed as Assistant Colonial Surgeon for Port Phillip in September 1837. By 1848 Cussen had been appointed Colonial Surgeon. Following separation from New South Wales in 1851, the civil establishment for the Medical Department, which was responsible to the Colonial Secretary (VRG 16), included the Colonial Surgeon, Melbourne who was also Surgeon to the Gaol and Surgeon to the Lunatic Asylum, the District Surgeon, Geelong, a Dispenser and the Superintendent and staff of the Lunatic Asylum (VA 2839). By 1852 following the discovery of gold, the civil establishment of the Medical Department had expanded to include the Colonial Surgeon, a Health Officer, Dispenser, Surgeon to Police and Watchhouses, three Assistant Colonial Surgeons in Melbourne and three others for Geelong, Williamstown and Ovens. Other staff were also located at Mt. Alexander, Bendigo and Ovens. By 1854 the civil establishment included a Chief Medical Officer, District Surgeons to Police and to Gaols and at Williamstown, Geelong, Portland, Belfast, Castlemaine, Sandhurst, Ballarat, Avoca, Beechworth, Kyneton and Kilmore and other staff based at Pentridge and at the hospitals established on the goldfields at Castlemaine, Sandhurst and Ballarat. There was also a Secretary to the Medical Board and Dispenser, a Medical Officer at Waranga and a Health Officer at Queenscliff.
Diverse Public Health Legislation 1854-1865
Control of Infectious Disease and Regulation of Noxious Trades
The Central Board of Health was established in 1854 under the provisions of An Act for Promoting Public Health in Populous Places in the Colony of Victoria (18 Vic., No.13). The Act also provided for the establishment of local boards of health which were to exercise joint responsibility for public health. The provisions were taken verbatim from an Imperial Act of 1848. The President and members of the Central Board were appointed on 21 February 1855. Under the Act the Central Board of Health and the local boards were required to make provision for the prevention, containment and treatment of infectious and contagious diseases; for the construction and maintenance of adequate drains and sewers; for the regulation of noxious trades; for the cleansing of streets and public ways and places and for the maintenance of adequate standards of sanitation and ventilation in both public and premises. No new hospital for the reception of patients suffering from a contagious or infectious disease was to be opened without the approval of the Central Board of Health and the appropriate local board and the Central Board could authorise the dispensing of medicines and the provision of medical aid to persons afflicted by or threatened by epidemic diseases. Local board officers were also empowered to seize unwholesome food from manufacturers and vendors and to bring the offenders before a Justice of the Peace.
Local boards were required to report every three months to the Central Board on the health, cleanliness and general sanitary state of the district for which they were responsible and each report was to be accompanied either by a certificate from the health officer stating that no epidemic, endemic or contagious disease had appeared or a report as to the progress or decrease of such a disease, including the number of deaths and the class of persons suffering from any particular disorder. The Central Board was required to make recommendations for the control of any epidemic disease and local boards were required to notify the Central Board immediately such a disease became evident.
Regulation of Common Lodging Houses
Under the provisions of An Act for the well ordering of Common Lodging Houses in the Colony of Victoria 1854 (18 Vic., No.8), local authorities were empowered to establish and enforce standards for the cleanliness, condition and conduct of common lodging houses. All such premises were to be registered with the local authority which was required to maintain a register. Under the provisions of the Public Health Act 1854, the Central Board of Health was empowered to regulate the number of inmates and occupants permissable in a lodging house or public building.
Compulsory vaccination of all children born after 1 January 1840 was required under the provisions of An Act to make compulsory the Practice of Vaccination 1854 (18 Vic., No.4). Medical Officers were to issue certificates affirming successful vaccination and parents were required to lodge the certificates with the local Registrar of Births, Deaths and Marriages. Registration of vaccination certificates later became a responsibility of the Registrar General (VA 2889). The Act required the Registrars to notify parents of the requirement to have their children vaccinated and parents who failed to do so could be fined. Medical Officers were not permitted to charge fees for the provision of this service.
Pollution of the River Yarra
From 1855, with the passing of An Act to prevent the further pollution of the waters of the river Yarra Yarra above the city of Melbourne 1854 (18 Vic., No.36), no new unwholesome trades or businesses could be established on the banks of the Yarra River above Melbourne.
Adulteration of Food or Drink
Requirements for the manufacture and sale of articles of food and drink which included medical drugs and items usually taken or sold as medicines became more stringent with the passing of An Act to prevent the Adulteration of Articles of Food or Drink 1863 (27 Vic., No.177).
Consolidation of Public Health Legislation 1865
In 1865, previous legislation regarding public health, vaccination, quarantine, pollution of the Yarra River, common lodging houses and the adulteration of food and drink was consolidated in the Public Health Statute 1865 (28 Vic., No.264). The Central Board of Health and the local boards continued to be responsible for the administration of all aspects of public health.
New Aspects of Public Health 1867 to 1890
Much of the subsequent legislation concerning public health simply increased or amended the powers of the Central Board of Health and the local authorities with regard to the administration of aspects of public health for which they had previously been responsible. However some of the legislation gave the boards responsibility for new aspects of public health.
From 1867, under the provisions of the Public Health Amendment Act, (No.310) persons wishing to open or extend any hospital, public building or place of amusement were required to notify the Central Board of Health and the local board and to submit a plan showing the proposed mode of construction, drainage and ventilation. No such building could be built or opened without the written approval of the Central Board of Health. The officers of the boards were also empowered to inspect such premises and to order work to be undertaken to improve the ventilation, drainage, entrances and exits and appliances for the extinction of fires. These requirements and the definition of buildings subject to regulation by the Central Board of Health were extended under the provisions of the Public Health Amendment Act 1883 (No.782).
From 1876 under sections 18 and 19 of the Public Health Amendment Act (No.524) which were re-enactments of an 1875 Imperial Act (38 and 39 Vic., C55), local boards were empowered to provide hospitals for the reception of the sick. The boards could establish the hospitals alone or combine with other boards to do so. Alternatively they could contract the use of an existing hospital or enter into an agreement with the management of an existing hospital to provide the required services. Managers of hospitals receiving aid from the State could be required by the Central Board of Health to enter into such an agreement with a local board. The costs of treatment were to be recovered from the patient or from his/her estate. The Public Health Act 1889 empowered the central authorities to establish hospitals where local authorities failed to do so.
Infant Life Protection
With the proclamation of the Public Health Amendment Act 1883 No.782, part III of which was a re-enactment of an Imperial Act 36 and 36 Vic., c38, 1872, local boards became responsible for the registration of premises and persons, other than parents, relatives or guardians, who were responsible for the care of infants. The boards were to maintain a register of premises and persons approved and those responsible were to keep a register of infants in their care and to notify the coroner or a justice of the peace of the death of a child.
Under the provisions of the Infant Life Protection Act 1980 the Chief Commissioner of Police was vested in 1890 with reponsibility for the registration of homes used for the purpose of nursing, maintaining and adopting infants. In 1907 a subsequent Infant Life Protection Act 1907 transferred responsibility for this function to the Department for Neglected Children, later known as the Children's Welfare Department (VA 1467) in the Chief Secretary's Department (VA 475).
The powers and responsibilities of the Central Board of Health and the local boards were further amended by the Public Health Act 1888 (No.1101).
, M.D. was appointed President and Captain Clarke and Richard Youl M.D. were appointed as members of the Board. McCrea was the Chief Medical Officer of the colony. The Board was to consist of from three to five persons and to be responsible for the execution of the Public Health Act. Subject to the approval of the Lieutenant Governor, the Board was to appoint a secretary, superintending inspectors and such other officers as were deemed necessary. The members and staff of the Central Board of Health were located in the Colonial Secretary's Office (VA 856) until 1855 and then in the Chief Secretary's Department (VA 475).
The Corporations of the City of Melbourne and of the town of Geelong and the councils of any municipal district were to constitute the Local Boards within their respective districts. Elsewhere the Lieutenant Governor was empowered to appoint persons to form a local board. The municipalities had also been given responsibility for the maintenance of public health under the provisions of such legislation as the Town and Country Police Act 18 Vic., No.14 (1854) and there is evidence that at least initially, some local authorities and in particular the City of Melbourne were reluctant to recognize the authority of the Central Board of Health. (See Report of the Central Board of Health 1856 in Votes and Proceedings of the Legislative Council, Session 1855-56, Volume 2, p.203.)
Appointment of Minister of Health, Establishment of Board of Public Health and Department of Public Health 1890
In 1890 following a Royal Commission to inquire into and report upon the Sanitary Condition of Melbourne (see Papers Presented to Parliament Volumes 2 and 4 1889 and Volume 2 1890), there were substantial changes to the administration of health in Victoria.
Following the proclamation of the Public Health Act 1889 (No.1044), the Chief Secretary, Alfred Deakin, was appointed Minister of Health (without salary) on 29 January 1890. The Central Board of Health was abolished and replaced by the Board of Public Health which was to be responsible for implementing and enforcing the provisions of the Public Health Acts 1865-1889. The Board consisted of a Chairman, the medical inspector and seven representatives to be elected by the councils of municipal districts. Charles Alfred Topp was appointed Chairman of the Board of Public Health from 31 January 1890.
The Chairman of the Board was appointed by the Governor in Council and subject to the provisions of the Public Service Act 1883. The Chairman was also to be the permanent head of the newly established Department of Public Health (VA 2904). The Act also provided for the appointment of a medical inspector who was to be a legally qualified medical practitioner and an expert in sanitary science and whose appointment was not subject to the provisions of the Public Service Act. The Act further authorised the appointment of "an engineering inspector, a secretary and such other inspectors, health officers, clerks and officers as may be deemed necessary", all of whom were to be members of the Public Service. Officers previously employed under the control of the Central Board of Health were transferred to the new Department of Public Health and were responsible to the Board of Public Health.
Existing local boards of health were abolished and the powers,duties and liabilities previously vested in the boards were to be vested in and executed by the municipal councils. Officers, inspectors, analysts and staff of the local boards became employees of municipal councils. The Minister was empowered to require the Board and local authorities to make certain regulations and by-laws and the Board could require local councils to appoint health officers, inspectors and analysts.
The Public Health Act 1889 (No.1044) also contained further provisions regarding the preparation and sale of adulterated and unwholesome food; prevention and control of infectious diseases including compulsory hospitalisation; quarantine; regulation of offensive trades and abattoirs etc.; drainage and sewerage; sanitation including waste collection and disposal; and regulation of common lodging houses; dwelling houses and streets. The Act also enabled the Chairman, at the direction of the Board, to establish hospitals where local authorities failed to do so and the Board was empowered to recover its costs from the local councils. The Act further provided that councils which established district hospitals could seek reimbursement of fifty percent of their costs from consolidated revenue.
Registration of Hospitals
The Public Health Act 1889 empowered the Governor in Council to make regulations for the registration, inspection, drainage, good management and sanitary regulation of all hospitals and institutions which provided for the medical or surgical treatment and care of patients and which were not in receipt of aid from the State. The Board of Public Health and its officers were responsible for the enforcement of these regulations.
Establishment of Commission of Public Health 1920
In 1920, under the provisions of the Health Act 1919 (No.3041) the Board of Public Health was abolished and replaced by the Commission of Public Health (VA 694) which was to consist of seven members being the Chief Health Officer (formerly the Medical Inspector) who was to be Chairman and six members to be appointed by the Governor in Council of whom not more than two were to be medical practitioners and of whom three were to be representatives of metropolitan municipalities, non metropolitan cities, towns and boroughs and non metropolitan shires respectively.
The Commission was to be responsible for the promotion of public health and for the implementation and enforcement of the provisions of the Health Act. In addition to the public health responsibilities inherited from the Board of Public Health, the Commission was to promote the prevention and suppression of infectious and preventable diseases; to advise the Minister on matters of public health; to carry out research and investigations, publish reports and hold inquiries into matters concerning public health and the prevention and treatment of disease; to advise and assist councils in regard to matters affecting public health and to prepare model by-laws for adoption by councils.
The Act provided for the appointment of a Chief Health Officer who was to be the permanent head of the Department of Public Health (VA 2904) and for the appointment of District Health Officers who were to be responsible to the Commission. As with previous legislation responsibility for the administration of the Health Act was shared between the Commission, the Department of Public Health (VA 2904) and local authorities.
Major Re-organisation of Health Services 1944
In 1890 when responsibility for public health was transferred to the Minister of Health, the Chief Secretary (VRG 26) had remained responsible for the administration of mental health and hospitals and charities. The latter became the responsibility of the Treasurer (VRG 23) in 1923. In 1944, with the proclamation of the Ministry of Health Act 1943 No.4988, responsibility for all health services was transferred to the Minister of Health and a Department of Health (VA 695) was established.
Under the provisions of section 3 of the Act, the Department of Health was to consist of the Minister of Health, a Secretary to the Department, a Chief Health Officer and a Director of Mental Hygiene and such other officers as were deemed necessary. The Secretary was to be the permanent head of the department for the purposes of the Public Service Act; the Chief Health Officer was to be a medical practitioner and an expert in sanitary science and to have control of the General Health Branch and the Director of Mental Hygiene was to be a medical practitioner and an expert in psychiatry and to have control of the Mental Hygiene Branch. The Chief Health Officer and the Director of Mental Hygiene retained their right of direct access to the Minister on matters affecting the branches for which they were responsible.
Under the provisions of section 5 of the Act, the Minister was to be responsible for the effective carrying out and co-ordination of measures conducive to the health of the people, including measures for:
(a) the prevention and cure of diseases and the avoidance of fraud in connexion with alleged remedies therefor;
(b) the treatment of physical defects and mental diseases and disorders;
(c) the training of persons for health services;
(d) the control, care and treatment of mental defectives and of epileptics; and
(e) the initiation and direction of research and the collection, preparation, publication and dissemination of information and statistics ...
The Act provided for the establishment of a General Health Branch and a Mental Hygiene Branch and for the establishment of new branches by order of the Governor-in-Council. On the recommendation of the Public Service Board, officers and employees of other departments previously responsible for functions to be transferred to the Department of Health, were transferred to corresponding offices and positions within that Department.
The Minister of Health became immediately responsible for the administration of the following legislation: Health Acts, Cemeteries Act, Part V of the Goods Act 1928 (in so far as it related to goods being, or used in the preparation of, food, drink, medicine or medicinal preparations for human consumption), Infectious Diseases Hospital Acts, Masseurs Acts, Midwives Act 1928, Nurses Acts, Venereal Diseases Act 1928, Heatherton Sanatorium Act 1916, Births Notification Acts, Hairdressers Registration Acts, Anti-Cancer Council Act 1936 and the Dietitians Registration Act 1942.
Transfer of functions to the Minister of Health/Department of Health
The Ministry of Health Act 1943 provided for the transfer of functions and responsibilities from a number of other departments and ministers to the Minister of Health and Department of Health (VA 695) in 1944.
Responsibility for the following functions was transferred from the Chief Secretary (VRG 26), the Chief Secretary's Department (VA 475) and the Department of Mental Hygiene (VA 2865) (located in the Chief Secretary's Department):
Mental health, including the care and treatment of the mentally ill, the mentally deficient and alcoholics and the administration of public and mental institutions under the provisions of the Mental Hygiene Acts, the Mental Deficiency Act 1939 and the Inebriates Acts.
Government Medical Services including medical treatment of infants, children and wards of the Children's Welfare Department and the department of reformatory schools and medical treatment of prisoners and members of the Police Force under the provisions of the Children's Welfare Acts, Crimes Acts, Gaols Act 1928 and the Police Regulation Acts.
Regulation and registration of health care professionals such as doctors, dentists, pharmacists and opticians under the provisions of the Medical Acts, Opticians Registration Act 1935 and the Workers Compensation Acts so far as the latter Acts related to certifying medical practitioners and medical referees.
Regulation of the preparation, sale and use of poisons and narcotic substances under the provisions of the Poisons Acts.
From the Treasurer (VRG 23) and the Charities Board of Victoria (VA 2707) the Minister of Health/Department of Health, assumed responsibility for Hospitals and Charities and the Talbot Colony for Epileptics and from the Minister of Public Instruction (VRG 35) and the Education Department (VA 714) responsibility for the provision of school medical and dental services under the provisions of the Education Act 1928.
Establishment of Maternal and Child Hygiene Branch
In June 1944, the Maternal and Child Hygiene Branch of the Department of Health was established. The Branch was to be responsible for pre-natal hygiene, pre-school children, the medical treatment of children, infants and wards of the Children's Welfare Department, School Medical and Dental Services and the Children's Court Clinic. Responsibility for infant welfare was transferred from the General Health Branch of the Department and responsibility for the Child Psychiatric Clinic was transferred from the Mental Hygiene Branch. (See Order in Council, Government Gazette, 28 June 1944, p.1604.)
In 1971 responsibility for the funding of Children's Homes was assumed by the Social Welfare Department (VA 946) and in 1976 the Minister of Special Education (VRG 35) and the Education Department (VA 714) became responsible for day training centres which provided for the non residential care and education of children with severe intellectual disabilities.
Throughout the period 1944 to 1978, several statutory authorities continued to be responsible for the development of policy and the administration and provision of health services in conjunction with the Minister of Health and the Department of Health (VA 695). These were the:
Commission of Public Health (VA 694) 1920-1978
Mental Hygiene Authority (VA 2838) 1952-1962
Mental Health Authority (VA 692) 1962-1978
Charities Board of Victoria (VA 2707) 1922-1948
Hospitals and Charities Commission (VA 693) 1948-1978.
In 1978, following the proclamation of the Health Commission Act 1977 (No.9023), the Health Commission of Victoria was established in accordance with the recommendations of the Committee of Inquiry into Hospital and Health Services in Victoria, whose report had been presented to the Minister of Health in July 1975.
The establishment of the Health Commission represented a major re-organisation of health services in Victoria and for the first time responsibility for the central administration of health services rested with a single agency. The Health Commission assumed responsibility for all functions previously administered by the Department of Health I (VA 695), the Mental Health Authority (VA 692), the Commission of Public Health (VA 694) and the Hospitals and Charities Commission (VA 693).
Municipalities (VRG 12) continued to have a significant role in the provision of health services.
Establishment and Functions of the Health Commission of Victoria
The Health Commission was responsible for the supervision, maintenance and co-ordination of health services in Victoria and for the administration of the Health Acts and related legislation. Under Section 3 of the Health Commission Act, health services were defined as including medical, hospital and nursing services; preventive health services, therapeutical services, dental services, pharmaceutical services, ambulance services, community health services, health education services, services for the care of pre-school children and welfare services necessary to complement the latter.
Under the provisions of section 7 of the Act, the Commission was to be responsible for the provision of health services and the necessary buildings and facilities; providing advice and assistance to councils in relation to matters concerning health services; the training of persons employed or engaged in the provision of health services; programmes for the rehabilitation of handicapped or disabled persons; provision of domiciliary health services; provision of medical and scientific research services in relation to health and health care; and the publication of information concerning health services, the health of the public and matters affecting health.
The Health Commission Act 1977 also provided for the establishment of the Health Advisory Council and the appointment of Consultative Councils. Under the provisions of the Public Service Act 1974, the Chairman of the Health Commission became the permanent head of the Health Department and the Health Commission Act provided for the transfer of the medical officers of the Mental Hygiene Branch (VA 2866) and the staff of the Hospitals and Charities Commission (VA 693) to the Public Service.
The responsibilities of the Health Commission were initially administered by three line divisions of Public Health, Hospitals and Mental Health. In 1981 a Mental Retardation Division was established.
Responsibilities of the Divisions of the Health Commission
Functions for which this division was responsible include:
the control and prevention of infectious and contagious diseases
administration of a communicable diseases centre dealing with sexually transmitted and infectious diseases and providing diagnostic, therapeutic, advisory and epidemiological services
maternal and child health care services including infant welfare, early childhood development, family planning, visiting child health nurses, pre-schools and school medical and dental treatment
community health services including services to youth, women and the disabled, rehabilitation and geriatric services, aboriginal and migrant health services, domiciliary care, nursing, and paramedical services
occupational health and safety including monitoring and investigating levels of metal, chemical and pesticide pollution and other health hazards in the workplace
medical assessment and occupational health services to government employees
medical and paramedical services to prisoners and those in the custody of institutions of correction
establishing and enforcing proper standards of sanitation including waste disposal and the prevention of pollution
administering land waste management functions delegated to the Commission by the Environment Protection Authority (E.P.A.)
establishing and enforcing standards for public buildings
regulation of offensive and dangerous trades
regulation of the manufacture, storage, distribution and sale of food products, proprietary and therapeutic medicines
registration of health care professionals
registration of masseurs, tattooists, chiropodists, cinematograph operators, plumbers and gasfitters
Establishment of Department of Health II
The Department of Health II (commonly known as the Health Department) (VA 2695) was established by Order of the Governor-in-Council under the Public Service Act 1974 on 26 August 1985. The powers and responsibilities of the Health Commission of Victoria (VA 652) and its Chairman were vested in the Department of Health and its Chief General Manager.
Functions of the Department of Health II
The schedule to the Order-in-Council designated the functions of the Department of Health II as being:
1. To provide advice to the Minister on:
the factors that affect the health of the people of Victoria and the need for health services, and
the development, provision, management and use of health services.
2.To promote the identification of the patterns and factors affecting the health of the community and the development of general strategies and programmes to improve the health of the community.
3.To protect the community against major environmental, microbiological, chemical, radiological and physical agents of disease and to promote behavioural and environmental changes conducive to health.
4.To ensure that health services of an appropriate standard and mix are provided on an equitable and accessible basis to meet the needs of the population within the context of Government policies and the optimal use of available resources.
5.To promote community participation and representation in the direction and management of health services.
6.To promote staff participation and consultation within the health sector.
7.To promote and undertake where appropriate, research for health, health services and health-related areas.
8.To develop and review policy options, plans and programmes for the health sector in consultation with operating agencies where appropriate, to co-ordinate policy development within the industry and to advise the Minister on industry plans, programmes, and institutional arrangements.
9.To develop guidelines and planning parameters to assist operating agencies in the health industry to develop plans and programmes and to provide advice to agencies.
10.To monitor and review the performance of operating agencies against a