Hospitals have changed from basic buildings offering limited and risky health care, which few entered by choice, to large complexes offering a wide range of usually effective services and treatments. The changing cost of establishing hospitals reflects this transformation – Auckland’s first public hospital (1847) cost less than £1,100 (about $100,000 in 2003 terms) to construct, compared to $447 million for the city’s new hospital in 2003.
The Gables building in New Plymouth’s Pukekura Park is the only one of the four hospitals established by Governor George Grey still standing (the others were in Auckland, Wellington and Whanganui). Built in 1848, it was relocated to its present site in 1904. The hospital was made tapu in 1854 after Te Āti Awa chief Rāwiri Waiaua died there – it is still a sacred place for this reason.
The first hospitals
The first public hospitals were set up shortly after New Zealand was settled by European immigrants – in Wellington and Auckland in 1847, New Plymouth in 1848 and Dunedin and Whanganui in 1851. Christchurch followed in 1862.
These hospitals were established to treat poor European people – most had to pay, but the very poor (and Māori) were treated for free. Other than those in Dunedin and Christchurch, the hospitals were all established by Governor George Grey, who believed that they would help introduce Māori to European culture and lifestyle. It was assumed that there would be little demand for hospitals by Europeans – most immigrants would be young and fit and sick people would be treated at home. The Destitute Persons Ordinance 1846 placed responsibility for the sick and destitute on the family. From 1885 public hospitals were run by charitable aid trusts.
Auckland’s hospital was on the tourist trail for 19th-century English visitor Annie Butler. In her book Glimpses of Maori land (1886) she wrote: ‘We had not been long at Auckland before we found our way up to the Hospital; and very much we enjoyed our visit. It is well worth seeing; is, like the Post Office, quite worthy of a place in London. And what would a London hospital committee give for the view which it commands?’1
Impact of gold rushes
Many hospitals were opened in the South Island during the gold rushes of the 1860s. Fourteen, mostly small, hospitals were set up on the goldfields, mainly to accommodate accident cases. By the 1890s those hospitals still in existence were filled with elderly male patients with nowhere else to go. They provided these men with food, warmth and a clean bed. In 1889 the inspector-general of hospitals, Dr Duncan MacGregor, said that the West Coast hospitals were little more than refuges for ‘old broken-down miners’.2 Nevertheless, local communities had a sense of civic pride in their hospitals, which were seen as a symbol of civilisation.