Specialisation, whether in separate hospitals or separate departments within general hospitals, became a feature of New Zealand hospital care in the 20th century. An important exception was psychiatric hospitals, which were administered separately from the beginning.
In the 19th century spas were credited with curing all sorts of bodily ailments and problems. Men suffering from ‘sexual impotence’ took to the waters, as did people suffering from ‘congestions of various “viscera” [internal organs]’ and those hoping to ‘reduce plethora [excess of bodily fluids] and corpulency [obesity] without prostration’.1 Another reputed therapeutic benefit was reducing craving for alcohol.
Rotorua was famed for the general therapeutic value of its geothermal springs. A sanatorium accommodating 12 patients was established there in 1885. A second, larger, one opened in 1891. In 1901 the Department of Tourist and Health Resorts took responsibility for the institution and a government balneologist (specialist in the therapeutic use of baths) was appointed in 1902.
Spa treatment of arthritis was provided in the late 1930s, and the complex became a convalescent hospital for wounded servicemen during the Second World War. Non-servicemen were also treated from 1948 for arthritis, rheumatism and other locomotor (movement) disorders.
A new purpose-built hospital (the Queen Elizabeth Hospital) was founded in 1966. Administration of the hospital was transferred from the Health Department to the Waikato Hospital Board in 1968. In the 2010s it was privately owned by QE Health. It still catered for locomotor illnesses, though modern medicines now complemented the use of local springs.
Tuberculosis patients often remained in open-air sanatoriums for months. A brochure about a Central Otago sanatorium published in 1928 said: ‘It would be hard to find a happier, more healthy looking lot of men and women than those at Waipiata. The high percentage of sunshine and the cheerful surroundings appear to work wonders with the patients, and it is not easy to realise that they are [there] to have their health restored. With their sunburnt faces and well nourished bodies they look to be in perfect physical condition. A happy band of holiday-makers is the impression they create.’2 There was no mention of the dead and dying patients.
In the late 19th century tuberculosis was a major killer of Pākeha New Zealanders, accounting for 10% of all deaths. Māori were even more vulnerable; by the 1930s their tuberculosis death rates were probably 10 times those of non-Māori.
In 1903 the Department of Public Health established Te Waikato, a sanatorium near Cambridge for the treatment of tuberculosis. It was open until 1922. Te Waikato provided open-air treatment, which consisted of fresh air, sunlight, exercise and good food.
Other sanatoriums were set up by hospital boards. By 1910 Wellington, North Canterbury and Otago all had sanatoriums. From 1908 Auckland Hospital Board provided accommodation for tuberculosis patients at the Costley Home (later Green Lane Hospital). Other hospitals also set up annexes to accommodate tuberculosis patients, and in the 1920s two further open-air sanatoriums were established in Hawke’s Bay and Otago.
By the 1930s enthusiasm for this form of treatment waned in New Zealand (as elsewhere). It was replaced by surgery, albeit with little more success. Surgery was quickly abandoned once effective anti-tuberculosis drugs appeared (the first, streptomycin, was discovered in 1942). In the 1960s sanatoriums were closed or converted to other uses.
During the 20th century hospitals developed and specialised. For example, Costley Home grew from a home for the aged poor into Green Lane Hospital, where highly technical surgery was carried out. It opened in 1890 and an infirmary ward was added in 1907. The following year tuberculosis patients were admitted and from 1914 shelters for open-air treatment of tuberculosis patients were erected. The home was renamed the Auckland Infirmary in 1924. It catered for geriatric, chronically ill (including cancer patients) and tuberculosis cases. In the 1930s it became a centre for the surgical treatment of tuberculosis.
During the Second World War the infirmary was used for general medical and surgical cases, and it was renamed Green Lane Hospital in 1942. About the same time the hospital’s surgeons expanded their work from treating tuberculosis to heart disease.
Under the guidance of surgeons Douglas Robb and Brian Barratt-Boyes, Green Lane became an internationally recognised cardiothoracic surgical centre. The first open-heart surgery in New Zealand took place at Green Lane in 1958, and the first heart transplant in 1987 (20 years after the first ever transplant). In the early 21st century the hospital became the Greenlane Clinical Centre, focused on outpatients and day surgery.