07/08/2026
"...an office which the Otago community have never ceased protesting against as needless, extravagant, and objectional in the extreme, as having a tendency to encourage and foster pauperism." Otago Witness, 16 April 1853 about the newly installed Dunedin Hospital.
As we await our new hospital (with, now three cranes!) it might be a good time to look back on Dunedin's very first hospital. But why did the Scottish settlers in Dunedin not want a hospital? To really understand, we have to go back a bit. Okay, a long bit.
The bubonic plague took place around the mid 14thC and killed roughly 40 to 60% of the population in England alone. At its lowest point, the population was 1.9 million until the 16thC it began to recover but a population boom is never without its problems and one of those problems was poverty. But why? (Is this relevant to the Dunedin hospital? Yes, hang in there!)
The population in 1530 rose to 3 million and by 1600 it was at 4 million. The rising population put pressure on resources, demand goes up, prices go up and the people just can't keep up.
Farming changed. Land owners closed in land that the villagers had used to graze animals and they chose large scale sheep farming instead of tenants.
1590s saw a series of bad wheat harvests due to the mini ice age.
Inflation - prices rose but wages stayed the same or fell but because the population increase, workers had little to no bargaining power.
Taxes increased. Wool demand dropped.
Henry VIII (8th) closed and looted the monasteries between 1536 and 1541 to fund his expensive war habit and to eliminate the opposition after he broke away from the Roman Catholic Church. He then made himself the head of the Church of England (which, no coincidence, allowed divorces). The monks and nuns had largely been responsible for charity - they provided food, clothing and shelter for the poor but now they were the poor, with no support.
All of this lead to a dire amount of poverty and something needed to be done. Enter, The Poor Laws. The next twenty years saw various laws written to look after the different types of poor people - impotent poor were aged, infirm and generally incapable of looking after themselves, they went into Poor Houses. The able bodied poor went into Work Houses and the rogues and vagabonds went into, effectively, prisons.
These houses were purposefully made to be disgusting, inhuman places so that people would only choose them as a last resort. And gradually over the various changes to The Poor Laws, they were funded by a compulsory tax and driven by austerity. By the 19thC, charity, where it once was a normal part of looking after society, was stigmatised. There was a deep shame in being poor and relying on government benefits.
Now to the hospitals.
In mid 19thC Britain there were two types of hospitals. Voluntary and variations on Work and Poor Houses. Voluntary hospitals were institutions that were funded by laymen. Doctors would work in them for free, giving them status and importance but would have private practices on the side for those who could pay for visits in their own homes which was preferable. They became places of research as well as benevolence; installing fever, eye, children and maternity wards. Prayers were part of the treatment in voluntary hospitals - to God but also to the benefactors who then had the privilege to nominate who could be admitted. Power corrupts, however and they began excluding particular aliments that seemed icky to them - namely maternity, venereal and infectious diseases.
The second type of hospital was for the 'sick poor' - people too poor to pay for the doctors in private practice. Attendants were untrained and provided a low standard of care. An importance was placed more on treating the symptoms rather than curing disease. They were filthy places that should be avoided at any cost but that was the point. The work houses and poor houses eventually became hospitals through the Poor Law system. By 1850 it was found necessary to appoint resident staff at these institutions and by 1861 the work and poor houses contained over 80% of the hospital beds in England and Wales.
So, when Governor Grey floated the idea of a hospital in the new settlement of Otago, the settlers weren't thrilled. Settlers who had been arriving on a boat who were unwell would be treated in wooden buildings at the harbour by New Zealand Company staff but the expectation afterwards was they would pay for their healthcare through private practices. They didn't see the need for a hospital because they were not going to have poverty in their settlement. This is what they were escaping. But Governor Grey gave Otago £400 in 1850 and the hospital was to serve the poor but mainly intended for Māori who were suffering from the introduced diseases (namely the measles and tuberculosis) and were promised equitable healthcare under the Treaty. The hospital was built in The Octagon where the Town Hall is now and was up and running by 1852.
However, the Central Government refused to financially support this hospital as did the Provincial Government - the Provincial Government even allowed the new Chief Constable and his family to live in it in 1855 which severely limited space for actual patients. Luckily, the majority of patients paid their own way during this time and the next Governor, Thomas Browne, paid for the Māori patients out of his own pocket.
By 1856, The Provincial Government succumbed to pressure and began to fund their hospital themselves and they hired a Provincial Surgeon - Robert Williams. He clashed politically with William Cargill, Otago's superintendent so he was replaced with Edward Hulme, a very experienced and skilled doctor although still British who the Scottish Cargill referred to as "the little enemy". Hulme took the hospital from strength to strength until his death in 1867.
That's long enough for now. Stay tuned for part two and find out what The Octagon hospital was like and why it isn't there anymore.
Pictures from The Otago Hospital Board And Its Predecessors by John Angus
