Paediatrics in New South Wales, 1945 TO 1965

Paediatrics became a viable medical specialty in Australia and New South Wales between 1945 and 1965. Paediatricians took possession of occupational spaces previously claimed by other medical groups and created their own new spaces. They argued that children were still growing and differed physically and emotionally from adults. Their special needs warranted the formation of a new division in medicine. Paediatricians adopted the new knowledge, technology and therapeutics that became available in the post-war period and demonstrated that they were capable of following the scientific medicine paradigm, the prevailing standard in internal medicine. Access to the children's hospital was essential for paediatricians as a workshop for their professional development, to treat their seriously ill patients, to support their claims for occupational space and for their authority and status as specialists in medicine.. Scientific medicine demanded more of the time of the paediatricians and in RAHC they elected to continue working in an honorary capacity. In another children's hospital, RCH in Melbourne, paediatricians were employed in a version of the full-time system. The different approaches to staffing illustrate the conflicts of interest found in specialty development in Australia and the pervasive influence of medico-political issues. As members of a privileged autonomous profession paediatricians in RAHC owed a duty to the people of NSW, and in their honorary positions, to the hospital. They had responsibilities to their patients, both private and public. They were committed to their own professional development and they had to make a living in private practice. By retaining the honorary system paediatricians in RAHC were obliged to give priority to their interests outside the hospital so that scientific medicine expanded only slowly. In RCH service development and research were enhanced because the conflicts of interest were reduced and paediatricians could devote more of their time to the hospital without compromising their other roles. The development of a new specialty required the acquisition by members of professional power, authority and status. This process was assisted by the formation of a professional association, but paediatricians had difficulty in creating an independent body that they controlled. For professional authority and status paediatricians in RAHC were strongly dependent on maintaining their dominant position in the hierarchy of the hospital. Although children were central to the development of paediatrics, their place at the bottom of the institutional hierarchy meant they were disempowered and unable to influence the development of the specialty.PhD Doctorat