groups and communities within Australia's scattered population has been problematic for more than a century. When modern scientific medicine was developing its present form, in the 1880s, Australia was composed of six self-governing colonies of the United Kingdom. Half of the population was dispersed in an agricultural and extractive economy supporting a few regional service towns, but commercial, financial, and governmental activities were concentrated in the seaboard capital cities. Numerous small hospitals were established by voluntary initiative in the country towns and voluntary initiative, often aware of a British model if not appealing directly to it, was responsible for a considerable part of the hospital services in the urban metropolitan areas. Dispersed voluntaryism may have worked in the United Kingdom, where landed wealth also was dispersed, but it was not adequate to the Australian situation, where hospital boards quickly fell into the habit of seeking subsidy from the colonial government for their institutions. The trouble with the subsidy was that it created political and financial obligations on governments to maintain institutions over whose establishment and expansion they had no control. The system
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