John Turnpenny Altree became ill in March 1787 while the ship still lay at anchor and was unable to tend to the female convicts as they came on board.
Governor Phillip wrote to Under Secretary Nepean (London) 18 March 1787. There is a necessity for doing something for the young man who is on board that ship as surgeon or I fear that we shall lose him, and then a hundred women will be left without any assistance, several of them with child. 
John Altree was taken on shore to Ryde at the Isle of Wight to recover where he was visited several times by Lieutenant Collins and Arthur Bowes Smyth. 
VOYAGE OF THE FIRST FLEET Magnify the map above by scrolling then click on the ship icons to read accounts from First Fleet Journals. Each of the eleven ships is represented by a different colour. Enlarge the map using the icon on the top right. Select here to find out more about this map
JOHN TURNPENNY ALTREE'S SERVICE
Governor Phillip to Under Secretary Nepean (Per Dutch snow Waaksamheyd)
Sydney 21st March 1791
This will be delivered to you by Mr. John Turnpenny Altree, who came from England in theLady Penrhyntransport with the First Fleet.
During the passage out he assisted in the attendance of such convicts on board the ship as required medical treatment, and has been since that time employed at Norfolk Island by Mr. King, the late commandant, and by the Lieutenant-Governor as an assistant to the surgeon there, and in clearing and cultivating the land, in which line he conducted himself, as far as I am informed, to the satisfaction of those who employed him, until he left the island, for which services he has never received any compensation except twelve pounds, which, since his arrival here, I have directed the Commissary to pay him.
What his future views are he can best explain. He wishes to return and the character given of him by Lieutenant King and Captain Hunter inclines me to wish he may succeed. He will, I presume, be thought to merit some little recompense for the time he was on Norfok Island, and his demands will not, I believe be very great.
He was in the militia as lieutenant and surgeon's mate, and wished to be received here as a subaltern in the New South Wales Corps.....A. Philip. - 
RETURN TO ENGLAND
John Turnpenny Altree returned to England in 1791....
Governor Phillip to Secretary Stephens
Sydney 13 March 1791 (Extract),
........Richard Ayley (Alley) and Lieutenant Thomas Edgar who were sent out in theLady Juliana, transport, and Mr. John Turnpenny Altree, who came out as surgeon in one of the transports that left England in May 1787, and who has been since employed at Norfolk Island, return to England (in the Dutch snow Waaksamheyd in 1791) 
 HRA., Series 1 Vol., 1 p. 258.
 HRA Series 1 Vol 1., p.254
 HRA, Vol 1, Part 2, Governor Philip to Under Secretary Nepean 18 March 1787 p.59