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History of Sydney Hospital

Written by the late Dr Frank Ritchie,
President, Sydney Hospital Board (1968 - 1982)

Front view of the Sydney Hospital and Sydney Eye Hospital
Front view of the Sydney Hospital and Sydney Eye Hospital

Sydney Hospital has always considered its heritage as deriving directly from Surgeon-General John White’s First Fleet sick tents which were pitched on the west side of Sydney Cove. The portable hospital was prefabricated in England from wood and copper, which had arrived in Sydney with the Second Fleet in 1790.

In 1816, convict patients were transferred to Governor Macquarie’s new hospital, built by contractors in return for a rum monopoly. But Macquarie’s Sydney could not sustain a general hospital on the scale provided. From the start, portions of the buildings were allocated for non-medical purposes. The present Parliament House (north wing) and the building known as the Mint (south wing), serve to remind us of the style and magnitude of the 'Rum Hospital'.

Colonial governments accepted a degree of responsibility for pauper patients who were not convicts. However, as convict numbers declined and the emancipated and free population grew, the government disengaged itself from direct responsibility for the 'respectable poor'. Meanwhile, the Sydney Dispensary had been created in 1826 to provide outpatient care for 'free poor persons, unable to pay for medical attendance'. It was conducted on traditional charitable lines and operated from several city premises before obtaining the south wing of the Rum Hospital. At the same time, the institution expanded to serve inpatients and changed its name to the Sydney Infirmary and Dispensary, a title officially approved in 1844. Convict inpatients continued to be treated in the separately managed hospital next door.

With the dissolution of the convict hospital system, the Sydney Infirmary and Dispensary gave up the south wing in 1848 in return for permissive occupancy of the entire middle section of the Rum Hospital complex. With minor variations, it has retained the site to the present day. The institution changed its name to Sydney Hospital in 1881.

A close-up view of the Sydney Hospital and Sydney Eye Hospital building.

From the Sydney Dispensary sprang a remarkable tradition of outpatient care which included visits by honorary doctors to the homes of patients too ill to attend the dispensary. By 1839, it was necessary to pay a 'district surgeon' to undertake this work. In 1845 there were four district surgeons and from 1862, six, each with his own territory. This system was discontinued in 1893, but for many decades thereafter, Sydney Hospital conducted two dispensaries located in the densely populated areas of Redfern and Paddington. The Eye Hospital is a surviving part of this offsite tradition, starting at Miller’s Point in 1882 and moving to Woolloomooloo in 1922. The Eye Hospital rejoined Sydney Hospital on campus in 1996.

Another crucial feature of our dispensary heritage concerns possession of the Macquarie Street site. Had it been possible to reserve the Rum Hospital complex for hospital purposes only; or even, had the infirmary and dispensary managed to obtain clear title to the central portion earlier than 1878; it seems to me that our acrimonious 100 year struggle for survival could have been avoided. The die was cast in those formative years. Without certain tenure, Sydney Hospital provided sport for critics of all persuasions. Yet public opinion has prevailed and hopefully we shall long remain to echo the loyalty of the Board of Directors of 1853, who declared:-

What would this city, what would the colony do without the Sydney Infirmary and Dispensary; where would the unhappy victims of disease meet with relief of cure? What doors would be open for the houseless stranger, or the sons and daughters of poverty, suffering under acute and dangerous disease? Day and night its gates are open for the reception of all who are thrown into jeopardy by accidents, and the best advice of the most skilful medical men, and the best of treatment are secured for them. If there be one benevolent Institution more deserving of support than another it is this ...

Although first, still the best