Royal North Shore Hospital

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In the 1880s a population of some 20,000 lived in relative isolation on the North Shore of Sydney. Any who became ill faced a long and hazardous journey by dray and punt to the city for attention. In 1885, Mr Frank Treatt, the local magistrate, and his wife were instrumental in establishing a committee of citizens to plan for a hospital and to raise funds.

A successful Industrial Exhibition and public appeals were held; the first Hospital Committee was formed in 1886. On 18 June 1887 the foundation stone was laid by Sir Henry Parkes, then the Colonial Secretary, on a site on the North Willoughby Road, St Leonards (now Crows Nest). The land had been given by Mr David Berry, one of a family of Scottish merchants who grew produce in the Shoalhaven area, transporting it to Sydney by coastal boat and landing at a site which now bears his name — Berry’s Bay — which was also in the large municipality of St Leonards. It was subsequently divided into districts, the main one becoming North Sydney.

On Monday 18 June 1888, the North Shore Cottage Hospital, with fourteen beds and a nursing staff of five, opened ‘for the reception of accident patients and illness occurring among the poor of the district’. The total cost, including the land, had been £2,960.

By the turn of the century the railway from Hornsby to St Leonards had been completed, the population had grown to 56,000 and, although enlarged twice, the Hospital could not meet the demands made on it. As has happened many times since, funds and facilities were insufficient and there was frequent public outcry due to patients being refused admission or being accommodated in sub-standard conditions. Public indignation reached its peak when it was found that a tent had been erected in the grounds to take the overflow. Part of the Gore Hill Reserve, half a mile to the west of the original site, was set aside to build a new hospital capable of expansion to meet future needs. It is of interest that the area derived its name from William Gore, who died there, ‘in exile’, in 1845. He had come to Australia in 1806 as Provost-Marshal to Governor Bligh. He was prominent in the arrest of Captain John Macarthur which led to the revolt by the NSW Corps and subsequent imprisonment of Bligh.

A public competition was held for a design for the new hospital. The winning plan, setting a pattern so familiar in later years, provided for the Hospital to be built in stages so as to comprise five two-storey pavilion wards. ‘The buildings are carried out in brick with stone dressings, the design being Renaissance and the dressing sparingly used on the score of expense, but with architectural effect.’ Given the styling Royal[1] by King Edward VII on 11 September 1902, following his Coronation, the new forty-eight-bed ‘Royal North Shore Hospital of Sydney’ opened on its present site on 10 June 1903.

The original Cottage Hospital, the site of which now faces Willoughby Road, Crows Nest, and is bounded by Holterman and Albany Streets, was subsequently purchased by the Sisters of Mercy. In 1906 they began there the Mater Misericordiae Hospital, which was also later to move to the highway to allow for expansion. The two Hospitals became formally associated in 1969 when the Mater became an affiliated Teaching Hospital with the Royal North Shore. This association has been most amicable and successful and of great value to the Sydney University’s Medical Faculty in being able to provide adequate clinical teaching during a most difficult era.

The original plan was followed until the time of the First World War when the Hospital, about half-completed, comprised 132 beds. This was still inadequate to meet the needs of the expanding population, but a proposed new six-storey block was an early casualty of the War. Between the Wars there were many developments, to prove of great importance later. A separate outdoor patients’ block was completed, a maternity block was built, a research institute was established, pioneering clinics for chest diseases and for the treatment of diabetes were set up, together with a clinic to enable Sister Elizabeth Kenny to introduce her methods for treatment of infantile paralysis. The bed capacity reached 354. But it was all rather haphazard and disrupted by the depression, giving the scattered and varied buildings which provide their own problems today. Fortunately, additional land was regularly acquired for expansion, so this has never proved a big problem. There were five major land allocations which, with numerous small blocks added, now total some thirty-five acres.

Following the Second World War consideration was being given to the establishment of additional clinical schools. Sir Norman Nock (who was to serve twenty-eight years as the Hospital’s Chairman), strongly believed that Royal North Shore was in an ideal position to be one of these new clinical schools. He, with the Board, planned and worked hard to this end, appointing a committee to prepare for such a development. The Chairman of this committee was W. Wilson Ingram, then an established Macquarie Street physician, who had been a leading force behind many of the improvements between the two wars. He was to become the first Clinical Lecturer and to be Chairman of the Board of Medical Studies for twenty-six years.

The outcome was that the Senate of the University, on 14 October 1946, resolved to invite the Board to ‘agree to the Hospital being recognised as a Clinical School for the instruction of Medical Undergraduates’. The Board accepted in November 1946 and immediately implemented another decision, taken in accordance with the recommendations of a public enquiry held in 1939, that the Chief Executive Officer should be a medical graduate. Wallace Freeborn, who was a Sydney graduate, commenced in this position on 10 December 1946. He was one of the few Australians appropriately qualified, having had extensive postgraduate training in London hospitals during the 1920s and 1930s and was established as a specialist in Harley Street at the outbreak of the Second World War. During the War he held various positions of command, finally that of Commanding Officer in a hospital ship. He immediately began organizing Royal North Shore along the lines of a London teaching hospital and introduced the registrar system of staffing and postgraduate training.

These three outstanding men (Nock, Freeborn and Ingram), whose names are now perpetuated within the Hospital, went on to play major roles in the future development of Royal North Shore, after the official inauguration of the Clinical School on 15 March 1948 by the Chancellor Sir Charles Bickerton Blackburn.

Starting with forty students, the total reached 128 in 1950 and thereafter fluctuated until it reached a peak of 210 in 1977. As a district hospital emerging from the neglect of the war years, patient facilities were far from adequate and of course facilities for students were nil. There were many promises but very little materialized, so that student accommodation was inadequate and overcrowded for years.

The new acute ward block, promised as part of the teaching hospital development, was similarly slow to materialize and the haphazard development of clinical facilities continued during the 1950s. A first-class thoracic unit had been completed in the Commonwealth Anti-T.B. campaign and with it an excellent nurses’ home, but otherwise temporary prefabricated units, converted cottages and other forms of makeshift took the available beds to 548, before finance and permission to proceed finally came. The four-stage development programme, approved in 1958, which included a 600-bed multi-storey ward block, took some twenty years to complete. Now, following some consequential re-organization of older facilities, the total number of beds available is 920.

The first part of the planned and long-promised ‘education block’ was not built until 1963, following the advent of the Australian University Commission’s triennial system of grants. Under this system twelve building projects were approved over five triennia. These provided: a clinical teaching block with a main lecture theatre and a library; a students’ amenities block and students’ residence joined by common rooms; various tutorial and demonstration rooms; and a five-level Professorial block adjacent to the Kolling Institute of Medical Research.

The last of these projects, the extension of the library, which completed the top floor of the teaching block, was finished in 1978. In a unique historical event, W. Wilson Ingram participated in his last official function for the Hospital when he unveiled a commemorative plaque to mark its completion on 6 December 1978, which was coincidentally his 90th birthday.

The first Sub-Professorial units were established with Associate Professor Reeve in Surgery in 1962, and Associate Professor Piper in Medicine in 1963. Appropriately both of these men, who have contributed so much to the teaching standards of the Clinical School, were appointed the first Professors when full Chairs were established, in Medicine in 1972 and Surgery in 1973. A Chair in Orthopaedics and Traumatic Surgery was established in 1970 and is held by T. K. F. Taylor, and a Chair in Rheumatology was filled in 1983 by P. M. Brooks.

Thus the fourteen-bed Cottage Hospital, founded by the local community to serve the residents of the North Shore, after nearly one hundred years has evolved into a major referral hospital of 920 beds, serving the whole Northern Metropolitan Region and beyond. Now one of the most modern hospitals in the country, it sets and pursues the highest possible standards and has been constantly stimulated in this through its valuable and esteemed status as a clinical school of the University of Sydney. Its history shows that the ‘North Shore’ Hospital has had leaders of outstanding vision and remarkable foresight who have taken far-reaching decisions and vigorously pursued them through the desperate straits of war, depression, inflation and periodic neglect to bring this about. Its founders and subsequent leaders may be justifiably proud of its position and standing today, as it too nears its centenary.

Source: I. R. Vanderfield, "The Royal North Shore Hospital" in Young J, Sefton A and Webb N, Centenary Book of the University of Sydney Faculty of Medicine. Sydney University Press, Sydney