History of Health Care: Transformation of the Hospital

Figure 1. Original building. Image: KGH Archive

The Main Building of the Kingston Hospital was built between 1833 and 1835, however due to lack of operating funds did not open until 1845, with incorporation in 1849 when a lay board was appointed. They had a mandate to operate the hospital as a charitable institution required to “supply necessities and relieve the condition of sick and destitute immigrants and other transients and the mariners of the lake” (Figure 1).

There were a dozen doctors in Kingston, at that time a community of 8,000. One physician per month provided free medical services at the Kingston Hospital. The initial staff included a housekeeper/nurse and her daughter as a helper, both of whom died caring for patients during the 1847 typhus epidemic. In 1851 a steward was appointed and in 1854 the staff included a matron, two male orderlies and the steward.

Thus, in terms of its mission and operation, the Main Building of the Kingston Hospital was consistent with the hospitals of the past elsewhere. It was sustained by private benevolence and government grants providing largely custodial care for sick indigents. The government grant support was increased to £1,000 annually in 1855 as a result of the initiative of John A. MacDonald, Member of Parliament.

The second half the nineteenth century saw the general hospital undergo a striking transition from a charitable institution to a centre of scientific medicine. In Kingston, this transition began with a number of gradual changes in the hospital during the decade 1850-60. The Queen’s University medical school established in 1854 required the hospital for teaching. This led to increased involvement of faculty physicians and a changing public attitude toward the hospital. The number of patients admitted increased. Thus the Watkins Wing was built in 1862 in response to the need for expanded hospital facilities.

With the introduction of anaesthesia and the increasing opportunity for surgery, as well as the understanding of the cause of contagious and infectious disease, the role of the hospital steadily began to increase. In Kingston, this lead to the construction and opening of the Nickle Wing in 1891, described to be probably one of the most complete hospitals in the country for the treatment of infectious diseases, the Doran Building in 1894 to serve as a lying-in hospital and the diseases of women, the Fenwick Surgical Amphitheatre in 1895 and the Nurses’ Home in 1904.

Nursing was recognized as an appropriate career for women in 1886 when the Kingston Hospital’s nursing school opened. However the entire staff of the hospital presented in Figure 2 is still small. The operating budget for the hospital in 1893 was $15,609.00.

Figure 2. The entire staff of KGH, 1894. Image: KGH Archive
Figure 3. Aerial view of KGH, 2010-1. Image: PCL Constructors Inc.

Research leading to new knowledge has progressed rapidly throughout the 20th century. This has been associated with an equally rapid growth and development of the health care disciples. Today there are more than 40 disciples contributing to the delivery of health care in the community and the hospital. The Kingston Hospital continued to expand with 20 projects adding extensions or new buildings to the hospital between 1921 and 2004. (Figure 3)

The introduction of universality of health care beginning in the 1960’s with hospital and medical insurance to assure optimal health care for all citizens, rich and poor, urban and rural as well as the northern outposts of the country, has led to an increased requirement for health care.

Thus the Kingston General Hospital today cares for approximately 20,000 admissions, 150,000 outpatients and 70,000 cancer patients. Health care including diagnosis and treatment is provided by 400 physicians, 1200 nurses and 2600 other staff. The operating budget for the hospital in 2009 was $383,080,000.00

History provides perspective for the present and insight for the future. The hospital is just one example of why the cost of diagnostic and treatment services that we all cherish have become so expensive and may well continue to increase in the future.

James Low,
Executive Director

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