The hospital is operated by Southern NSW Local Health District and serves as a regional referral facility providing a range of general, surgical and some specialist services.

The Chisholm Ross Centre is a 32 bed inpatient psychiatric unit for patients suffering acute mental health conditions.

The intent of the Base Hospital system was to treat major cases at important provincial centres, instead of sending patients to Sydney.

Residents of County Argyle petitioned Governor Bourke for the provision of public services, including a hospital, in June 1832 on the occasion of his visiting Goulburn Plains.

Some were unhappy with the result, a complainant in the following year claiming[18] that there was only one room in the facility, with not even a provision for a store or a morgue.

By 1848[23] the Secretary of the committee was a Mr. Kitson, with Captain William Hovell, one of the original petitioners of 1832,[15] chairing the Public Meeting.

Debate at that meeting centered on a conflict between those wishing to run the hospital cost efficiently by say, competitively tendering for services and by those supporting the medical staff making appropriate management decisions.

A new hospital was completed in September 1849,[24] next to the previous weatherboard structure at the corner of Clifford and Sloane Streets, currently occupied by the Police Station.

Willam Ross served as Subscribers' Committee Secretary for twenty years until his death in 1869,[26] with Captain Hovell continuing as president for some of that time.

Despite the privatised charitable structure post 1842, much of the capital and half of the operating losses (shortfall) were being funded by State Government by 1913.

A major electrical upgrade was completed as part of the works allowing extra medical equipment to be acquired for the operating theatre and imaging departments.

"I do have a feeling though from some of my previous visits that part of the core of this hospital cannot be redeveloped because of the load bearing nature of the walls.

"The need for a major upgrade at Goulburn Hospital is clear, which is why we are making this significant investment to ensure this facility can deliver first-class care for patients well into the future", Skinner said.

Mrs Skinner said the announcement will have wide-reaching benefits, particularly for the 16,000-plus patients who attend the Goulburn Hospital emergency department each year.

It is where we have welcomed new life and farewelled loved ones and I could not be prouder we are committing to its major redevelopment today", Ms Goward said.

Since then, some of this capacity has been taken up, but nurses continue, three years later, to refuse to work what they claim is excessive overtime, when requested do so by management in order to keep beds open in the absence of the required permanent staff.

Criticisms in 2014 included that the buildings had been added to in an uncoordinated fashion and were therefore not suitable for modern care, and that management forced surgeons to work in unsuitable operating facilities in order to save money.

[41] The former Base Hospital surgeon who wrote this letter to the editor also stated that: "A recent comment by a politician that the opinion of doctors in Goulburn over the years has been dismissed as simply being self-serving epitomises the problem.

"This quotation demonstrates that the controversy around who should best make decisions for the hospital, medical staff or management, continues to rage much as it did in the 1840s.