The hospital was completely rebuilt on a much larger scale between 1910–1916 to a design by architect John James Clark in partnership with his son E.J.
[3] In 1986, with the pending relocation and amalgamation of the hospital, the site was to be redeveloped to house expansions of the State Library and Museum located on the block next door to the north, and a competition was held, with a condition being the preservation of the three towers.
One such design by post-modern architects Edmond & Corrigan included a giant pyramid as the new book stacks on Swanston Street.
As the site continued to remain relatively unused and abandoned in the centre of Melbourne's business district, it was called a "bloody disgrace" by then Premier Jeff Kennett.
After Nauru struggled to pay for the empty block, it was returned to the Melbourne City Council in 1999, which announced plans to develop the site.
Grocon was awarded the tender to develop a $600 million "urban village" on the site, with the remaining building to become the Queen Victoria Women's Centre.
It was conceived by Roger Nelson FRAIA of NH Architecture in 1999 went on to coordinate the efforts of all the collaborators and design the podium and ground levels as well as working in Joint venture with John Wardle and McBride Charles Ryan for QV1 and QV2 respectively.
KTA (Kerstin Thompson Architects) designed the infill building on Russel Street that includes the Child Care facility on the roof.
The latter is low-rise to meet height restrictions on Swanston Street, intended to allow greater viewability of the dome of the State Library of Victoria.