Many of the 736 convicts who survived the voyage of the First Fleet from Portsmouth, England arrived suffering from dysentery, smallpox, scurvy, and typhoid.

Soon after landing Governor Phillip and Surgeon-General John White established a tent hospital along what is now George Street in The Rocks to care for the worst cases.

Upon his arrival in the Colony of New South Wales at the beginning of 1810, Governor Macquarie discovered that the Sydney Cove's hospital was an affair of tents and temporary buildings.

They were to receive convict labour and supplies and a monopoly on rum imports from which they expected to recoup the cost of the building and gain considerable profits.

It is unclear who prepared the design for the three Old Colonial Georgian buildings comprising the Sydney Hospital complex, but there were apparently many involved with its construction.

John O’Hearen is probably the stronger contender for being the building's designer, for he not only defended the methods of its construction against critics but also signed himself as 'Architect' in related correspondence.

[3] As the hospital was nearing completion in 1815, the now famous convict architect Francis Greenway was asked to report on the quality of the work.

Macquarie ordered the contractors to remedy these defects but by 1820 the southern wing was deemed particularly unsafe, with reports that some of it had collapsed and had to be rebuilt.

Macquarie capitulated and the northern wing (originally designed for the Principal Surgeon) and a portion of the central building were given over to Supreme Court Judge Jeffrey Hart Bent as chambers as well as for a temporary courthouse.

First, he had been one of the three contractors who had built the Hospital under the "rum contract" with Macquarie, and secondly, his son, William Charles Wentworth, explorer and journalist, became one of the most important figures in the development of Parliamentary democracy in New South Wales, and is regarded as the "father of the constitution".

On 3 January 1829, Governor Darling released a despatch foreshadowing the intended appropriation of the North Wing for the accommodation of the Legislative Councils.

When the General Hospital was completed in 1816 the southern wing was used for its planned purpose as the quarters for the Assistant Surgeon as well as a storage facility.

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 in 1845 where it remained until 1848.

In 1851, the New South Wales Legislative Council petitioned to establish a mint in Sydney, to take advantage of the gold discovered by Edward Hargraves at Ophir, just outside Bathurst.

Plans were drawn up for the Sydney branch on a site selected at the corner of Bridge and Macquarie Streets, however it was decided to locate the mint in the southern wing of the general hospital to save time and costs.

Its establishment required the extensive internal remodelling of the former hospital wing for accommodation for the Mint Master, administrative offices and receiving and storage rooms for bullion.

Rowe was heavily criticised by his peers for the practice of under quoting building costs in order to win a competition, and the Sydney Infirmary was his cause célèbre.

New South Wales politician Henry Parkes (who later became premier) was concerned about the state of the Sydney Infirmary and Dispensary and appealed for help to Florence Nightingale for trained nurses.

[6]A Royal Commission on public charities in 1873 condemned the Sydney Infirmary, accusing the management committee of neglect and interfering in the duties of the nurses.

Lucy Osburn was described by her successor at Sydney Hospital, Miss McKay, as "an exceptional woman" who regarded nursing "as the highest employment" to be entered with "a spirit of devotion".