Today, the Royal Adelaide Hospital is an adult-only hospital, but that wasn’t always the case. For much of its history, children were admitted to the hospital for treatment, alongside adults.
Early Days: The Adelaide Hospital
Prior to the opening of the first purpose-built Adelaide Hospital in 1842, sick patients were treated at home. As the population of Adelaide grew, there was an urgent need for a purpose-built hospital, leading to the building of the first Adelaide Hospital. As the Adelaide Hospital was the only public hospital in South Australia, patients of all ages were admitted. Throughout the 19th century and well into the 20th century, admission of children to the hospital was common.
A report from the South Australian Advertiser in November 1875 revealed that there were approximately 250 children admitted to the Adelaide Hospital for that year. Children, regardless of age, would be admitted alongside adults, and there were no designated areas or wards for paediatric patients.
Establishing a Children’s Hospital
As public demand for specialised paediatric care grew, the South Australian government responded by opening the Children’s Hospital in 1878. This facility was designed specifically to cater to the needs of children. However, the rules of the Children’s Hospital were strict. Children under two years of age and those over ten years were not allowed to be treated there. The Adelaide Hospital therefore covered the gap.
Despite a purpose-built children’s hospital, the Adelaide Hospital continued to receive children. A report from the Weekly Herald in December 1898 highlighted the confusion and tension between the two institutions:
There are at the present time 250 patients in the [Adelaide] Hospital. I asked why so many children were admitted as no ward is set apart for them; and was told that for some reason or other, many excuses are made at the Children’s Hospital for sending boys and girls to the adult Hospital. On the verandah a small baby rolled about looking perfectly happy, if not safe. The rules say ‘No infant shall be admitted on account of the condition of the mother alone, except with the advice of the honorary medical officer’. There are too many children altogether in the Adelaide Hospital.”
Weekly Herald, 31 December 1898
Changing Landscape
Despite the opening of the Children’s Hospital, there were still many situations in which children had to be admitted to the (Royal) Adelaide Hospital, particularly those under two and over ten and pregnant women with complications.
It was not until 1902, that the Queen Victoria (initially called the Queens Home) opened as a maternity hospital and took some pressure off the Adelaide Hospital by specialising in maternity care. By 1914, the Children’s Hospital adjusted its rules to allow any child under ten (including babies) to receive treatment. It wasn’t until 1926 that the upper age limit for children was raised to twelve.
Consequently, children from twelve years and up were still being admitted to the Adelaide Hospital and being cared for alongside adults.
Royal Adelaide Hospital Specialised Children Ward
In 1958, Medical Superintendent Bernard Nicholson established a specialised children’s ward at Royal Adelaide Hospital for children aged 3 and above. This ward was created to provide care for children who required specialised treatments that the Children’s Hospital could not accommodate, such as cardiac and neurosurgery cases.
The children’s ward was located on the top floor of the McEwen Building and could hold four to six cots. The children would be seen at the Woman’s and Children’s Hospital as outpatients. If they required surgery, they would then be admitted to Royal Adelaide Hospital. The children would then stay at the Royal Adelaide Hospital for post-operative treatment. Once recovered they would be returned to outpatients at Woman’s and Children’s Hospital. This arrangement helped streamline care for children who needed a higher lever of medical treatment than what could be provided at the Children’s Hospital.
The end of Paediatric Care at RAH
By the late 20th century, the role of the Royal Adelaide Hospital in treating children was steadily diminishing. In 1968, there were still reports of children being admitted to Royal Adelaide Hospital for serious injuries, such as a 14-year-old boy who was transferred to the hospital after being accidentally shot in the head. In the 1970s, there were also instances of children being treated for traumatic injuries at Royal Adelaide Hospital, including a 14-year-old girl who was seriously injured in a car accident (1976) and a 17-year-old boy involved in a motorcycle crash (1982).
1 September 1976
Despite these occasional admissions, it became increasingly clear that Royal Adelaide Hospital was no longer the best facility for treating children. The Women’s and Children’s Hospital, which significantly expanded during the 20th century, became the dedicated paediatric hospital for South Australia. By the late-1980s, it became the norm that children would be treated exclusively at the Women’s and Children’s Hospital, and the Royal Adelaide Hospital ceased to admit children as patients altogether.
Written by Margot Way, CALHN Health Museum