The Royal Children's Hospital: 150 years of caring

The Royal Children’s Hospital has had a relationship with the University of Melbourne, and in particular with its medical school, from the time the hospital came into being (as the Institution for Sick Children) in 1870. Both were founded in the mid-19th century, during a period of amazing growth due to Victoria’s gold rush, with the capital’s population reaching 200,000 in the 1870s. As Melbourne became one of the truly great cities of the world, later characterised as ‘Marvellous Melbourne’, its citizens and leaders sought to build foundational institutions worthy of such a status, including the University of Melbourne (1853) with its medical school (1862) and the Children’s Hospital.

Professor Emeritus Glenn Bowes AO

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The coat of arms of the Royal Children’s Hospital was officially granted by the College of Arms in London on 5 May 1966.1 The design is the result of a collaboration between the college (established in 1484) and Mr Peter G Jones (1922–1995), then a young assistant cardiac surgeon (see pages 94–95). Jones had a strong interest in medical history, and worked closely with the college to create a design that would officially and proudly situate the hospital in its own historical context.

The antique royal lion of England represents the hospital’s royal charter (granted in 1953); the rods with snakes are the staff of Aesculapius, the Greco-Roman god of medicine (in ancient times, snakes were thought to have everlasting life and to be rejuvenated by shedding their skins); while the Southern Cross represents the State of Victoria. The helmet represents the status of the bearer: corporate bodies such as a hospital are granted an iron helmet with the visor closed and pointing to the left. The Australian pelican, Pelecanus conspicillatus, is found throughout Victoria and signifies devotion to the young, based on an ancient (though incorrect) belief that the female pelican pecks at her own breast to produce blood on which she feeds her fledglings. The two ‘supporters’ are, appropriately, children, wearing clothing modelled on ancient Greek sculptures to avoid the dating effect of modern dress. The Latin motto, freely translated, is ‘Trustworthiness, knowledge and love’.

Creating a coat of arms is a highly technical task; heraldry is a language in pictures. Each part of the design tells a story that plays a role in locating the hospital’s purpose in its history. The honouring of trust, knowledge and love stills bears great relevance for the children for whom the hospital cares. After all these years, we see how prescient were all those involved, to boldly claim that high-quality paediatric care requires not only knowledge, but also trust and love.

Sarah J Jones

1 Royal Children’s Hospital annual report, 1965; PG Jones, ‘A clash of symbols’, Proceedings of the Medico-Legal Society of Victoria, vol. 11, 1967, n.p.; PG Jones, ‘The arms of the Colleges of Surgeons’, Australian and New Zealand Journal of Surgery, vol. 40, no. 2, 1970, pp. 105–27.

Combining Victoria’s renowned enthusiasm for arts and culture with a dash of outdoor adventure, Me and UooUoo: The RCH150 Anniversary Art Trail brought curiosity and colour to the streets of Melbourne and Geelong in a spectacular public art project. Dotted through laneways, around street corners, in parks and on beaches, Me and UooUoo connected 100 sculptures to create an extraordinary walking experience.

Launched in January 2021, Me and UooUoo featured a specially designed sculpture by Alexander Knox, and was brought to life by 100 local, emerging and Indigenous artists. These enchanting, colourful creatures quickly found their way into the hearts of Victorians and visitors alike.

From January through to April, people explored the trail, with more than 11,000 users downloading the app, 226,000 sculptures unlocked and 12,500 photos shared. Explorers were able to use a free map developed by the Herald Sun newspaper to navigate the trail, and, thanks to our supporters, they could unlock enticing rewards along the way.

Walking, dancing, skipping or running, Victorians were able to explore Me and UooUoo at their own pace, and do it with their family, friends or colleagues. The trail proved a great way to get moving, see new art and improve the health of future generations. At the farewell event, held at the Melbourne Convention and Exhibition Centre, we welcomed more than 3,000 people for a final wave goodbye. Our UooUoos then went under the hammer at our fundraising auction, raising more than $867,000 for the hospital.

The UooUoos are now in their new homes in backyards, offices, loungerooms and public parks across Victoria, Australia and the world. Through the generosity of the community, the funds raised will help the hospital continue to provide the best care to our children for generations to come.

Sue Hunt

Binga is named after a word that comes from my son’s own unique lingo. It means balloon. This UooUoo is inspired by my son’s imagination. His reaction to it was epic, and I feel I hit the mark in a child’s mind.

Josh Muir

A significant project of the RCH150 program was Celebrate. Create. Connect. The RCH150 Aboriginal Art Project, which featured two specially commissioned Indigenous Australian artworks permanently installed at the hospital. This project was a gift to the hospital from the RCH Foundation, and created a culturally significant legacy for generations to come.

In response to an Australia-wide call-out, the RCH Foundation received submissions from across the country, including remote Western Australia, Far North Queensland, and Alice Springs. All were reviewed by a specially appointed committee of Indigenous leaders in the creative industries, co-chaired by senior Wurundjeri Elder Aunty Joy Murphy AO and senior Boonwurrung Elder N’arweet Dr Carolyn Briggs AM. The committee shortlisted five artists for further concept development and presentation, and had the privilege of awarding two projects, by unanimous decision.

The RCH Foundation commissioned both works: a large-scale mural painted on the facade of the hospital by artists Elizabeth Close (Pitjantjatjara and Yankunytjatjara) and Samantha Roberts (Wurundjeri and Dja Dja Wurrung), titled Together, and a large bronze sculpture installed in the hospital’s north court by Robyne Latham (Yamatji), titled Leaf.

The RCH150 Aboriginal Art Project represented a unique opportunity for philanthropy to change the face of the RCH and help shape a more inclusive future for paediatric health care. Mr Ken Harrison AM KSJ and Mrs Jill Harrison OAM DSJ, together with support from Sylvia and Peter Stach and the Debbie Stach Memorial Gift Fund, worked with the RCH Foundation to fund the project and bring the artworks to life over a two-year period. The mural and sculpture were officially unveiled on 27 May 2021 with an intimate blessing ceremony as part of National Reconciliation Week.

This project allows the hospital and the RCH Foundation to continue to grow and strengthen their relationships with Indigenous communities across the country, while promoting the importance of good health in a culturally safe environment.

Bebe Backhouse

Leaf celebrates 150 years of the Royal Children’s Hospital and its continuing care for Aboriginal and Torres Strait Islander children and their families. The patterns in the sculpture refer to the diversity of Australia’s First Nations cultures, through the vibrant circularity of the seasons, and from the past to the future, while embracing the now. Leaf is dedicated to those who have deeply listened to, and heard, each other.

Robyne Latham (Yamatji)

William J Smith (1846–1929) was born in England and studied medicine in London, where he then worked as a surgeon at the Victoria Hospital for Children and lectured at the Charing Cross School of Medicine. Both William and his brother Charles, also a surgeon, emigrated to Australia: Charles went to Adelaide, whereas William arrived in Melbourne in 1869.

At this time George Halford, the University of Melbourne’s inaugural professor of anatomy, physiology and pathology, needed the help of a demonstrator in anatomy. The only applicant was Dr Smith, and he was appointed in April 1870, based on his outstanding academic record.

As well as demonstrator and supervisor of the dissecting room, Smith was curator of the pathology museum of the Melbourne Hospital. Halford wanted a post-mortem room there to serve as a reference for students and honorary staff for practical teaching. This insight serves as a reminder of the very close nexus of teaching and training between clinicians and students of the university.

Also in 1870, Smith established a small children’s clinic in central Melbourne. The location was not ideal, so Smith joined with Dr John Singleton and moved to 39 Stephen Street (now 49 Exhibition Street). This was the first children’s hospital in Victoria, known as the Melbourne Free Hospital for Sick Children, established as a charitable institution for the poor. It had six rooms and treated more than 1,000 children in the first year.

A committee of management and rules were established, which included prevention of the spread of infectious diseases. Smith was appointed attending surgeon and honorary secretary, Halford a consulting surgeon and Dr Singleton attending physician.

In 1871 Smith resigned to take up general practice in Casterton, western Victoria. In recognition of his founding role he was appointed life governor of the hospital. In 1875  he returned to England, added Jerome as a surname, and was appointed lecturer in medical pharmacology and materia medica at Oxford. He died aged 83 after a life filled with contributions to medical research and teaching, and pioneering the establishment of the Royal Children’s Hospital in Melbourne.1

Professor Emeritus James Angus AO

1. References: KF Russell, The Melbourne Medical School 1862–1962, Melbourne University Press, 1977, p. 47; RL Jones, Humanity’s mirror:150 years of anatomy in Melbourne, Melbourne: Haddington Press, 2007, p. 64

It is a rare distinction to be acknowledged as the founder of a medical specialty. Yet in Australia William Snowball (1854–1902) is known as ‘the father of paediatrics’. Born in the inner-Melbourne suburb of Carlton, Snowball was to lead the country’s first public hospital established for the care of sick children.

Snowball graduated from the Melbourne Medical School in 1875 and continued his studies in Britain. Pivotal to his future was experience gained at London’s Hospital for Sick Children in Great Ormond Street, established in 1852 by Dr Charles West due to the city’s high level of infant mortality. Similar circumstances were the catalyst for the founding of the Melbourne Hospital for Sick Children in 1870. When Snowball joined as a resident medical officer in 1878, it had just moved to its first major building, in Rathdowne Street, Carlton. Snowball was instrumental in determining how these premises were to be used and operated. Infectious diseases were a major problem. The hospital generally refused such cases—to avoid cross-infection—except for children who were dying. Among Snowball’s initiatives were stronger infection control, less overcrowding in wards, better accommodation for nurses, and establishment of training for nurses and clinical teaching. In 1882 he left for private paediatric practice, but continued his remarkable contribution as an honorary staff member, until his death at the age of 47. Indeed, he is credited with leading the hospital’s development from ‘a small parochial hospital to one of world ranking’.1

Snowball was considered a great physician and gifted teacher. Contemporaries described him as a person of considerable charm and gentle manner, adored by his patients and respected by his peers. The words of Professor Harry Brookes Allen confirm Snowball’s legacy as a clinician and educator:

When he first joined the staff, his colleagues were men in general practice. With much prescience, he saw that the time was coming when, with advantage to the public and themselves, they would become specialists in paediatrics, and give themselves up entirely to the study and observation of that branch of medicine.2

Dr Jacqueline Healy

1  HB Graham, Beacons on our way: Some memoirs of the Children’s Hospital, Melbourne, Sydney: Australasian Medical Publishing, 1953, p. 8. 2  Quoted in B Hewitt, ‘The founder of Australian paediatrics’, in J Healy (ed.), A body of knowledge: The University of Melbourne; In celebration of 150 years of Melbourne Medical School 1862–2012, University of Melbourne, 2013, p. 94.

The forerunner of the Children’s Hospital was a small outpatients’ clinic and dispensary established in March 1870 by Dr William Smith, in Bourke Street on the corner of Romeo Lane (now Crossley Street). Several months later, Smith was joined by Dr John Singleton, and the ‘Institution for Sick Children’ moved to this modest building at 39 Stephen Street (now 49 Exhibition Street). At this time the building was listed in the Melbourne City Council rate books as being a two-storey brick house of six rooms, on land measuring 18 feet by 88 feet (about 5.5 by 27 metres), owned by Mr W Johnston. The net annual value was £60 and the ordinary rates were £3, with a lighting rate of £1. On 9 September 1870 a public meeting elected a hospital committee, and the hospital was named the Melbourne Free Hospital for Sick Children. Soon afterwards the committee decided to prepare the building to receive six inpatients, and authorised the purchase of six cots or bedsteads for patients, one bedstead for the nurse, mattresses, macintoshes, sheets (two pairs for each bed), blankets (three per bed), quilts, pillows and cases, two dozen towels, kitchen towels, a toilet service, soap, house flannels, hip bath, water can, pails, a set of washing tubs, a large boiler for washing, a fountain, tray, chairs, stair broom, sweeps broom and a table. This was all it took to furnish and equip the Children’s Hospital for its initial intake of inpatients in late 1870. The nursing and housework duties of the hospital were dealt with just as easily: ‘It was decided that the nursing and housework should be divided between Mrs Bail, and a person to be appointed, Mrs Bail taking the precedence and receiving board and wages at the rate of £26 per annum.’ Mrs Sheldon was appointed to assist Mrs Bail, but she was dismissed early in 1871 ‘in consequence of her being through ill-health unfit to fulfil her duties’.1 There are no figures available for the number of inpatients treated in the hospital’s first year, but the number of outpatients was about 1,400, all children ‘of necessitous circumstances’.

Dr Peter Yule

1 Quotations are from the minutes of the hospital’s committee of management.

After the committee had spent several years searching for a suitable site for a new hospital, the solution came suddenly and unexpectedly when Redmond Barry offered his house and land in Carlton for £10,000. Irish-born Barry had been one of the first barristers in Melbourne, arriving in 1839, and had been a Supreme Court judge since 1852. He was one of the prime movers in the establishment of many of the colony’s public institutions, including the University of Melbourne and the State Library. Barry’s single-storey classical villa stood on a block of about 1.5 acres (0.6 hectares) in Carlton, bounded by Rathdowne, Pelham and Drummond streets. The purchase was finalised by January 1876, with the terms being £5,000 cash and the balance in six years at 6 per cent interest.

After extensive renovations, the new hospital was opened on 27 September 1876 by the Governor of Victoria, Sir George Bowen, who startled those present by saying that ‘he would not make a speech but would refer those present to one made by Charles Dickens on a similar occasion, which would be found at page 166 of Foster’s life of that author’. Sir George then sat down, feeling his duty had been done.

Although Redmond Barry’s house was a great improvement on the Spring Street premises, it was not a purpose-built hospital, and over the next three decades the committee spent large sums on modifications and adaptations. The biggest extension came in 1886, when a second storey was added to the house (as seen in photograph opposite, above). This gave the hospital 30 extra beds, an operating theatre, large balcony (soon to be filled with beds), baths, and better accommodation for nurses, as well as increasing the height of the original wards to give them more air and light.

The house was demolished in 1911 as part of a complete rebuilding of the hospital on the Carlton site.

Dr Peter Yule

Penicillin was discovered accidentally by Alexander Fleming in 1928, with subsequent purification and animal experiments conducted by Howard Florey and Ernst Chain in the 1930s, culminating in the first in-human clinical trial—overseen by Florey in 1941. Before these nascent times in the development of antibiotics, it was common to care for adults suffering from suspected infectious diseases in isolation hospitals and wards. The isolation of children in similar circumstances was less common. This photograph depicts the children’s isolation ward of the Children’s Hospital at Carlton in 1926. The nurses are helping their charges ‘take the air’, which was also common practice in sanatoria around the world. During their hospitalisation, children were isolated not only from other patients, but also from their families.

For several decades the practice of setting aside wards for those with infections remained routine. For example, towards the end of the era of the hospital in Carlton a ward was allocated for children with croup, and a separate one for those with gastroenteritis. I recall when I started as a resident at the hospital in 1962 that the croup ward was a single large space where children were nursed in special humidity cribs designed by Dr Glyn White, a returned World War II Digger and renowned neonatal paediatrician. Steam was used as a therapy, filling the ward with heat and humidity and designed to concentrate in the deep cribs in an attempt to ease the breathing of the young child who was placed at the bottom. Antibiotics would not have helped these children, as croup is usually caused by a virus. Steam is often used by parents to ease their children’s breathing today. Although potentially comforting when in the familiar surroundings of one’s own home, it was unlikely to have been so in the isolation ward, and steam is not used as a treatment in hospitals today.

Dr Hugo Gold

It was perhaps the most anticipated opening in Melbourne history, except for the Olympic Games in 1956. The ‘new’ Royal Children’s Hospital was officially opened on 25 February 1963, although the first patients had been transferred in 1962 and the nurses’ home had been occupied since 1958.

The modernist building stood majestic; however, by 1996 it was showing signs of fatigue. Nevertheless, it remained home for many hundreds of staff and patients, and a haven for carers and visitors. At times it was a difficult building to navigate, as there  seemed to be secret places, long corridors, and rumours of a wartime tunnel connecting it to the Royal Melbourne Hospital.

The mid-to-late 1990s was a time of momentous change, upending hospital traditions and introducing new ways of working. New technologies transformed communications, while administrative structures that aspired to equality led to the abandonment of some older ways. In 1996 for example, the dining room for senior medical staff was transformed into the Starlight Room, providing a treatment-free space for patients to play and safely enjoy time away from the wards. The dining halls with elevated platforms, formerly symbols of rank, were gone; the nurses’ dining room that divided the most senior nurses from the junior staff was no longer. Such hierarchical architecture and structures spoke of a bygone era.

The various hospital wards had different designs and functions, but all were constrained by 1960s style and limited space. Medical advances and evolving attitudes made change inevitable: the oncology ward was refurbished, and life-saving technology installed. Isolation rooms with negative air pressure offered bone-marrow transplant patients greater protection from infection. There was no longer a burns unit, as it was incorporated into the surgical ward. Legislation and public awareness campaigns significantly reduced the number of children needing attention for burns: flammable materials were no longer permissible in children’s clothing, and the abolition of ‘cracker night’ marked the end of a dangerous, albeit thrilling, experience of Australian childhood. An adolescent unit was established, where young patients had their own space and activities, and a rooftop garden was created.

Buildings adapt in response to the rhythm of an ever-changing society. Hospitals are places where despair can be crushing. But they are also places offering joy and hope. Sometimes, the two narratives can merge.

Anne Rahilly

P Yule, The Royal Children’s Hospital: A history of faith, science and love, Sydney: Halstead Press, 1999, p. 384.

Bates Smart’s design for the new Royal Children’s Hospital is one of our proudest achievements of the past decade. In a joint venture with Billard Leece Partnership, with HKS as international advisors, we completed this significant project in 2011 as a public–private partnership with our client Lendlease under the guidance of the Victorian Department of Health.

The architectural design sought to embed the hospital in its landscape, to maximise the connection to nature and the benefits of healing provided by its location. The building first and foremost provides an identifiable street frontage on Flemington Road, before bending in towards the parkland. Early in the planning process we turned the building (and therefore the major internal circulation) to face due north, to maximise views to the parkland and allow abundant natural light into the building.

The hospital is a campus-style arrangement of buildings, designed to reduce scale and allow the parkland environment to permeate the plan at critical junctions. Purposely horizontal in expression, the building form relates directly to the surrounding natural elements: the leaves of gum trees are referenced in the glazed screening, and the trees’ grey-white bark in the shifting tones of the inpatient unit’s concrete and glass panels.

Internally a central orientation space or ‘main street’ provides intuitive wayfinding for visitors and creates a social heart for the hospital. Patient bedrooms have three zones (clinical, patient and family), which respond to the emotional needs of children and help improve patient experience and recovery rates. Because more than 85 per cent of the rooms are designed for single occupancy, children can personalise their space and feel that their bedroom is a safe and personal haven.

Child-friendly illustrations of local flora and fauna by artist Jane Reiseger are carefully integrated into the hospital, not only to help people navigate the building, but also to help clinicians distract patients during treatment.

To benefit the broader community, we used the excavated soil to create a large hill, which was incorporated into a new playground designed by landscape architects TCL. Children adore running up and rolling down the hill, creating joy and laughter adjacent to the hospital environment.

Mark Healey

In his address to the Royal Children’s Hospital annual general meeting in 1969, Sir Clive Fitts, nephew of Herbert Hewlett and prominent physician, said of his uncle:

after his return from Edinburgh, he never went overseas again … it is quite wonderful that encouraged in the beginning by Dr Snowball, he should have seen the future of radiology as early as 1896 and kept himself in the forefront of knowledge … After his death I came into the possession of his belongings … I came across this small leather case … in perfect order … On it in gold letters is stamped: Herbert Hewlett from W. Snowball.1

Like many of his generation of Australian medical students, Herbert Maunsell Hewlett (1872–1957) went overseas to complete his education. After three years of medical studies at the University of Melbourne, he completed his degree at the Edinburgh Medical School, graduating with distinction in all subjects of the final year (MRCP 1896). While overseas he also gained the knowledge and inspiration that were to guide his choice of career, as he followed with particular interest reports of Röntgen’s discovery of X-rays in November 1895, and subsequent developments in that field.

Returning to Australia in 1896, on 18 November he was appointed as an honorary medical relieving officer at the Children’s Hospital. Under the stewardship of Dr William Snowball, Hewlett developed a radiology department at the hospital—Melbourne’s first. In 1897 the hospital purchased an X-ray machine for £25 and appointed Hewlett as honorary skiagraphist.2 This early term for radiographer is derived from the ancient Greek skia (shadow) and grapho (writing)—particularly apt in the specialty’s early days, due to the blurriness of the images. By 1911, Hewlett was officially announced as skiagraphist at St Vincent’s Hospital, and at the Children’s in 1912, all the while operating his own radiology clinic in Collins Street. He served at the Children’s for 38 years, holding the roles of honorary physician, surgeon and radiologist.

Like his mentor Snowball in paediatrics, Hewlett at the Children’s Hospital laid the foundations  for the development of radiography in Victoria and beyond. This was recognised on the international stage when he was honoured as a pioneer radiologist by the Antoine Béclère Centre in Paris.3

Professor Patricia Desmond

1  Royal Children’s Hospital. Address given by Sir Clive Fitts at the 99th annual general meeting held on 23rd September, 1969, p. 5. 1978.0103.00035, University of Melbourne Archives.

2  P Yule, The Royal Children’s Hospital: A history of faith, science and love, Sydney: Halstead Press, 1999, p. 54.

3  Malcolm McKeown, ‘Hewlett, Herbert Maunsell (1872–1957)’, Australian dictionary of biography, vol. 9, Melbourne University Press, 1983.

Dr Ethel Mary Vaughan Cowan (1868–1943) was the first female doctor employed at the Children’s Hospital, paving the way for innumerable women.

After undertaking nursing studies at Ballarat Hospital, Cowan graduated from the University of Melbourne in 1897 with a Bachelor of Medicine, only six years after the first female medical graduate. She was one of only two women in her graduating class, and subsequently also graduated with a Bachelor of Surgery in 1898.

Dr Cowan faced rejection at her first few attempts at medical employment, including her application to return to Ballarat Hospital. Her application to work as an assistant medical officer at the Women’s Hospital was accompanied by the ‘most flattering testimonials’, and her talents were described by the president of the hospital. However, a committee composed of women almost unanimously elected one of the two male applicants. This prompted a scathing article in Melbourne Punch:

Oh! woman, in your hour of ease

You may abuse us as you please;

When pain and anguish wring your brow

You want a male M.D., we vow.1

In 1898, Dr Cowan was offered a one-month trial in the outpatients’ department of the Children’s Hospital, without pay. Following her success in this role, she was offered a landmark appointment: an 18-month residency. This opportunity cemented Mary Cowan as the first female resident doctor at the Children’s Hospital, and one of the first in Victoria. Sir Charles Ryan (a member of the honorary medical staff) said: ‘I have formed a high opinion of her ability, and take pleasure in recommending her to any institution requiring the services of a well-qualified Resident Officer.’

Dr Cowan resigned the following year, and sailed to London on the steamer Yarrawonga as the ship’s registered doctor. This was an extraordinary occurrence—a female doctor from Melbourne did not travel again as a ship’s doctor for another 27 years. On returning to Melbourne in 1902, Dr Cowan was appointed honorary physician to the outpatients  at the Queen Victoria Hospital (which had nine other female honorary medical staff), but resigned later that year. In 1904 she married William Stanley John Eaves and had two children, almost certainly signalling the end of her career, but leaving an undeniable legacy.

Dr Sarah McNab

1. Melbourne Punch, 20 January 1898, p. 3.

Dr Frank Shann, pictured here at the bedside of a seriously ill child, was the third director of the paediatric intensive care unit (PICU) at the Royal Children’s Hospital, from 1983 to 2005, and in 1995 became Australia’s first professor of critical care medicine, through the University of Melbourne.

Professor Shann’s research in paediatric intensive care contributed to several paradigm shifts in the practice of medicine. The scoring system he developed (called PIM) and his research comparing centralised and decentralised intensive care services have been used by policy makers to improve paediatric intensive care services in many countries. Shann also published Drug doses, used by tens of thousands of doctors and nurses around the world for three decades.

At the time of this photograph, a team of five ICU physicians worked at RCH:

Drs Frank Shann, James Tibballs, Warwick Butt, Rob Henning and Mike South. Tibballs was instrumental in developing the medical emergency team at RCH, and with Henning developed the home ventilation service, which now supports hundreds of children in the community. Henning ran the paediatric emergency transport service for 20 years, coordinating the care and transport of critically ill children from around Victoria. Associate Professor Warwick Butt was director of the PICU from 2011 to 2020. In the 1980s he had brought extracorporeal membrane oxygenation (ECMO) to RCH; ECMO is rightly credited with saving the lives of hundreds of children. Butt led the PICU when it moved to the new hospital in 2011 and established the model of care that we have today. He oversaw the expansion of the PICU team to 10 consultants, specialisation in cardiac and general intensive care, and the introduction of modern quality and safety mechanisms. Butt was succeeded as director in 2021 by Dr Thomas Rozen.

PICU works with every clinical department in the hospital, and has trained hundreds of doctors, nurses, allied health professionals and clinical technologists who have gone on to work in paediatric units across Australia, and throughout the world. Its world-class research program combines epidemiology, biosciences, clinical research, and technology. In the 1990s Professor Shann estimated that at least one in 80 Victorian children would spend time in PICU, and the figure is probably even higher today. PICU is a truly international unit that holds a special place in the hearts of the people of Victoria.

Professor Trevor Duke

Born in Melbourne but educated in South Australia, John Haughton Colebatch(1909–2005) graduated in medicine in 1936, and after two years studied for postgraduate qualifications in England, where he also married. In 1939 he and his wife returned to Australia and John enlisted in the Australian Defence Forces, rising to the rank of major. At the end of the war he returned to Melbourne, and in 1946 was appointed as a paediatric consultant to the Children’s Hospital and Royal Women’s Hospital.

In 1948 in Boston Colebatch met with paediatric pathologist Dr Sidney Farber, regarded as the father of modern chemotherapy. After observing the results of aminopterin treatment of children with acute lymphoblastic leukaemia, Colebatch was the first in Australia to try to achieve prolonged remissions in such patients, and the first to commence clinical trails. He encountered much opposition, but eventually prevailed.

As the new chemotherapeutic agents became available, in the 1960s Colebatch recruited 12 paediatric institutions to participate in a clinical study of cyclical as compared to longitudinal maintenance treatment in leukaemia, which earned international acclaim. He practised and taught the discipline of adhering to protocol and achieving statistically significant results. He introduced the concept of a tumour board of specialists from all relevant disciplines to plan the treatment of children suffering from solid tumours, at a time when no one else did. In time this approach was accepted by adult oncologists, and is now almost universal.

To bring about these fundamental changes in attitudes to the treatment of cancer required wisdom, strength and an almost bulldog-like tenacity. John Colebatch had all of these, and for his contributions was made an Officer of the Order of Australia and received many other honours. His contribution to the remarkable progress in curing paediatric cancers cannot be overestimated; John Colebatch was truly the father of the modern treatment of cancer and leukaemias in Australia.

Professor Henry Ekert AM

A modern paediatric hospital is a collection of many people with many different skills—a team looking after sick children and their families.

One turning point at the Children’s Hospital in Melbourne was led by Professor Vernon Collins (later medical superintendent from 1948), who appointed staff to care only for children: physicians became paediatricians, and in the 1940s he appointed the respected general surgeon Russell Howard to operate on children only. Howard’s expertise resulted in Australia’s first successful repair of the birth defect oesophageal atresia, in the late 1940s. He became chief of surgery in 1952, in turn appointing other paediatric surgeons. Many advances were made possible by developments in anaesthesia and post-operative care. Gretta McClelland became director of anaesthesia in 1956 and John Stocks developed the intensive care unit in 1964. Complex and delicate operations on thoracic and abdominal problems could now be more safely and expeditiously performed.

Complex operations like the separation of conjoint twins need a large team of experts. The separation of two girls in 1988 (illustrated opposite) required neonatal physicians, radiologists, cardiac team and gastroenterologists. Another turning point towards paediatric specialists was in cardiac surgery. In the 1960s I was a trainee in the cardiac unit with George Westlake. He was a world-class surgeon and I am grateful for his teaching, but he was basically an adult surgeon. Progress accelerated with the appointment of Bill Braun from Birmingham and Roger Mee from New Zealand. For instance, transposition of the great vessels is a classic cause of ‘blue baby’. Bill Mustard in Toronto designed an operation to transfer the blood at atrial level, but the right ventricle was eventually too stressed to pump blood around the body. Roger Mee designed a ‘switch’ operation to restore the anatomy. Due to his skill and attention to detail, his first 50 operations on sick babies were performed without a single death—amazing!!

The RCH’s role in training paediatric surgeons means that its people now work all around Australia and the world. One area of particular interest is the South Pacific: Cook Islander Kiki Maoate trained at RCH, is now based in Christchurch, and is influential across the region. Finally, it is now recognised that actively involving the family is vital to the successful treatment of sick children.

Dr Alex Auldist AO

‘Surgeons separate twins in six hours’, Canberra Times, 20 October 1988. National Library of Australia.

Infectious diseases have always been the major cause of sickness and death among children in Victoria, and they remain so today, causing one-quarter of children’s hospitalisations. However, their effects have been remarkably curbed by vaccines, and to a lesser extent by antibiotics. Put simply, immunisation of children is the greatest public health success story in recent human history, and Victorian children have been the beneficiaries since community immunisation began here in 1932.

Before the era of widespread immunisation, many children died from infections including pneumonia, meningitis, diarrhoea, measles and whooping cough. Management of these conditions was generally symptomatic and expectant, with very few effective therapies. Isolation of infected children was common. But between 1932 and 1970, vaccines against diphtheria, tetanus, whooping cough, measles and polio were introduced in Victoria. In 1930, the mortality rate of Australians aged under five years was 70 deaths per 1,000 live births. By 1970 it was 22 per 1,000. Although immunisation cannot claim all the credit, vaccines brought a huge benefit. The effect of the poliomyelitis vaccine is especially noteworthy. Polio was a devastating illness, and the Children’s Hospital dedicated tremendous resources to the care of afflicted children. Vaccines were introduced in 1956, and Australia’s last locally acquired case was recorded in 1972.

Vaccines for children and adolescents included rubella (introduced 1971), mumps (1981), hepatitis B (1983), meningitis (haemophilus 1992, meningococcus 2002, pneumococcus 2005), chickenpox (2001), rotavirus (2007), cervical cancer (2007), pandemic influenza (2009) and seasonal influenza (2010). In 2020, the child mortality rate was 4 per 1,000.

Of course, we do not have a vaccine for every infectious disease, and antibiotic treatment has also brought a remarkable reduction in death and disability. As discussed on pages 25 and 90, the first antibiotic given to a child at RCH was penicillin, administered in 1944. It remains useful against several infections, including pneumonia and sore throat, although the rising danger of resistance to antibiotics means that fewer conditions can be treated with penicillin today than in the 1940s.

Fast-forward to 2021, and the COVID-19 pandemic is a stark reminder of the ever-present threat of infectious diseases, but also of the astonishing power of immunisation.

Professor Andrew Steer

When the Melbourne Free Hospital for Sick Children opened in 1870, there was no organised general nursing training in Victoria; most skills were handed down from one nurse to another. In 1879 Mrs Bellaine, a graduate of Sydney’s Lucy Osburn nursing training school, which espoused the Nightingale principles, was appointed assistant matron to Mrs Sarah Bishop. Bellaine incorporated the Nightingale principles into the Free Hospital’s emerging training program, and by 1887 the hospital was officially recognised as a nursing training school.

After two years of lectures on anatomy, physiology and general nursing, a student would receive a certificate showing attendance. Evelyn Conyers (1870–1944) obtained her certificate in 1894 at the Children’s Hospital, and became a foundation member of the Nurses’ Registration Board and the Victorian Trained Nurses Association in 1901. Together with other members from the Melbourne Hospital (where she now worked), Conyers resolved to have a standardised final exam and nursing curriculum. After her remarkable service in World War I, she maintained her interest in children and, with Matron Grace Wilson, formed the League of Former Trainees in 1921 to advocate for nurses’ education and recreational needs.

Patten was appointed director of nursing at RCH in 1982. Concerned by the increasing complexity in patient care and technologies, nursing shortages, graduate staff retention and high educational costs, Patten, with the support of the RCH committee of management, resolved to replace the undergraduate basic training school with a university-based curriculum. In 1987, after 98 years of nursing training at RCH, the last group graduated.

A paediatric graduate year was established and the existing post-basic and intensive care paediatric courses were transferred to the University of Melbourne in 1994.

Suzanne Scott

Reference: M McInness, Caring for our children: The history of nursing at the Royal Children’s Hospital, Melbourne, Melbourne: Australian Scholarly Publishing, 2006.

Physiotherapy, the Royal Children’s Hospital, and the University of Melbourne have journeyed together for more than a century. Formal education of physiotherapists in association with the University of Melbourne commenced in 1906 at the Children’s and Melbourne hospitals. The course involved medical theory and clinical practice at the university and a 12-month placement in physiotherapy practice in a recognised hospital.1

The essential contribution of physiotherapists to adult rehabilitation—through electrical modalities, exercise, massage and baths—was recognised during World War I, but the particular needs of physiotherapy for children were revealed by polio epidemics, beginning in 1908. In 1928, Dr Jean Macnamara, a medical practitioner, was appointed to oversee the Children’s Hospital’s new physiotherapy department. In 1959 she appointed Val Irwin as the first physiotherapist to head physiotherapy. Outpatients were a focus, particularly children with respiratory conditions and cerebral palsy. For the latter group, Irwin introduced innovative developmental techniques.2

The relationship between physiotherapy and the university continued to grow until the 1960s, with medical sciences taught at the university and physiotherapy subjects at Fairfield Hospital. Physiotherapy education was then transferred to Lincoln Institute of Health Sciences, but the relationship with the university continued. In 1974 Anne McCoy was appointed head of physiotherapy, which she led for three decades. McCoy was the first RCH physiotherapist to complete a Master of Science, supervised by Professors Dinah Reddihough and Terry Nolan. Her Churchill Fellowship work led to the establishment of the first paediatric gait laboratory in Australia (as discussed on pages 108–9).

The period 1976–91 saw an increase in childhood complexity and specialisation, bringing a multidisciplinary approach to child-focused care. A successful campaign followed to secure physiotherapy education at the University of Melbourne in a dedicated school of physiotherapy. For the first time, physiotherapy at RCH was funded for clinical education in line with its medical equivalent.

The strengthening of the relationship with the university has resulted in the acquisition of more postgraduate qualifications, leading to world-recognised physiotherapy research and clinical specialist roles.

Anne T McCoy AM

1  JM McMeeken, Science in our hands: Physiotherapy at the University of Melbourne 1895–2010, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 2018.

2  P Yule, The Royal Children’s Hospital: A history of faith, service and love, Sydney: Halstead Press, 1999

Isabel Hodge, having completed the inaugural Melbourne almoner (medical social work) course, started the Children’s Hospital’s Almoner Department in 1931. The hospital also trained almoner students and from 1933, when general education for social workers was established, taught students of the evolving University of Melbourne social work course.

In 1962, when Kath Dawe was appointed head of the Almoner Department, its name changed to Social Work. Dawe is remembered for her work with Dr Birrell in the 1960s, the early days of intervention in child maltreatment—until then an unrecognised phenomenon. A family bereavement service was started in 1989 by psychiatrist Julie Jones. Subsequently, bereavement programs have been provided by the Social Work Department, largely under the direction of social worker Dr Jane Sullivan, whose expertise resulted in her joining the hospital’s organ retention after autopsy team in 2020.

Between 1953 and 1982 Joyce Grant (LSE Mental Health Certificate) established psychiatric social work at RCH. In 1983 the mental health social work team was merged with the main Social Work Department, and American-trained social worker Anita Morawetz was employed as a consultant family therapist. Sarah Jones followed Morawetz and continues as a consultant in clinical supervision and culture change.

From 1990 Dr Brigid Jordan—with Dr Campbell Paul and Dr Frances Salo—was part of the internationally recognised infant mental health team, which established postgraduate infant mental health courses at the University of Melbourne. Amalgamation of the Travancore Clinic in 1992 brought a new social work team into the hospital, under the leadership of social worker and family therapist Harry Gelber. Jordan became inaugural associate professor of paediatric social work (2007–20). From 1993, during Jane Miller’s tenure as head of social work, the Aboriginal Liaison Program (see pages 144–5) underwent radical service innovation. Sarah Connolly was appointed chief social worker in 2014. She also manages the pastoral and spiritual care service and holds honorary positions in the departments of paediatrics and social work at the University of Melbourne.

Since 2016 the RCH Social Work Department has led a whole-of-hospital response to family violence and its effects on children. In 2020 COVID-19 brought increased demand as the department responded to the repercussions of the pandemic for children and families.

Dr Jane Miller AM

References: J Miller, ‘Skills, bravery, courage and foolhardiness: Seventy-five years of social work in health care in Melbourne, Australia’, Social Work in Health Care, vol. 43, nos 2/3, 2006, pp. 173–91; B Robb & J Sullivan, ‘The past and the present: Listening to parental experiences of autopsy practice’, Grief Matters, vol. 7, no. 2, 2004, pp. 39–43; C Delany et al., ‘Reflecting before, during and after the heat of the moment: A review of four approaches for supporting health staff to manage stressful events’, Journal of Bioethical Inquiry (in press).

Speech therapy at the Royal Children’s Hospital began as a service in the Department of Psychiatry in the 1930s and 1940s. During the 1950s the establishment of an outpatient plastic surgery team supported moves to independence that saw a department declared in 1984. Mirroring the tremendous growth of the profession in the 1960s and 1970s, the Speech Therapy Department contributed to international progress in the management of stuttering, articulation disorders, language difficulties, and eating problems, and in the assessment of reading and spelling.

Speech therapy as a profession in Australia changed its name to speech pathology in 1973. The introduction of four-year speech therapy degree courses in some Australian universities heralded greater capacity for dealing with a wider range of more complex paediatric conditions. Speech pathologists at the RCH worked both independently and as members of multidisciplinary teams. The department became increasingly involved in assessing and managing children with neurological conditions (congenital and acquired), craniofacial anomalies (including cleft palate and Pierre-Robin sequence), velo-pharyngeal dysfunction, swallowing disorders, and disorders of infant feeding development. The department’s work in managing neonate feeding, children before and after cardiac surgery, and children in intensive care has increased significantly. Assessment of swallowing to determine the safety and progression of oral feeding has become an important role for speech pathologists at RCH.

The RCH Speech Pathology Department was involved in the course advisory process when the University of Melbourne established its Master’s degree in speech pathology.

Technological advances have brought greater accuracy to assessment processes. Videofluoroscopic imaging has allowed speech pathologists to view the ingestion and swallowing of foods and fluids, an assessment previously possible only through clinical observation. Similarly, videofluoroscopic imaging of velo-pharyngeal function has allowed speech pathologists to provide more accurate advice on the aims and potential success of any surgical interventions. Advances in sound and imaging technology have assisted analysis and assessment of voice disorders and endoscopic assessment of the functional effects of surgery.

Bernadette O’Connor

Reference: P Yule, The Royal Children’s Hospital: A history of faith, science and love, Sydney: Halstead Press, 1999

Audiology at the Children’s Hospital began, as did speech pathology, as part of the Department of Psychiatry in the 1930s and early 1940s. Miss Ruth Drake is credited with starting both services in the child guidance nursery. Drake recognised that hearing loss could contribute to behavioural disturbance or apparent developmental delay. The Audiology Department became independent of the Psychiatry Department in 1984.

The history of the Audiology Department from 1960 until 1997 is inextricably linked with Eddie Keir (pictured opposite). A trained electrical engineer and audiologist, with majors in child psychology and teaching of the deaf, Keir joined the department in 1960 and oversaw a gradual growth in staffing, being joined by a second audiologist in 1965. Keir and his colleagues recognised the need to assess a child’s capacity to hear not only isolated sounds but sounds in noise, to discriminate speech in noise, and the role of auditory processing. The department developed specialised protocols for assessing these various areas of hearing and listening. The department also pioneered techniques and processes to assess and examine children who were previously deemed untestable or too uncooperative due to behavioural or age factors. StimLab was developed in the early 1990s by the biomedical engineering team at the Royal Children’s Hospital: digital bandpass filtering of sounds familiar to children, such as the Play School theme, crying babies, barking dogs, and music, ensured accurate, frequency-specific assessments.

Developments in technology have considerably expanded the capacity to assess and give clinical advice for a much wider range of patients. For example, hearing in infants can be reliably determined via auditory brainstem response audiometry. Children undergoing oncology treatment can be monitored for the effects of any potentially ototoxic drugs used in their treatment. Middle ear function can be measured and documented via tympanometry.

The Audiology Department at RCH is a centre of excellence in paediatric assessments. Use of the best equipment, with unique features to help specialist staff identify hearing loss at a very young age, enables the department to provide a high-quality service to all children in the community.

Bernadette O’Connor

Reference: P Yule, The Royal Children’s Hospital: A history of faith, science and love, Sydney: Halstead Press, 1999.

Despite care for people’s mental health having a low community profile until recent times, when compared to that accorded to their physical health, the psychological and emotional wellbeing of children has nonetheless had a long and influential presence at RCH.1

From origins in the 1920s under Professor RJA Berry of the University of Melbourne Medical School and Dr John F Williams, the hospital’s first (and honorary) psychiatrist, along with kindergarten teacher Ruth Drake, the hospital’s care for the mental health of children has been based on a holistic framework and multidisciplinary approach. This involves understanding and treating emotionally distressed and disturbed infants, children and adolescents in the context of their families, their wider communities and their individual circumstances of health, life challenges, development, strengths and vulnerabilities.

The recognition that children often have complex and confusing inner worlds of thoughts, feelings and understanding that compromise their mental health and general development underpinned the philosophy of mental health services under the leadership of Dr Winston S Rickards. From 1955 to 1983 he further developed the team model of child psychiatry, including the allied health professions of speech pathology, audiology, psychology, child psychotherapy, social work, psychiatric nursing and teaching. Paediatricians including Professor Vernon Collins, Dr Bernard Neal and Dr Howard Williams actively supported this throughout the hospital.

Consultation liaison for hospital inpatients developed in the 1970s. Early clinics where mental health disciplines were active in medical teams included haematology and oncology, burns, and child maltreatment. In recent decades RCH has been a national leader in infant mental health, family therapy, child abuse, child trauma and community consultation. Collaborative research involving several departments and clinics reflects the hospital’s holistic and multidisciplinary approach to paediatric mental health, and has also focused on specific problems such as eating disorders and childhood anxiety.

Over the years the Royal Children’s Hospital’s mental health disciplines have provided training for child psychiatrists (the first in Australia), paediatric registrars and also, in association  with the University of Melbourne and other universities, for related allied health professions.

Ruth Wraith OAM

1  L Gardiner, Royal Children’s Hospital Melbourne 1870–1970, Melbourne: Malcolm Printing, 1970, pp. 131–2; P Yule, The Royal Children’s Hospital: A history of faith, science and love, Sydney: Halstead Press, 1999, pp. 557–69.

The year 1995 was a turning point in the partnership between the University of Melbourne and the Royal Children’s Hospital. Until then, the Stevenson Professor and head of the Department of Paediatrics had always been on the RCH committee of management, and was a hospital administrative leader, as well as an academic leader for the RCH campus. But 1995 saw the Victorian (Kennett) government’s restructure of the Victorian hospital system in response to the recommendations of the Metropolitan Hospitals Planning Board, creating the now defunct hospital network system, which included the Women’s and Children’s Healthcare Network. Under the guidance of Professor Peter Phelan, at RCH this led to a separation of church and state: the Stevenson Professor was no longer a formal executive of the hospital. Nevertheless, leadership at RCH, including board membership of the soon to be formed Murdoch Children’s Research Institute and of the RCH Foundation, continued to be important functions for the Stevenson Chair, and remain so today.

This shift in emphasis was important for a number of reasons. Firstly, independence of academic leadership enabled strong advocacy for children first and foremost, distinct from advocacy for the campus or RCH, and simultaneously enabled the university to advocate more strongly for RCH. Secondly, academic leadership, with a push for world-class research and education on the RCH campus, would be better served. The formation of wide academic links locally, nationally and internationally, and a research vision that went beyond the walls of the hospital, assisted in achieving those goals. By 1995, the university’s Department of Paediatrics, in partnership with RCH, had embarked on an expansive program to attract professors, by offering dual hospital–university appointments, protected research time, access to students, and greater research grant opportunities, while embedding leadership in hospital departments. This transformation led to today’s strong cohort of professorial leaders on campus who strive to improve the lives of children.

Finally, the ability to provide academic and career mentorship for junior staff from medical, nursing and allied health ranks at RCH, without being in direct line management, increased the breadth and depth of support for junior staff and created many more research and educational opportunities at the hospital.

Professor Paul Monagle

The Royal Children’s Hospital was founded to care for very young children. Yet, over the latter part of the 20th century, technological advances resulted in increasing survival of older children with complex health conditions and disabilities—including adolescents. Adolescent health had not been part of traditional paediatric training, and clinicians struggled to meet these patients’ needs.

Dr John Court (far right) was the pioneer of adolescent medicine at RCH. In the early 1980s he established a clinical program in adolescent medicine, persuaded the hospital’s committee of management to lift the upper age from 14 to 18 years, and developed an adolescent ward which recognised adolescent nursing. By the late 1980s, in response to growing community concerns about adolescent health, RCH invited up-and-coming US academic Dr Bob Blum to visit. He recommended establishing a centre for adolescent health, which would integrate research, education, clinical care and advocacy. This was achieved

in 1991 with funding from the new Victorian Health Promotion Foundation. Professor Glenn Bowes (third from right), an adult respiratory physician, was appointed inaugural director (1991–97). Based at 2 Gatehouse Street, the new Centre for Adolescent Health felt as challenging to the hospital as the age-group did for the hospital’s staff; it extended RCH clinical practices with new ways of consulting, new models of clinical care (such as peer support), and new settings for health care (for instance, clinics for homeless adolescents).

Investment in academic leadership has created many legacies: teaching in adolescent health and medicine is now mainstream for medical students and paediatric trainees; adolescent and young adult medicine is now an accredited subspecialty in Australasia; and the multidisciplinary postgraduate program in adolescent health and wellbeing at the University of Melbourne that Mary-Anne Hope, Judy Davey (fifth from left) and

Dr Michael Carr-Gregg developed still feels ahead of its time. Back in the 1990s, the young adolescent psychiatrist Dr George Patton (centre director 1998–2005) initiated a research program that quietly established the Melbourne Children’s Campus as Australia’s leading academic centre. Over the past decade these efforts have becoming globally influential, with recognition that the 2016 Lancet commission on adolescent health and wellbeing helped achieve the extraordinary framing of adolescent health in the UN’s Sustainable Development Goals.1

Professor Susan M Sawyer AM

1  Our future: A Lancet commission on adolescent health and wellbeing, Lancet, vol. 387, no. 10036, 11 June 2016.

From 1995 to 2011 the Royal Children’s Hospital, through RCH International, collaborated with Hanoi’s National Hospital of Pediatrics (now the Vietnam National Children’s Hospital or VNCH) in a series of training projects aimed at building capacity in administration, training and clinical skills. RCH International had earlier been commissioned by Atlantic Philanthropies to prepare a hospital services plan and functional design brief for the complete rebuilding of VNCH. Funding was provided by Atlantic Philanthropies and project management expertise by the Nossal Institute of Global Health. All levels of personnel at VNCH, from administration to project management, medical, nursing and laboratory staff, were involved in this three-year project, which was supported by the Vietnamese Ministry of Health. A significant exchange of staff between Melbourne and Hanoi took place and strong friendships developed. Among the project’s achievements were 19 directors and administration staff members gaining MBA degrees, a train-the-trainer postgraduate paediatric nursing course (continuing today), and advanced paediatric life support courses across Vietnam. Quality-assurance projects resulted in several laboratories gaining ISO accreditation. Professor Glenn Bowes, Professor Christine Kilpatrick, Mr John Stanway and dean of medicine Professor James Angus all visited Hanoi as part of the project.

Another major training project was delivered at the Cardiovascular Centre in the Hue Central Hospital. In this five-year program, 117 doctors, nurses and technical staff received training at five cardiovascular centres in Vietnam, Australia and France. Professor Dan Penny, Associate Professor Michael Cheung and Ms Mai Eames all played major roles. Professor Garry Warne AM was awarded the People’s Health Medal of the Vietnamese Ministry of Health in recognition of his role as director of these two projects.

RCH International also delivered a major three-year project to aid the recovery of a devastated regional hospital in Meulaboh, Aceh Province, Indonesia, following the 2004 Indian Ocean earthquake and tsunami. This project, funded by World Vision, was managed by the Nossal Institute of Global Health and implemented through a collaboration with the Universitas Gadja Mada in Yogyakarta. A major element was the establishment of a mental health service in Meulaboh. Professor Graeme Barnes AO initiated the collaboration and Ms Ruth Wraith OAM played a major role.

Professor Garry Warne AM

Occupational therapy (OT) at the Royal Children’s Hospital started in the 1930s, when the Orthopaedic Section was located at Mt Eliza (see page 117) and its patients’ average length of stay was 500 days. In OT’s early decades its main aim was to provide a ‘diversion’ for children enduring lengthy hospital stays and separation from their families. From the mid-1940s a ‘diversional therapist’ was employed at the Carlton site, but by the time of the hospital’s move to Parkville in 1963 there was a true department of five full-time therapists, who worked across many clinical areas, with burns being a specialty. During the 1960s the gradual reduction in length of inpatient stay resulted in a transition in OT services from group activities to individual treatments.

In the 1970s and 1980s OT matured as a discipline, which was reflected at RCH with the development of OT services for a broader range of children, including those recovering from surgery, cancer or head injury, or experiencing developmental disabilities or mental health problems. With an enduring goal of encouraging and developing children’s independence and mastery in their various ‘occupations’ of daily life, OT at RCH developed many areas of specialisation and expertise.

For some time, the OT department managed the hospital’s play therapy service. Now called child life therapy, this service has been a separate entity since 1982. Another major transition occurred in the late 1990s, when a dedicated research position was funded by the Parkville Auxiliary. This resulted in OTs contributing to research in areas such as neurology, developmental disability, pain, orthopaedics and plastic surgery—an involvement that continues today. Along with other allied health disciplines, OTs have developed a significant role in the assessment and diagnosis of conditions such as autism spectrum disorder, cerebral palsy and post-traumatic amnesia. The department developed the Melbourne Assessment 2, a standardised upper-limb assessment that is now sold internationally.

Occupational therapy has evolved to become an intrinsic and necessary service to RCH. Using evidence-informed practice, therapists support acute inpatients, provide expertise in specialist outpatient clinics, rehabilitation, pain management, palliative care and mental health, and through research actively contribute to the creation of new knowledge and evidence that informs paediatric practice worldwide.

Bernadette O’Connor

Reference: P Yule, The Royal Children’s Hospital: A history of faith, science and love, Sydney: Halstead Press, 1999.

The origins of the Prosthetics and Orthotics Department lie in the earliest days of the Royal Children’s Hospital. Honorary surgeons arranged for splints to be manufactured

for children afflicted with tuberculosis of the bones or osteomyelitis, and in the 1920s the department was kept busy during a polio epidemic. The advent of polio vaccination and decreasing rates of tuberculosis and osteomyelitis saw the department’s workload reduce significantly in the late 1950s and early 1960s, and the making of splints was outsourced.

The department was revived in the late 1970s. The advent of plastic materials and new capacity to intervene in conditions like paraplegia and cerebral palsy led to increased staffing and new technologies. The ability to custom-mould thermoplastic orthoses for children saw the end of metal callipers, providing a more aesthetically acceptable device. In 1976 the Splint Workshop was renamed the Orthotic Department, acknowledging this wider scope and coinciding with changes in professional education, from apprenticeship to a Diploma of Health Sciences. RCH was at the forefront of these changes, running education and professional development workshops for its counterparts across Australia.

In the late 1980s, prosthetic assessment, manufacture and fitting were taken on by the department, which became the Orthotic and Prosthetic Department. It also established Australia’s first myo-electric upper-limb prosthetic program: families could procure state-of-the art ‘robotic’ hands from the department’s Limb Bank, at minimal cost.

In 2011 the department introduced 3D-imaging and CADCAM (computer-aided design and computer-aided manufacturing), purchasing a scanner and carver to shape polyurethane blocks. This was a turning point: to be able to provide advanced care for patients, superior-fitting helmets for babies with flattened heads, and safer work practices for clinicians. Scanning, CADCAM modification of scans, and 3D-carving of foam blocks have helped patients with scoliosis, allowing the creation of devices not previously possible. Technicians fabricate spinal braces using 6-kilogram foam torso models, instead of

60-kilogram plaster. These clinical and technical skills provide the digital literacy for the next step: 3D-printing, the new frontier in orthotics and prosthetics.

Bernadette O’Connor

Reference: P Yule, The Royal Children’s Hospital: A history of faith, science and love, Sydney: Halstead Press, 1999.

Clinical photography began as a service at the Children’s Hospital in 1934, at both Carlton and the Orthopaedic Section at Mt Eliza. By 1938–39 all children were photographed on admission and discharge. A distinct Clinical Photography Department was established in 1948; Mr Cyril Murphy was appointed as the clinical photographer and a dedicated studio space assigned.

The service and department grew and accommodated new technologies, such as colour photography (first reported in 1942–43, but routine for decades before this). A medical artist was employed in 1967, and in 1971 the department head, Adrian Daniel, helped establish the Bachelor of Applied Science in photography at Royal Melbourne Institute of Technology.

Diversification and innovation are the hallmarks of this department. As new technologies became available, staff incorporated them to improve the clinical management of patients and support teaching and training. The latter included production of diazo slides, while the former benefited from vastly improved lighting techniques in the 1970s that enabled effective portrayal of conditions. The advent of computers revolutionised clinical photography and this evolution continues as the digitisation of numerous processes continues to change. A fully integrated digital medical information photography system was implemented in 2009.

Clinical photography has become an integral part of the multidisciplinary management of many paediatric medical conditions. With the advent of mandatory reporting of child abuse, for example, a clinical photographer remains on call to assist in collection of evidence for medical and forensic investigation. Children aged under six undergoing radiation therapy have the necessary mask prepared for them using 3D-imaging and custom manufactured by the Orthotics Department, thereby reducing trauma and avoiding the need for general anaesthesia. Surgical and non-surgical management of conditions such as craniosynostosis and pectus carinatum are not possible without this 3D-imaging service.

In research, the 3D-Imaging Centre was integral to the Australian Headshapes Examination and Analysis Database (AHEAD) project, led by RCH’s Department of Plastic and Maxillofacial Surgery, which generated a databank of 3D images of the normal craniofacial anatomy of 1,900 children.

Bernadette O’Connor

Reference: P Yule, The Royal Children’s Hospital: A history of faith, science and love, Sydney: Halstead Press, 1999.

The winter of 1881 was a very difficult and distressing time for William Barak (1824–1903), an Aboriginal leader in the Coranderrk mission near Healesville, and traditional ngurangaeta (Elder) of the Wurundjeri-willam clan. His wife, Annie, died on 8 July. His despair worsened when their only surviving son, 14-year-old David, also become gravely ill.

Barak sought the permission of the mission manager, Reverend Strickland, to take his son by coach for treatment at the Melbourne Hospital. He was granted permission and a pass. However, when they arrived at the hospital, no one was there to meet them as had been arranged. Barak carried his son to the home of Anne Fraser Bon at Kew. Mrs Bon was a long-term friend to the people at Coranderrk and later became a member of the Board for the Protection of Aborigines. She gave Barak and David a meal and took them back to the Melbourne Hospital, where at her request David was admitted. She also gave Barak a shilling for his room for the night. Barak returned to the hospital to say goodbye to David the next morning, not realising he would never see his son again, as the lad died not long afterwards.

William Barak’s experience at the Melbourne Hospital was, sadly, not unusual for Aboriginal people for more than a century. Aboriginal families visiting the nearby Children’s Hospital faced similar difficulties in obtaining care.

From the 1980s onwards, steps were taken to improve access to hospital care for Aboriginal people across Victoria. At the Royal Children’s Hospital, Rita Watkins (née Clarke) was employed as one of the first Aboriginal hospital liaison officers while I was working at the Koori Health Unit in the Victorian Health Department in 1986. She worked tirelessly for a number of years to ensure that Aboriginal families and children received better care.

Since Clarke’s time, programs such as the Wadja Aboriginal Family Place have been set up to provide welcoming and culturally safe places for Aboriginal families. The staff of programs such as this support Aboriginal and Torres Strait Islander families as they attend outpatient clinics or seek emergency care, and assist families who have a sick child in hospital. They work to ensure that Aboriginal families are supported culturally, socially and emotionally. They also advocate for Aboriginal people and promote a culturally safe hospital.

Professor Ian Anderson AO

The Royal Children’s Hospital’s first Aboriginal hospital liaison officer, Ruby Lako, was appointed in 1984 following the Wronski report on Aboriginal health in Victoria. Although she provided a valuable service, Lako’s role as the sole liaison officer was marginalised and could not generate the level of change that was needed.

In 1993 the establishment of a new Community Division and appointment of a new head of social work, Jane Miller, became a catalyst for change. An Aboriginal Policy Advisory Committee, the first RCH committee with Aboriginal representation, was chaired by Christine Minogue, co-director of the Community Division, and provided a forum in which senior staff and Aboriginal Elders could solve problems together. The liaison officer now had advocates at the highest level of the organisation, and in this role Robynne Nelson inaugurated the hospital’s first cross-cultural education program (1993). From 1994 Angela Clarke’s leadership developed the basis of today’s integrated, culturally safe Wadja Service. Additional philanthropic funding enabled a new way of working that recognised the need for a small cohort of Aboriginal staff and a culturally affirming stand-alone unit.1 The 1997 Bringing them home report into the Stolen Generations heralded a fundamental shift in attitudes across the hospital. The Aboriginal Family Support Unit was established in 1998, receiving several public health awards and leading change in Victorian hospitals.

In 2008 the RCH Foundation funded an improved model of care that provided case management and an Aboriginal Child Health Clinic. In 2021 Selena White, employed since 2005, has managed the team of four Aboriginal case managers. This unique service continues to evolve and lead.

Shawana Andrews and Dr Jane Miller AM

1  A Clarke, S Andrews & N Austin, Lookin’ after our own: Supporting Aboriginal families through the hospital experience, Melbourne: Aboriginal Family Support Unit, Royal Children’s Hospital, 1999; A Clarke, N Austin, S Andrews & J Miller, ‘Your way, my way: Improving access of Aboriginal children and their families to the Royal Children’s Hospital, Melbourne’, in Wendy Weeks & Marjorie Quinn (eds), Issues facing Australian families: Human services respond (3rd edn), Melbourne: Longman, 2000; A Clarke, H Goodman, N Austin, J Miller & S Andrews, ‘Promoting Koori children’s health: An affirmative approach’, Health Promotion Journal of Australia, vol. 8, no. 1, April 1998, pp. 29–33

The Royal Children’s Hospital Interpreter and NESB Services Department offers patients and families of non-English speaking backgrounds interpreting services in more than 100 languages and dialects, to ensure that they are not disadvantaged in obtaining quality health care.

The origin of this service stems from the end of World War II: between 1945 and 1965 more than two million people emigrated to Australia.1 Hospitals and health care providers needed to adapt and evolve to serve a newly diverse and multicultural population. Until 1970, the RCH relied on multilingual volunteers, staff members and family members (including children) to communicate between NESB families and medical staff—not the ideal method for translating sensitive and complex medical information, potentially even endangering a patient’s health. Medical staff supported professionalising this service, and in 1971 hired Silvio Proy, the hospital’s first full-time interpreter. Born to Austrian and French parents, Proy came to Australia from Turkey in 1964 and was fluent in Turkish, French, Greek, Italian and Spanish. Within just a year of his appointment he had developed the interpreter service to support families on site from 9.30am to 10pm seven days a week, and via a telephone service between 10pm and 9.30am.2

For many years the department was staffed by a small team: in 1982 for instance there were just two full-time, one part-time and seven volunteer interpreters. Trained volunteers were particularly important when permanent staff went on leave. By the late 1980s Proy had helped establish the Australian Association of Hospital Interpreters, an external organisation maintaining standards and quality. He was instrumental in developing the department into what it is today, setting strict guidelines, and training and testing the interpreters to ensure ethics, cultural protocols and linguistic skills of the highest calibre. Interpreters worked closely with hospital staff, promoting the department’s services and educating colleagues on the interpreter’s role and how to communicate successfully with families from diverse cultural backgrounds.

Lucy Beattie Hughes

1. National Museum of Australia, ‘Defining moments: Postwar immigration drive, 1945: Australian government announces postwar immigration drive’, nma.gov.au/defining-moments/resources/postwar-immigration-drive, updated 23 July 2021.
2. LEG Sloan (medical director, RCH), All staff memo: Interpreting Service, 31 August 1972. Royal Children’s Hospital Archives and Collections Department.

In 2003, the Royal Children’s Hospital received its first referral from a trans (transgender) young person who required medical care. In 2012, with a rise in demand for trans medicine, the service was formally established, with a multidisciplinary team led by the Department of Adolescent Medicine in collaboration with the departments of mental health, endocrinology and gynaecology. In 2015, the Victorian government provided specified funding for clinical services at the Royal Children’s Hospital Gender Service (RCHGS). In 2017, philanthropy via the RCH Foundation supported a longitudinal cohort study, known as Trans20, which formed the core of the RCHGS research program. By 2020, referral numbers had reached 473 per year and the RCHGS had established its reputation as an international leader in the field.

The RCHGS team led the creation of the inaugural Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents. First published in the Medical Journal of Australia in 2018,1 the Australian guidelines became the subject of an editorial in The Lancet endorsing its collaborative, gender-affirming approach.2

The RCHGS team also became known for its successful advocacy in improving trans rights for young people more broadly. With RCH as an independent intervenor in the case of Re Kelvin (2017), and the director of the RCHGS, Associate Professor Michelle Telfer, as the expert medical witness, the Family Court of Australia ruled to allow young people to obtain hormone treatment without the authorisation of the court in circumstances where there was no dispute. This was a landmark victory for trans rights in Australia and was included in the Federal government’s 2018 report under the United Nations Convention of the Rights of the Child.

As the RCHGS became known as an international leader in progressive, trans-friendly, child and family–focused health care, it also drew significant criticism from socially conservative individuals and organisations. This was most publicly evident through a series  of more than 50 highly critical articles published in The Australian newspaper between August 2019 and mid-2021. Nevertheless, with backing from state and federal governments and the Royal Australasian College of Physicians, multidisciplinary, gender-affirming trans care continues to be offered across the country, with clinical demand continuing to grow.

Associate Professor Michelle Telfer

1  MM Telfer, K Pang, C Pace & M Tollit, ‘The creation of the Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents’, Medical Journal of Australia, vol. 209, no. 3, 18 June 2018, pp. 132–6.

2  Editorial: ‘Gender-affirming care needed for transgender children’, Lancet, vol. 391, no. 10140, 30 June 2018, p. 2576.

The Children’s Hospital’s focus on children with disabilities dates back to the 1920s and 1930s and the establishment of the Orthopaedic Section at Mt Eliza, where young people with poliomyelitis and tuberculosis were admitted for rehabilitation.1 Between 1950 and 1967, these acquired conditions were almost eliminated, and the majority of patients had cerebral palsy, spina bifida or muscular dystrophy. When Mt Eliza closed in 1971, the Handicapped Children’s Centre was established on the Parkville campus, headed by Dr Keys Smith. The Spastic Centre begun by Dr Jean Macnamara and teacher Madge Ogilvy in the 1940s became a child assessment and treatment centre, with children attending two to four days per week. It moved from the ground floor of the hospital to a large Victorian house in North Melbourne and was renamed Uncle Bob’s Child Development Centre. In 1978 Dr John Court took over the service. He became deeply involved in the care of adolescents and, in 1986, two separate departments were formed: Court became head of adolescent medicine and Dinah Reddihough head of child development and rehabilitation.

There were urgent needs: to care for children with disabilities and their families, attract and train a workforce, raise the profile of disability on the campus, and conduct research. Most treatments were not based on evidence, and many were time and resource intensive. Over the following years research increased substantially, and the treatment of cerebral palsy in particular was revolutionised. Alternative methods of feeding, usually via gastrostomy tube, were introduced for children with aspiration and failure to thrive, Botulin toxin became a common treatment for spasticity, more invasive treatments such as intrathecal baclofen pumps and selective dorsal rhizotomy were initiated, but above all there was an increasing impetus to provide family-centred multidisciplinary care, with decisions made jointly by patient, family and providers.

In 2004, Solve@RCH was formed, a partnership between the community and the campus, resulting in the establishment of Australia’s first chair in developmental medicine, with funding from the Apex Foundation for Research into Intellectual Disability and the RCH Foundation. Subsequently a generous donation created the Lorenzo and Pamela Galli Chair in developmental medicine, further strengthening research into the causes and treatments of developmental disability.

Professor Dinah Reddihough AO

1  P Yule, The Royal Children’s Hospital: A history of faith, science and love, Sydney: Halstead Press, 1999, pp. 196–7.

The Royal Children’s Hospital Child Protection Unit, staffed with one doctor, three social workers, a nurse, and part-time psychologist and psychotherapist, was established in 1986. Later becoming the Gatehouse Centre, the focus was on care for children in the context of their family. Numerous legislative, systemic and funding changes over the years have seen the Gatehouse staff grow to more than 30, including art therapists, nurses, psychologists and social workers, plus a part-time neuropsychologist, occupational therapist and psychiatrist to respond to the ever more complex needs of the children who attend.

It was, however, a 4 Corners and The Age series, ‘Our children, our shame’,1 and the Fogarty Report,2 that brought the existence of child sexual abuse boldly to the public’s attention. Mandatory reporting of child abuse was first legislated in the Children and Young Persons’ Act 1989, sparking an increase in children identified as needing a therapeutic response, not just a child welfare or justice response. The Victorian Law Reform Commission continued developing responses to child sexual abuse, recommending, in 2004, 302 improvements to legal responses to child sexual abuse and creating the Child Witness Service.

Our therapeutic work with children and young people has developed significantly. Better recognition of the effects of trauma on children saw the emergence of new, trauma-focused therapies, while the Children, Youth and Families Act 2005 introduced therapeutic treatment orders for young people with problem sexual behaviour. Service provision has diversified: in addition to assessment, treatment, advocacy and outreach, the Gatehouse provides education and training and undertakes research. Since the 2013 Royal Commission into Institutional Responses to Child Sexual Abuse,3 demand for services has continued to grow, and an understanding of the importance of collaborative, trauma-informed services that meet our clients where they are, has become central to all that the Gatehouse Centre provides.

Karen Hogan and Dr Helen Kambouridis

1  ‘Our children, our shame’, The Age, May 1988.

2  JF Fogarty, Protective services for children in Victoria: A report, Melbourne: Child Protection Services Branch, Community Services Victoria, 1993.

3  Royal commission into institutional responses to child sexual abuse, Commonwealth of Australia,

https://www.childabuseroyalcommission.gov.au/.

A Royal Children’s Hospital prescription booklet dating back to the 1960s remains a prompt for memories, while also speaking profoundly about another time.

Melbourne is threaded together by stories of immigration: people who have arrived here by choice or by chance. The story of the De Feudis family reflects both choice and chance. Woven into that narrative is the path to the RCH and the legacy of a child born seriously unwell.

Arriving in this world on 10 September 1954, on what should have been a joyous occasion, Joseph Bernard (Joey) De Feudis was born with cardiac and structural anomalies, and it was predicted that he would not reach adolescence. For mother Josephine, the language barrier was impenetrable, so power and language remained in the hands of the father, Michael. As an Italian farming soldier captured overseas during World War II and brought to work on a farm in South Gippsland, he had been taught to read, write and speak English. But even with his language skills, he too became frightened and hoped that Joey’s illness would just disappear. It was never spoken of, its consequences unknown, and, as Joseph grew up with two younger siblings, the need to confront the ‘illness’ was too overwhelming for the parents.

Sadly, Joey was not to know about his condition until, as a young man embarking on his first job in a bank, he underwent a medical examination. The stunned doctor announced to Joseph that his heart was on the wrong side. This shocking revelation changed him. Suddenly, he understood the past: the trips to the RCH, the scars where catheters had penetrated, his exclusion from sports, and why, when he was puffed out, his lips would turn blue.

The silence imposed upon Joseph about his condition was meant to protect him. But, when he was 24, a dentist’s appointment resulted in a fatal combination: dentistry, cardiac problems and severe infection. This connection was not well understood in 1978 and, in November of that year, Joseph died suddenly while a patient at the Alfred Hospital.

Joey’s was a life cut short, but it was also a life prolonged by many trips along the road from South Gippsland to the Royal Children’s Hospital in Parkville.

Anne Rahilly

The Teddy Bear Hospital (TBH) is a volunteer student initiative established in 2009. This collaboration between the Royal Children’s Hospital and the University of Melbourne is a unique educational program that benefits both children and health care students. It is coordinated by a 60-member committee of students from across the Faculty of Medicine, Dentistry and Health Sciences, and is overseen by Professor Paul Monagle of the Department of Paediatrics.

The TBH has two main aims: firstly, to demystify health care for children through positive imaginative play with their bears, and secondly, to provide opportunities for students to develop their paediatric communication skills. It is a delight to see kids with their bears, interacting with health professionals, and returning year after year. We consistently observe that after even one event, students’ confidence in interacting with kids grows significantly, and we receive feedback to this effect from the students themselves.

We create an entire hospital experience, with services ranging from radiology, pathology and nursing to dentistry and physiotherapy—and more. The children take their bears through these services, guided by students. All our equipment has been handcrafted by our student committee over the years. Our two major annual events are the Good Friday Appeal and the Chadstone Winter Check-up. Typically we will welcome some 2,000–3,500 kids, and involve up to 1,200 students. We proudly contribute all the funds raised from our ticket and bear sales towards supporting the excellent work of the RCH. We also conduct events at metropolitan and rural kindergartens and primary schools, community centres and the Victorian Aboriginal Health Service.

The RCH is the team’s base for meetings, volunteer training and equipment storage. The RCH is also one of Melbourne Medical School’s sites for paediatric placement, and the TBH has become a regular part of the placement experience—a powerful recognition of its value.

The TBH program is a mammoth effort by the student cohort, but we could not do it all on our own. We receive support from many organisations, including VISY, Emergency Services, our venues—the Melbourne Convention and Exhibition Centre and Chadstone shopping centre—the University of Melbourne and RCH. We are deeply grateful to them all.

Chelsea Xu and Kate Wishart

Philanthropy has been a part of the Royal Children’s Hospital since the very beginning. Founding doctors William Smith and John Singleton had a vision in 1870 ‘to help sick and injured children free of charge’.

In 1989 this philanthropic spirit was formalised when the hospital’s committee of management established the Royal Children’s Hospital Foundation. Initially set up as a trust to secure donated funds and show donors the benefits of their support, it soon developed into a nationally renowned fundraising organisation. The Royal Children’s Hospital Foundation brings together supporters from across Australia, including community fundraisers, corporations, bequests, trusts and foundations, as well as our dedicated Auxiliaries and the Good Friday Appeal.

From relatively modest beginnings (raising some $2 million in 1989), the Royal Children’s Hospital Foundation has grown significantly, thanks to this dedicated community that rallies together to support world-leading care for patients at the hospital. In 2019 alone, the foundation raised a remarkable $62.3 million. This immense generosity has helped make the Royal Children’s Hospital a pre-eminent institution. While the Victorian government funds the hospital’s operating costs, donations enable medical excellence that otherwise would not be possible. The programs and initiatives funded by donated money go above and beyond the hospital’s day-to-day activities. They take the Royal Children’s Hospital from being a good hospital to a great one.

For 32 years, the Royal Children’s Hospital Foundation has supported thousands of initiatives, based on four pillars: leadership, education and training; patient and family–centred care; equipment and technology; and ground-breaking research. Thanks to this community support, innovation has been made possible on campus through such pioneering projects as the establishment of the Victor and Loti Smorgon Chair in paediatrics, the Gender Service, Wadja Aboriginal Family Place, the electronic medical record system, and the purchase of the intraoperative magnetic resonance imaging system.

The Royal Children’s Hospital Foundation continues to inspire the community to invest in the hospital and its campus partners, to transform children’s health today and into the next 150 years.

Sue Hunt

Sometimes, to look forward, it is important to look back. The Royal Children’s Hospital’s vision of ‘Great Care, Everywhere’ has its origins in a department established more than 25 years ago, which focused on meeting the needs of children in the context of their family and community. The Centre for Community Child Health, driven by the partnership of founding director Professor Frank Oberklaid and deputy director Associate Professor Jill Sewell, led the way in treating what were then the ‘new morbidities’ of developmental and behavioural paediatrics. Their patients were children who required not hospital beds, but well-trained paediatricians who understood the community context. Perhaps even more radical at the time was the emphasis on equity, prevention, early intervention and the application of evidence to policy, practice and parenting.

Well ahead of its time, the Centre has led many influential statewide and national initiatives, including the Australian Early Development Census, the Victorian Infant Hearing Screening Program, right@home, and the Raising Children Network. This is knowledge translation in action.

The Centre’s purpose is that every child thrives. To achieve this, its unique structure supports innovative research, provides specialist developmental and behavioural clinics and paediatric training, delivers infant hearing screening for all Victorian babies, and is at the vanguard of translating evidence into action. Fundamental to its success is collaboration. By working with children, families, practitioners, communities and government, the Centre can better ensure that decisions are based on evidence, and can reform systems and services to provide better experiences and environments for children.

As RCH commemorates its 150th anniversary, we are in a time of unprecedented turmoil—one that magnifies the disparities in our community. Now more than ever, the Centre is pursuing equitable health, development and wellbeing for all Australian children, and will continue to play a unique and integral role at RCH. We aim to provide and inspire the best care, everywhere, now and into the future.

Professor Sharon Goldfeld

For 150 years, the Royal Children’s Hospital has provided excellent health care to children and young people in Melbourne and Victoria, and even across Australia. Upon reaching this milestone we can reflect on the achievements, innovations and challenges of the past 150 years, and chart a roadmap for the future that will increase our capacity to improve paediatric health care at the RCH and beyond.

We have already made excellent progress in transforming the RCH into a digital hospital—responding to a need that has been exacerbated by the COVID-19 pandemic and the disruption it has caused to our services. It is in part through this disruption that we have recognised the need to take greater strides towards adopting virtual methods of health care.

Over the next five years, the RCH will implement a virtual care strategy to help us achieve our aim of delivering ‘Great Care, Everywhere’. This will use digital and telecommunications technology as we provide continuous, connected and coordinated care for our patients and their families. These new models of care will take the form of telehealth, digital care coordination and remote monitoring, linking together patients, clinicians and the wider community, to allow patient care to be accessible from home and in the community, as well as in hospital. The future of health care lies in providing services outside the walls of the hospital, with an inspired workforce, community, patients and families working together under our virtual care philosophy, applying innovative models of care and technology to achieve better results for patients. Ultimately, our vision is to use virtual care technology to offer the best care, in the best place, at the right time.

Importantly, the opportunities we have before us are immense—not only in the adoption of digital technologies to deliver care, but also in where this great institution could lead paediatric health care in the future. Let us build on our rich history and the foundations we have laid over the past 150 years to continue our work in being a great children’s hospital, leading the way for the benefit of generations to come.

The Hon. Rob Knowles AO