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In 1855 a municipal sub-committee recommended the erection of a hospital in Port Elizabeth and thus a Provincial Committee for the Management of the Port Elizabeth Provincial Hospital came into being to guide its establishment in November 1855. While the building of the hospital was being undertaken, a temporary hospital was opened on 10 September 1856.

In 1856, Act No 5 for Regulating the Provincial Hospital at Port Elizabeth (CCP 6/2/1/1) was passed, which vested all control of the institution in a Board of Managers.

The completed hospital building was occupied in 1859 and the temporary hospital closed. By 1900 the need for a new hospital was realized and the foundation stone of this hospital was laid in 1912.

In terms of Ordinance No 5 of 1912 (Province of the Cape of Good Hope Official Gazette No 218, 27 January 1912), Hospital Districts were created in Divisional Council areas. Hospital Boards, named after the division or town in which the main hospital was situated, were constituted to control and manage all institutions under and created by them.

The Alexandra Institution for the Feebleminded was opened in 1921. It was situated on what was formerly the Nieuwe Molen Estate.

It was decided to erect a hospital on the site to replace the Old Somerset Hospital, and the foundation stone was laid on I3 January 1906 by HRH the Duke of Connaught. Owing to the delays that seem inevitable in the construction of any public building, it was not until 1914 that the buildings were ready for occupation. By that time, the First World War had broken out, and so it was taken over as a military hospital. After the war, the Government decided to open it as South Africa's first institution for mental defectives. Patients were admitted in July 1921.

The first group came from Valkenberg and the Pretoria Mental Hospital, and by September they numbered 153 (all of whom were white females). By the end of the year, the numbers had increased to 245, of whom 92 were males. It had its share of teething troubles, many of which arose because the buildings had not been constructed to house defectives; for example, the admission of males was considerably delayed because the doors had no locks. Despite such handicaps, the development of the institution progressed well, and the numbers of patients and staff increased rapidly. Owing to ignorance of the scope and purpose of the institution, many unsuitable patients were sent there in the early days and had to be returned to tile hospitals from which they had come.

One of the first developments was the opening of a school for the younger defectives. Specially trained teachers from abroad were engaged, and special emphasis was laid on the development of muscular co-ordination and manual skills, rather than on scholastic attainment. There was an early institution of occupational therapy for both sexes, and this was highly developed over the years. Among the activities available for males were boot making, tailoring, painting, upholstery, woodwork, building, and plumbing. The females did laundry, sew, and fancy-work.

A development from 1947 was that the high-grade defectives now did paid work for outside firms. It began with rug-fringing, but in 1949 patients began to make bags for a tobacco firm; they earned 4 shillings for 1 000 bags.

When the institution was opened in 1921, Dr HC Watson was the first medical superintendent. Dr Watson was succeeded in 1923 by Dr RA Forster, who remained in charge until 1940. In addition to its medical staff, it had several psychologists, and several graduate students in psychology, from the University of Cape Town were doing research and practical work there.

The management of the 18th century hospital was in the hands of Regents or Governors who were members of the Council of Policy. A Board of Management for each hospital succeeded the Governors during the 19th century. These Boards controlled all the property and funds of the hospital and appointed and dismissed the staff of servants not on the fixed establishment of the civil service. Each Board elected its own chairman.

The advent of Union in 1910 brought changes in the control of the hospitals. The four existing colonies became provinces each under a provincial administration. Hospitals in the Union came under the provincial administration of their respective provinces.

The Province of the Cape of Good Hope passed the Cape Hospitals and Charitable Institutions Ordinance No 5 of 1912 which came into full operation on 1 March 1913. This date must be regarded as an outstanding landmark in the history of Cape Hospital Administration.

Under this ordinance all divisional council areas where state-aided hospitals were situated, were constituted hospital districts. In each hospital district there was to be a hospital board for the control and management of these institutions. Each board was to be financed by provincial subsidies, calculated on the amount of their revenue derived from patients’ fees, voluntary contributions, and bequests. With the approval of the Administrator, a board could establish (a) hospitals for the reception or relief of persons requiring medical treatment, (b) dispensaries, (c) maternity homes, (d) convalescent homes, (e) sanatoria and (f) institutions for any other purpose declared to be for a public charitable purpose. When the ordinance of 1912 became operative, the following existing institutions in the Peninsula were controlled by boards or committees: Somerset Hospital, Woodstock Hospital, Victoria Cottage Hospital, Wynberg, Rondebosch and Mowbray Cottage Hospital, Simonstown Cottage Hospital, Eaton Convalescent Home and the Cape Town Free Dispensary.

A hospital board constituted under the provincial ordinance was to consist of six members or multiples of six, but not exceeding thirty-six. In 1913 the Cape Hospital Board was constituted with the maximum number of members and took under its control the abovementioned institutions. The members of the Board were elected by contributors, appointed by local authorities, by the Administrator, by the Honorary Visiting Medical Officers and later by the University of Cape Town.

Standing Committees:

According to Section 58 of Ordinance No 5 of 1912, the Board may, for the administration of any matter within its powers “if and so long as it thinks fit, establish and maintain from amongst its members, a Committee, and every such Committee shall, subject to the control of the Board, have the general administration of the matter in respect of which it is established.” At a meeting of the Board on 27 March 1913, the members discussed the question of standing committees, and at a meeting of the Board on 8 May 1913, a Special Committee was appointed to look into the matter of standing committees. Following this committee’s report, it was decided on 23 May 1913 to appoint the following committees as standing committees of the Board:
1. The General Purposes Committee
2. Finance Committee
3. Buildings, Grounds and Equipment Committee

According to section 32 of the Rules of Order of the Hospital Board, each committee could elect its own chairman. According to section 39 of the rules “The duties of the several standing Committees shall be such as the Board may from time to time define and assign” and section 40 “All Committees shall submit to the Board … a report of their acts and proceedings in carrying into effect the purpose of their appointment, and such matters or things as the Board may have authorized any committee to manage, regulate or conclude …”

The number of members of each committee was decided on by the Board.

On 24 June 1925 a Special Committee was appointed by the Board to consider the whole question of the departmental working of the Board including the constitution and the duties of the standing committees. On 28 October 1925 the committee recommended “that the several Standing Committees of the Board be abolished, and that in place of them there be constituted one committee to consist of seven members comprising (a) the Chairman and Vice Chairman of the Board, (b) five other members, two of whom shall be appointed at each ordinary meeting of the Board …” The Chairman of the Board was to be automatically the chairman of this committee. This committee functioned for the period November 1925 – November 1926.

On 1 October 1926 Ordinance No 17 of 1926 “Ordinance to amend the law relating to the constitution of the Cape and Kimberley Hospital Boards” was passed. This ordinance characterized a new era in hospital administration in the country. According to this ordinance, the Cape Hospital Board “… shall consist of not more than eighteen members” and “… of the said members one sixth shall be appointed by the Administrator, one sixth shall be appointed by the Honorary Visiting Medical Officers, one third shall be appointed by the local Authorities … and one third shall be elected by the registered contributors”.

At an ordinary meeting of the Cape Hospital Board on 8 November 1926 it was decided to constitute another Committee to be styled the Finance and General Purposes Committee, “and that this committee consists of the chairmen of the five institutional committees, together with two other members, to be appointed by the Board”. The Committee that had been responsible for this until then, was abolished on 26 November 1926.

Gradually the idea took root again to separate the functions of the Finance and General Purposes Committee once more. In this connection various proposals were put before the Board, but it was not before 6 June 1940 that it was finally decided and approved to separate the two committees. At the first meeting of the Board in the new year, 6 January 1941, the standing committees were reorganized and a separate General Purposes Committee to consist of 6 members and a Finance Committee to consist of 3 members, were appointed.

The functions of the General Purposes Committee were as follows:
(a) deal with and report upon all questions appertaining to the general policy of the Board;
(b) be responsible for the control of the Head Office;
(c) arrange, co-ordinate and supervise the training of nurses;
(d) deal with all other matters which do not fall within the jurisdiction of any of the other Standing Committees.

The Finance Committee on the other hand was to be responsible for the financial supervision of the Board.

At a special meeting of the Finance and General Purposes Committees on 21 September 1943, the desirability of reconstituting the standing committees of the Board was again discussed. In view of the increased and increasing activities of the Board, it was felt by certain members that the time had arrived that the machinery for carrying out the Board’s work, should be reorganized – it was considered that a rearrangement of the work of the committees would undoubtedly improve the Board’s efficiency and ensure smooth working. At a meeting of the Board on 29 September 1943 a proposal was put “… that the Standing Committees of the Board be reconstituted as follows: Finance and General Purposes Committee … and that the new arrangements shall come into force on 1 January 1944”. This proposal was agreed to and on 10 January 1944 the new Finance and General Purposes Committee was appointed, consisting of 12 members. On the same date a Finance Sub-committee was appointed to the Finance and General Purposes Committee. The Finance and General Purposes Committee functioned to December 1949 when the Cape Hospital Board was abolished.

Apart from these Standing Committees, the Board appointed from time to time occasional committees, such as the Committee for Further Hospital Accommodation, etc to investigate and report upon certain matters.

Committees of Management:

Sections 59 – 63 of Ordinance No 5 of 1912 laid down that “Every institution in a District, if there be more than one institution therein, shall, subject to the control of the Board, be managed by a committee to be styled ‘The Committee of Management of the (naming the institution)’… every such committee shall consist of such number of persons as the Board may from time to time consider necessary” and further “Every such Committee shall, subject to the control of the Board, be responsible for the general management of the institution … all the Acts and proceedings of a Committee appointed under the Ordinance shall be reported to the Board … and shall not have any operation or effect until approved at an ordinary meeting of the Board … The proceedings and powers of every such Committee shall be governed and determined by Regulations made from time to time by the Board with the approval of the Administrator”. It was felt inadvisable by the Administration to prescribe the exact relationship that should exist between the Board and the various committees of management. It was thought preferable to vest all power in the Board with the clear understanding that the Board could delegate to each committee by means of regulations such powers as might be deemed by it to be necessary to enable that committee to properly vary out its work.

At the first meeting of the Board on 17 March 1913 it was decided to have a committee of management for each of the following hospitals:

Somerset Hospital: A committee of 15 member
Woodstock Hospital: A committee of 12 members
Rondebosch/Mowbray Hospital: A committee of 15 members
Victoria Hospital, Wynberg: A committee of 12 members
Simonstown/Kalk Bay Hospital: A committee of 15 members
Cape Town Free Dispensary: A committee of 12 members
Eaton Convalescent Home: A committee of 12 members

A large measure of self-government was granted to these committees. As far as financial matters were concerned, it was decided on 24 July 1913 that “… each Committee of Management retain and bank all subscriptions and other moneys elected by them, pay all accounts due by them and furnish a return of such moneys monthly to the Secretary and Treasurer of the Board …” and further “that the Provincial Governments’ Subsidy on all moneys so collected be paid to the Board, and that the Board remit monthly to each Institution such amount as may be required within the provisions made on the Annual Estimates.”

The Cape Hospital Board took under its control in 1913 seven institutions. When it ceased to exist in December 1949, the number had increased to fifteen. During 1914 the McGregor Convalescent Home came under the control of the Board and was put under the supervision of the Committee of Management for the Eaton Convalescent Home. Also, during 1914 the District Nursing Organisation was established under its own committee. In 1915 a free dispensary for the poor was established in the Woodstock/Salt River area under a separate committee and in 1923 this was amalgamated with the Woodstock Hospital. Later the work of the Cape Town Free Dispensary was amalgamated with that of the Outpatient Department of the Somerset Hospital. During 1918 the Peninsula Maternity Hospital came under the supervision of the Cape Hospital Board with its own committee. During 1938 the Groote Schuur Hospital was opened. Two very important institutions were placed under the control of the Board in the early thirties, namely the Lady Michaelis Orthopaedic Home and Princess Alice Home of Recovery. These two institutions were placed under the control of the Combined Institutions Committee.

With the promulgation of Ordinance No 6 of 1920 the name of these committees was changed to “The Committee of the (naming the institution)”and after 1926 it was simply called “(name of the institution) Committee”.

Ordinance No 17 of 1926 brought a vast change in the administration of the various institutions. According to this Ordinance “… all Committees appointed under provisions of sections fifty nine to sixty three (both inclusive) of Ordinance No 5 of 1912 to manage separate institutions under the control of the Cape Hospital Board shall go out of office and no such Committee shall thereafter be constituted” and further “… the Cape Hospital Board shall have power in its discretion to appoint from amongst its members committees to assist in the management of the institutions …”

A meeting of the Special Committee on Procedure and Organisation was held on 2 November 1926 to discuss the position of Institutional Committees. In their report to the Board, they recommended that there be five Institutional Committees of 6 members each, as follows:
1. Somerset Hospital: One committee
2. Woodstock Hospital and Rondebosch/Mowbray Hospital: One committee
3. Victoria Hospital, Wynberg and Simonstown/Kalk Bay Hospital: One committee
4. Eaton Convalescent Home and McGregor Convalescent Home: One committee (to be styled Convalescent Homes Committee)
5. Peninsula Maternity Hospital, District Nursing Organisation and Cape Town Free Dispensary: One committee (to be styled Combined Institutions Committee)

Every committee could elect its own chairman. It was further decided “that each of these institutional committees be given authority to incur expenditure within the limit provided on the Annual Estimates of the Board in respect of each Institution”.

In addition to these institutional committees, it was decided on 22 December 1926, upon recommendation of the Finance and General Purposes Committee to appoint “a Special Committee, to be called the New Hospital Committee, consisting of the Chairman, the Vice Chairman of the Board and four members to deal with all matters in connection with the new hospital to be erected on the Groote Schuur Estate, and that this Committee be responsible directly to the Board”. On 29 October 1929 this committee’s name was changed to Groote Schuur Hospital Committee. On 25 October 1933 it was decided “that the work of the two institutions (Somerset Hospital and Cape Town Free Dispensary) be amalgamated under the control of the Somerset Hospital Committee.”

During September 1935 it was recommended that “in view of the fact that the deliberations of the Somerset Hospital Committee tend to become more and more concerned with the preparatory work in connection with the Groote Schuur Hospital … when the Board and Committees are reconstituted in October, the Somerset Hospital and Groote Schuur Hospital Committees be amalgamated, and consist of nine members …” On 28 October 1935 the new Somerset Hospital and Groote Schuur Hospitals Committee was appointed to take the place of the separate committees for these two hospitals. From this date the Cape Town Free Dispensary came under the supervision of this committee as well.

During November 1935, a Groote Schuur Hospital Equipment Committee was appointed as a sub-committee to the Finance and General Purposes Committee. This committee had the power to deal with any question of the equipment for the new hospital. On 24 February 1937, this committee was constituted a special committee of the Board with the instruction to report to the Board directly.

With the reorganization of the committees of the Board on 29 October 1937, Groote Schuur Hospital was granted a separate committee to have supervision over Somerset Hospital and Cape Town Free Dispensary also. With the opening of the Groote Schuur Hospital early in 1938, this hospital retained its separate committee while both Somerset Hospital and Cape Town Free Dispensary were transferred to the Combined Institutions Committee.

For quite a long time the members of the Hospital Board had not been satisfied with the composition of the various Institutional Committees. Nearly all of them felt that the time was ripe for a reconstruction of the Institutional Committees. The whole question of committees was referred to the Finance and General Purposes Committees. They recommended on 29 September 1943 that the Institutional Committees be composed as follows:
1. Groote Schuur Hospital Committee – 9 members
2. Somerset Hospital Committee – 6 members
3. Wynberg/Woodstock/Rondebosch Hospitals Committee – 6 members
4. Combined Institutions Committee (with supervision over Peninsula Maternity Hospital, Cape Town Free Dispensary, District Nursing Organisation Midwifery Service and Northern Suburbs Hospital) – 6 members
5. Convalescent Homes Committee (with supervision over Lady Michaelis Orthopaedic Home, Princess Alice Home of Recovery, Eaton and McGregor Convalescent Homes and False Bay Hospital) – 6 members

These recommendations were agreed to, and the new committees were appointed on 10 January 1944.

This was the position up to 17 September 1946. On this date an ordinance styled Ordinance No 18 of 1946 was promulgated. With this ordinance the supervision of hospitals was transferred to a new Hospital Department of the Cape Provincial Administration. According to the relevant sections of the ordinance “there shall be established within the Administration a Department to be styled the Hospital Department …” and “the Hospital Department shall, with the assistance of such Departments of the Administration as may be necessary, carry out all functions required in connection with or incidental to hospitals, including the establishment, maintenance and control of provincial hospitals …”

Although this ordinance was promulgated in 1946, the actual handing over of hospital administration to and the succession of the Hospital Department of the Cape Hospital Board, had been delayed to the end of 1949 so that the actual taking over only took place on 1 January 1950. As from this date the Cape Hospital Board had been suspended and the function of control of hospitals had been handed over to the Hospital Department of the Cape Provincial Administration.

The Archives:

The Archives of the Cape Hospital Board consist of minute books of the Board, minute books of the various standing committees, minute books of the committees of management of the various institutions, correspondence files, financial papers and press cuttings.