It was the first hospital between Goulburn and Sydney and owed its existence to the dedicated efforts of a Hospital Committee and the support of local people.

Initially the compact building could accommodate six patients, four males and two females, but had been designed so the wards could be extended.

The building had all requirements, including linen room, kitchen, wash house and fuel room, and fireplaces in the wards and main rooms. The Grounds Committee planted many trees supplied by Sydney's Botanical Gardens, built a perimeter fence, entrance gates and a pathway.

On Wednesday, September 4, 1889, the official opening was performed by the Hon John Lackey, MLC, in the presence of local dignitaries and some 700 people. In his address he paid tribute to Dr Newmarch and Mr Copeland Bennett, who initiated the setting up of the hospital, and to the district's medical gentlemen who offered their services.

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It would have been a proud day for all involved. From 1885 the Hospital Committee had struggled with funding but eventually raised over 900 pounds through local subscriptions, concerts and fetes. The land cost 362 pounds and the building 833 pounds, not including fitting out and running costs. A hoped-for Government grant of 875 pounds was not received until December 1889.

From June 1886 the district's ladies provided support. A meeting convened by Mrs Sarah Reed led to the formation of a Ladies Working Committee. Within a year it had raised 231 pounds. As well, the Ladies gifted all the hospital's requirements for table and bed linen, blankets, quilts, towelling, blinds, garments for patients and other small items.

As the late Win Smith, one of the hospital's long-serving nurses, says in "Blessed are They", her book about the hospital, those early ladies set the pattern of community involvement which has continued ever since and been of inestimable value. Over the years a Ladies Working Association supported the hospital in myriad ways and provided extras for patient comfort. They were the forerunners of the present Hospital Auxiliaries.

In its early years, the Cottage Hospital managed under conditions very different from today. Water was drawn from a well. The only lighting was by kerosene lamps. There were no telephones. When a doctor was needed a message had to be sent by hand. There was no sewerage; the night cart called twice a week and emptied the pans.

Patients treated in 1898 numbered 115. This included 14 accident patients and 35 who underwent surgery in a newly built operating theatre. Further buildings were added in 1901: a separate fever ward and a brick complex with two nurses' bedrooms and a boardroom.

In 1911 the State Governor, Lord Chelmsford, in the presence of a large gathering, opened further additions which increased capacity to 23 beds.

In 1935, on land obtained alongside the cottage complex, a much larger Berrima District Hospital was opened by Mark Morton MLA in the presence of almost 1,000 people. With the addition in 1961 of the Milton Park Wing, and the provision of new gardens and carparks, the district finally had a well-equipped, major district hospital.

From early days there was confusion about the hospital's name and its location. Complaints were received from patients and visitors trying to locate the hospital and first travelling to the Berrima township. Mail was often delayed by first being delivered to Berrima. Eventually, in 1968, after the whole district became involved in serious discussions and submissions, the hospital was renamed as the Bowral and District Hospital.

The original cottage buildings are still in use today, located behind the present-day private hospital. Two magnificent magnolia grandiflora, planted in front of the cottage hospital soon after it opened, still survive.

For over 125 years, due in no small part to the support of local people and auxiliaries, patients at Bowral and District Hospital have been well cared for by its doctors, nurses and staff.

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