Government Civil Hospital (GCH) was founded in 1849, about 7 years after Hong Kong became a British colony. When Dr Philip Burnard Chenery Ayres arrived in 1873 to take up the post of colonial surgeon, he deemed the hospital, which had been converted from an old private house, entirely unsuitable. Although Ayres strongly advocated for its replacement, it was ultimately a typhoon that destroyed the old building, prompting the government to construct a new purpose-built hospital on the aptly named Hospital Road in 1879. This new facility served as the main government hospital for the civilian population until it was replaced by Queen Mary Hospital in 1937.1

While Western-trained doctors were appointed medical superintendent at GCH, nursing care was left to the European wardmasters and Chinese coolies who had no formal training. Dr John Murray, colonial surgeon (1859-1872), commented in his annual report, “If it were possible to induce the Sisters of Charity to undertake this duty, the benefit would be incalculable.”2 Something close to this wish came true but not until much later.

Among his many achievements, Dr James Cantlie—one of the founders of the Hong Kong College of Medicine and known for rescuing his student Dr Sun Yat-sen after his kidnapping by the Qing Embassy in London—is credited with introducing the first trained British nurse to Hong Kong. In 1888, he invited Maude Ingall to serve as a private nurse. When Cantlie founded the Peak Hospital in 1890, Ingall became its matron. She also served as nurse to Governor Sir George William Des Voeux, who later supported the introduction of trained nurses to the GCH as proposed by Dr John Mitford Atkinson, GCH’s medical superintendent (1887-1897).3

Previously, Dr Atkinson had worked in London, where hospitals had been reforming and revolutionising nursing since the middle of the century. By the 1880s, trained nurses were widely recognised by the medical community as a cornerstone of hospital treatment, and all the London teaching hospitals—with the exception of St Thomas’s—had their own nursing schools.4 Dr Atkinson proposed hiring five Europe-trained nurses from England, including one to be head nurse.5 Governor Des Voeux supported the scheme in principle but preferred to hire five nursing sisters from a religious background instead.6 Eventually, in 1889, five French nursing sisters from a branch of St Vincent de Paul were employed. The scheme was terminated 1 year later; although the nursing sisters were very conscientious in their work, their training did not meet the doctors’ requirements. Moreover, they were too few to cover night duties. Atkinson’s original proposal was adopted in 1890, with the alteration that six nursing sisters from England would be sought, as admissions to GCH had increased.7

The six British nursing sisters—one head nurse, two day nurses, two night nurses and one special-duty nurse—arrived in November 1890. At that time, the hospital compound could accommodate approximately 130 patients. The nurses were initially housed in temporary quarters at the new Lock Hospital facing Queen’s Road West, before moving to new nursing quarters on High Street in 1892.8 The superintendent consulted with the head nurse every morning in his office at 9:30 am. The day nurses worked from 9 am to 9 pm and were expected to join the superintendent on his morning rounds of her wards and document his treatment instructions. The day nurses administered medicines as prescribed to their patients, monitored their patients’ temperatures and ensured their hygiene, especially for those patients who were unable to look after themselves. The night nurses worked from 9 pm to 9 am. They received handover from the day nurses so as to be fully acquainted with the seriously ill patients’ conditions. In other ways, their duties were the same as those of the day nurses.9

The nurses wore uniforms to distinguish them from other workers in the hospital (Fig). The uniform was similar to those worn in contemporary London hospitals and consisted of a full-length bib and apron over a dress. Other accessories included a cap, collar, and cuffs. The nurses often carried a chatelaine, bearing scissors, forceps, tongue depressors, and other useful tools.

The nurses’ performance earned high praise from GCH’s doctors, contributing to a growing number of private patients choosing to attend the hospital. The sisters faced a real challenge in 1894 when bubonic plague hit the colony. Although there were now nine nurses, they also covered the infectious disease hospital at Kennedy Town and the hospital ship Hygeia. Dr James Lowson, the medical officer in charge of the hospitals, was full of praise for the sisters, “If ever this colony has had reason to congratulate itself, it was when we were able to procure well-trained British nurses… had it not been for their presence, there could have been no well-run epidemic hospital during last summer.”10

Plague returned almost annually for the next 30 years, sadly claiming the lives of two nursing sisters in 1898. In their honour, the Hong Kong community made a striking clock, a wooden chest, and a silver rose bowl, which were kept in the sisters’ mess.11

Following the plague epidemic, the medical department was reviewed by a committee. At the committee hearing, Lowson suggested training local girls to meet the increased demand for nurses. However, GCH’s matron doubted whether there was enough experience at the hospital to train new nurses. In any case, locally trained nurses could not replace the sisters. Instead, the matron proposed taking in two Eurasian girls as an experiment.12 The first probationer was appointed in September 1896, and a total of 16 were recruited up until 1904. Only three completed the 3-year probation.13 The first six male nurses (dressers) in the history of GCH were appointed in 1916. The government only started to train local Chinese nurses in 1921, but nurses from Britain continued to take the helm until long after the Second World War.1 A local Chinese nurse did not assume the top role of principal nursing officer until 1979.

1. Hong Kong Museum of Medical Sciences Society. Plague, SARS and the Story of Medicine in Hong Kong. Hong Kong: Hong Kong University Press; 2006: 86-8.

2. Murray J. Hong Kong Colonial Surgeon’s Report for 1868. Hong Kong Blue Book, 3 Apr 1869.

3. Stewart JC. The Quality of Mercy: The Lives of Sir James and Lady Cantlie. Edinburgh, United Kingdom: Rowan Books; 1983: 52.

4. Helmstadter C. Early nursing reform in nineteenth-century London: a doctor-driven phenomenon. Med Hist 2002;46:325-50. Crossref

5. Atkinson J. Report from the Superintendent of the Civil Hospital for 1887. Hong Kong Government Gazette 1888 (Supplement), 14 Jul 1888.

6. Des Voeux to Knutsford. 2 Jul 1888. Colonial Office CO129/238: 8-12.

7. Fleming to Knutsford. 7 Apr 1890. Colonial Office CO129/244: 328-37.

8. John Atkinson. Report from the Superintendent of the Civil Hospital for 1890. Hong Kong Government Gazette 1891 (Supplement), 2 Apr 1891.

9. Fleming to Knutsford. 7 Apr 1890. Colonial Office CO129/244: 345-7.

10. Lowson JA. The epidemic of bubonic plague in Hong Kong, 1894. Ind Med Gaz 1897;32:45-59.

11. Stratton D. History of nursing in government hospitals. Hong Kong Nurs Jr 1972;May:34-7.

12. Medical Committee Report on the Plague, 3 April 1895: 11-4. Available from: http://sunzi.lib.hku.hk/hkgro/view/s1895/1457.pdf. Accessed 24 Jun 2025.

13. Nursing Probationers. 22 Oct 1904. Colonial Office CO129/324: 182-4.