From 1881 - 1928, patients arriving at the hospital as either emergencies or accidents were examined in a small casualty room, just inside the original hospital main entrance. With the opening of the Front Block on Riddiford Street in 1928, the hospital had its first purpose-built Casualty Department. Initially this comprised a series of single rooms in the NW wing of the ground floor, a larger ward in the NE wing, together with a sterilising room and an emergency theatre. The larger ward was intended for children, and especially for short-term admissions for 'Ts&As'. Ambulances arrived at the basement level, and patients were brought up to the Casualty Department in one of two lifts.
Over time, this Casualty Department expanded first into part of the area originally intended for outpatients, and then into the Front Block extension, opened in 1960. The Department was renamed 'Emergency and Accident' in 1969.
By the 1980s, the department was too small and outdated in design for the increasing workload, and by the 1990s, it was hopelessly inadequate. Planning for a new facility began, and the new Emergency Department to the south of the main corridor was opened in 2000.
From 1881 until 1903, there was only one Resident Medical Officer, the Medical Superintendent, available to
attend to patients arriving acutely at the hospital. In 1903 he was joined by Dr James Elliott, the first
'house surgeon', who shared in managing the acute workload. Successive house surgeons increasingly took over the role
of being the first to attend patients arriving acutely, and this practice continued after the opening of the Front Block,
until 1932.
On 1/10/1932, Dr William A Chapple was appointed the first Resident Casualty Officer. This appointment was
remarkable for the fact that Dr Chapple was 68yrs of age, and had formerly (1898 - 1900) been Honorary Physician at
the hospital. He had, however, pursued a political career from 1910 until 1924, mainly in England.
He remained Resident Casualty Officer until 31/3/1934. He was succeeded by Dr R G Sowter, but he resigned
after only 3 months, citing "difficulties with nursing staff" and "no one takes any notice of me - I am not respected".
The Board decided that the position of Resident Casualty Officer was not to be readvertised, and that the
duties were again to be performed by the house surgeons. However, the house surgeons expressed unwillingness to
do the extra work. Dr Leslie I Parton was appointed as temporary Casualty House Surgeon, a position he held
for 3 months, before accepting an appointment of Assistant Urologist at Auckland Hospital. Dr J Verney
Cable, who was in his second house surgeon year, provided cover after Dr Parton's departure. Dr J A Roland O'Regan
was engaged to undertake morning sessions in Casualty from 5/9/1934, at £2/2/- per session, and Dr Cable agreed to do the
afternoon sessions. His salary was increased to £300 pa. It is noteworthy to record that the
first Casualty nursing Sister was Rena Bradshaw, who subsequently married Rolland O'Regan. Both Rolland
O'Regan and Verney Cable finished their duties in Casualty at the end of 1934, O'Regan commencing private surgical practice
in Wellington (before being appointed on to the surgical staff in 1936), and Cable commenced duties as Medical Registrar in
1935. House surgeons provided cover in Casualty from 1935 - 1936.
Dr Philip Benham was appointed full-time, though non-resident Senior Admitting Medical Officer in December 1936, a position he
held until 1943, when he took leave for WW2 service, before becoming in 1944, the first Medical Superintendent of Silverstream Hospital. The vacancy in
Casualty was temporarily filled (for 3 months) by George Jennings, who was subsequently appointed Orthopaedic Surgeon.
Dr J Alistair Loan occupied the Casualty role 1945 - 1946, and in January 1947, Dr Colvin McKenzie was
appointed Admitting and Outpatient Medical Officer, a position he occupied until 1959.
The period 1959 - 1967 saw successive short-term (typically 1 year) appointments of surgically-qualified medical officers,
including Dick Laurenson, Fergus Ferguson, Dick Aldridge, Jim Walker, Ted Watson, and Don Urquhart-Hay.