In 1861, the public began to petition for a hospital along with backing from the Royal Engineers.
 At the time, a hospital's function was to serve as a charitable place for the community's most poor to be able to access some form of healthcare, and was a common institution in England.
 In a plea written by the British Columbian on July 11, 1861, it was stated that “our sick, for want of a hospital are dying alone and destitute in their own cabin.”.
 As a response, a municipal council was formed within the month to explore options.
 Initial fundraising came from surrounding areas such as Lillooet, who provided $600 in under an hour from its citizens who understood the need for a hospital.
 A tax of $1 per person was also enacted to help make up the difference, as well as some colonial grants.

The first Royal Columbian Hospital, designed for 30 patients and located on the corner of Clement (now 4th Street) and Agnes Street was opened on 7 October 1862 to care for men only.
Women, children, and "the incurable and the insane" were excluded from care.
The Royal Engineers planned and helped build the hospital, the first in the colony.
The cost was $3,396.
A chain gang from the penitentiary helped clear the site.

Royal Columbian moved to its current location in the Sapperton area of New Westminster in 1889; the large property purchased meant the hospital could expand and build additional structures.
 This new building is constructed in that year, however due to financial setbacks the patients are not moved until February 1890.
An early physician and surgeon connected with the hospital at this location was Richard Irvine Bentley.

In 1893, the Christian Temperance Union established a women's hospital in a home, and had eight beds.
 In 1901, due to the lack of funds to keep the women's hospital running, provincial legislature was passed to integrate the women's hospital with Royal Columbian as well as establish a nurse's training school.
 The nurse's school was beneficial in that it provided a cheap form of labour that would eventually be trained to supervise and teach new students, which would prove to be beneficial in future years when finances became tight.
 The Ladies Auxiliary was formed in 1903, and in its first year set aside $600 for the hospital to build a maternity cottage.
 
In the 1920s, the economic boom that took place allowed for the hospital to continue to reduce its debt load and expand where needed.
 The standardization movement taking place in the United States provided footing to compel the municipalities to finally begin funding the hospitals that served their citizens.
 A paediatric ward opened in 1921 that allowed younger patients to be attended to separate from the adults, and a doctor was appointed as medical superintendent, as the lady superintendent felt that the job would be better suited to someone more medically trained.
 However, due to a tacit rejection of his recommendations by the staffed doctors, he resigned along with the newly appointed laboratory attendant.

The standardization movement made its way to British Columbia and Dr. Malcolm MacEachern, the physician from Vancouver General Hospital was at the forefront of it.
 In 1927 it was determined by American College of Surgeons, the hospital board, and the Fraser Valley Medical Association that certain requirements had to be met in order to be approved as meeting standardization requirements.
 At that time, it was required to have a pathologist spend a minimum amount of time reviewing lab work, a radiologist to supervise the x-ray department, and further administrative organization changes relating to staff, conferences and regulations.
 Royal Columbian was among the better performing hospitals due to its filing systems and regular meetings.


Among the big changes in the hospital during this time period one was the construction of  the 130-bed Health Care Centre, opening in August 8, 1978 at a cost of $27 million.
The ceremonial opening of the Healthcare Centre was done by Prince Philip, his son Prince Andrew, and Health Minister Bob McClelland.
In 1861, the public began to petition for a hospital along with backing from the Royal Engineers.  At the time, a hospital's function was to serve as a charitable place for the community's most poor to be able to access some form of healthcare, and was a common institution in England.  In a plea written by the British Columbian on July 11, 1861, it was stated that “our sick, for want of a hospital are dying alone and destitute in their own cabin.”.  As a response, a municipal council was formed within the month to explore options.  Initial fundraising came from surrounding areas such as Lillooet, who provided $600 in under an hour from its citizens who understood the need for a hospital.  A tax of $1 per person was also enacted to help make up the difference, as well as some colonial grants.
The first Royal Columbian Hospital, designed for 30 patients and located on the corner of Clement (now 4th Street) and Agnes Street was opened on 7 October 1862 to care for men only. Women, children, and "the incurable and the insane" were excluded from care. The Royal Engineers planned and helped build the hospital, the first in the colony. The cost was $3,396. A chain gang from the penitentiary helped clear the site.
Royal Columbian moved to its current location in the Sapperton area of New Westminster in 1889; the large property purchased meant the hospital could expand and build additional structures.  This new building is constructed in that year, however due to financial setbacks the patients are not moved until February 1890. An early physician and surgeon connected with the hospital at this location was Richard Irvine Bentley.
In 1893, the Christian Temperance Union established a women's hospital in a home, and had eight beds.  In 1901, due to the lack of funds to keep the women's hospital running, provincial legislature was passed to integrate the women's hospital with Royal Columbian as well as establish a nurse's training school.  The nurse's school was beneficial in that it provided a cheap form of labour that would eventually be trained to supervise and teach new students, which would prove to be beneficial in future years when finances became tight.  The Ladies Auxiliary was formed in 1903, and in its first year set aside $600 for the hospital to build a maternity cottage.  
In the 1920s, the economic boom that took place allowed for the hospital to continue to reduce its debt load and expand where needed.  The standardization movement taking place in the United States provided footing to compel the municipalities to finally begin funding the hospitals that served their citizens.  A paediatric ward opened in 1921 that allowed younger patients to be attended to separate from the adults, and a doctor was appointed as medical superintendent, as the lady superintendent felt that the job would be better suited to someone more medically trained.  However, due to a tacit rejection of his recommendations by the staffed doctors, he resigned along with the newly appointed laboratory attendant.
The standardization movement made its way to British Columbia and Dr. Malcolm MacEachern, the physician from Vancouver General Hospital was at the forefront of it.  In 1927 it was determined by American College of Surgeons, the hospital board, and the Fraser Valley Medical Association that certain requirements had to be met in order to be approved as meeting standardization requirements.  At that time, it was required to have a pathologist spend a minimum amount of time reviewing lab work, a radiologist to supervise the x-ray department, and further administrative organization changes relating to staff, conferences and regulations.  Royal Columbian was among the better performing hospitals due to its filing systems and regular meetings.

Among the big changes in the hospital during this time period one was the construction of  the 130-bed Health Care Centre, opening in August 8, 1978 at a cost of $27 million. The ceremonial opening of the Healthcare Centre was done by Prince Philip, his son Prince Andrew, and Health Minister Bob McClelland.
Royal Columbian Hospital