Sous-série organique TG 15.2 - Patient records

The Toronto General Hospital (TGH) had its origins in 1819 when the Loyal and Patriotic Society of Upper Canada organized a trust fund to support the construction and maintenance of a hospital in the provincial capital, the Town of York. Construction began in 1820 and the General Hospital of the Town of York was opened for patients in June 1829. The TGH was formally dissolved as an independent hospital by legislation passed in the Ontario Legislature on October 29, 1986 effecting the merger of the TGH with the Toronto Western Hospital to form The Toronto Hospital.

The TGH was first legally sanctioned in 1847 when its governing body, the Board of Trustees, was incorporated by an Act of the Government of the Province of Canada (10/11 Victoria, C. 57). The purpose of the Act of Incorporation was

"to establish a Corporation...for the better management and disposition of the lands and property...held in trust for the...Hospital, and to make...rules and by-laws for the internal management and regulation of the...Hospital."

At Incorporation the Board of Trustees was composed of seven members, jointly appointed by the City of Toronto and the provincial Governor in Council:

"the Mayor of the City of Toronto...the President of the [Toronto] Board of Trade...three persons resident in...[Toronto], to be...appointed by the Governor in Council, and also the two Senior Professors of any School of Medicine to be hereafter established in...[Toronto], and in default or until the establishment of such School, any such medical men resident in...[Toronto] as shall be nominated and appointed...by the Common Council of the...City [of Toronto]."

The Board of Trustees remained the governing body of the TGH throughout its history, although the Board’s legislated composition, duties and powers were frequently modified. For example, the Toronto General Hospital Act (R.S.O. 1937, C. 396, S. 2) specified that the Hospital

"and the property, revenues, business and affairs thereof shall continue to be under the government, management, conduct and control of a board of twenty-five trustees, of whom eight shall be appointed by the Lieutenant Governor in Council, five by the Governors of the University of Toronto, and five by the municipal council of the corporation of the City of Toronto, and seven shall be elected by the subscribers."

Throughout its existence the TGH Board of Trustees was headed by a chairman elected from its membership by the Board and whose influence on the Hospital’s administration and planning was sometimes slight, and sometimes extensive as during the productive chairmanships of J.W. Flavelle (1904-22), who oversaw the Hospital’s affiliation with the University of Toronto, and Norman C. Urquhart (1946-66), who supervised the great building campaign of 1951-59.

Until 1863 the day-to-day administration of the TGH was conducted jointly by the Board of Trustees and its principal appointee, the Resident Physician and Surgeon. In 1863 the Board created the office of the Medical Superintendent, the first of many titles for the Hospital’s chief administrative officer. The official designation of this office was successively changed to Superintendent (1905), Executive Director (1963), and President (1974). Beginning in 1968, the Hospital’s chief administrative body was the Administrative Council, headed by the Executive Director (1968-73)/ President (1974-1986). Mr. V.W. Stoughton was the last serving Chief Executive Officer of the TGH (1981-1986), preceded by Dr. C. O’Reilly (1876-1905), Dr. J.N.E. Brown (1905-1911), Dr. C.K. Clarke (1911-1917), Mr. H.L. Brittain (1917-1919), Mr. Chester J. Decker (1919-1947), Dr. J.E. Sharpe (1947-1966), Mr. J.D. Wallace (1967-1970), and Mr. J.A. McNab (1970-1980).

Through the years the chief administrative officer was assisted in his duties by various subsidiary officers. In 1869 the office of the Lady Superintendent was created, subject to the authority of the Medical Superintendent, and the incumbent given charge of all nursing services (to which, in 1881, was added the title and duties of Superintendent of the Training School for Nurses). In 1913 this officer was designated Superintendent of Nurses and Superintendent of the Training School for Nurses; in 1957, Director of Nursing/ Director of the TGH School of Nursing; and in 1974—following the transfer of diploma nursing education in Ontario to the community college system, and the cessation of the TGH School of Nursing —Vice President, Nursing.

In 1921 two new administrative positions were created: Assistant Superintendent, Medical and Assistant Superintendent, Administrative, signaling the division of the Superintendent’s historic dual responsibility for medical management and financial/bureaucratic administration. In 1963 when the Superintendency was re-designated the Executive Directorship, subsidiary administrative officers became departmental Directors. Similarly, with the creation of the Presidency in 1974, subsidiary administrative officers became departmental Vice Presidents.

The medical staff of the TGH was, in its earliest incarnations, appointed annually by the Board of trustees and subject to the authority of the Resident Physician and Surgeon. Prior to 1888 no distinction was made between physicians and surgeons in the internal organization of the medical staff and no medical/surgical specialties were recognized. In 1888 the medical staff was reorganized with physicians and surgeons separately identified in staff lists, although not yet formally designated, respectively, the Departments of Medicine and Surgery. At the same time a limited number of specialty services were recognized as discrete units, including gynaecology and ophthalmology.

Although the internal departmental organization and composition of the TGH medical staff changed with great frequency through the years, the essential tripartite structure remained intact—the Department of Medicine, the Department of Surgery, and an ever—changing (and expanding) list of specialty services/departments. In 1913, the year the TGH moved to its College St./University Avenue location, the active staff was organized in two main departments: Medicine and Surgery, and nine specialty departments: Gynaecology; Obstetrics; Ophthalmology; Otology, Rhinology, and Laryngology; Anaesthetics; Electrical; Pathology; Therapeutic Inoculation; and Psychiatry. In 1985-86, the last year of the Hospital’s independent existence, the medical staff was comprised of the Departments of Medicine and Surgery (themselves comprising several sub-departmental medical/surgical specialty services) and fourteen other specialty departments: Anaesthesia, Anatomical Pathology, Clinical Biochemistry, Dentistry, Emergency, Family and Community Medicine, Microbiology, Obstetrics and Gynaecology, Oncology, Ophthalmology, Otolaryngology, Physical Medicine and Rehabilitation, Psychiatry, and Radiological Sciences.

Until 1910 the TGH medical staff was appointed by the Board of Trustees and subject to the direct authority of the Medical Superintendent, who was ultimately responsible for both the administrative and medical management of the Hospital, the latter function in consultation with the Medical Advisory Board (created 1876). In 1910, as a result of an agreement between the TGH and the University of Toronto, whereby the Hospital became a teaching/training site for University medical students, the Joint Hospital Relations Committee was formed and given the responsibility of supervising medical staff appointments.

In 1919 a system of organization and administration for the medical staff was established which endured with minor changes throughout the subsequent history of the TGH. The departmental organization was retained, with University department heads nominated, ex officio, as Hospital departmental chiefs of service, with responsibility for appointing staff in their departments. Thus, for example, the head of the University Department of Medicine was cross-appointed as TGH Physician-in-Chief.

In the course of its history the TGH subsumed or became responsible for the joint administration of several other institutions. In 1878 the TGH took over the administration of the Burnside Lying-in Hospital, which became for many years the nexus of the Hospital’s obstetrical/ gynaecological service. In 1932 the Ontario Institute of Radiotherapy was established at the TGH, jointly managed by the Hospital and the Government of Ontario. From 1948 to 1959 the TGH administered the Wellesley Hospital as the Wellesley Division of the Toronto General Hospital (the Wellesley retained its independent status in January 1960). Finally, in 1986 the TGH merged with the Toronto Western Hospital, becoming the General Division of The Toronto Hospital and subject to the Board of Trustees and President of The Toronto Hospital Corporation.