The New Zealand Governor, Sir George Grey, commissioned four national hospitals in 1845. The first to be built was a two-storey brick and plaster structure in the Wellington suburb of Thorndon, opening in 1847. The land was donated by local Iwi. The site is now occupied by Wellington Girls’ College.

The government set aside a ten-acre site in Newtown and engaged a Danish architect - Christian Julius Toxward - to draw up plans for a larger and more modern hospital. These were submitted in 1875 with work beginning in 1876 using local prison labour for construction. The hospital opened in 1881 with four 24-bed wards and two smaller private wards of 4 beds each, giving a total of 104 beds. A separate fever ward was remote from the main building, containing another 8 beds.

Key full-time staff were transferred from the Thorndon site.
These were:

• Dr G G Gillon, Resident Surgeon: appointed 1879, salary £350 p.a

• Mrs Baillie, Matron: appointed 1880, salary £100 p.a
• Mr E C Hodgson, Dispenser & House Steward: appointed 1880, salary £125 p.a

• Two head wardsmen, salary £75 p.a
• Two under wardsmen, salary £52 p.a
• One night wardsman, salary £52.16.0 p.a
• One head nurse, salary £66 p.a
• One night nurse, salary £52 p.a
• One fever nurse, salary £52 p.a

Polio spread around the world in the first half of the 20th century. Repeated waves, initially affecting mostly children, caused paralysis of the respiratory muscles, meaning patients became unable to breathe. To help them, the cumbersome 'iron lung' was invented. This was a large box into which a patient was placed, with air blown in and out to inflate their lungs - an early version of the ventilators (life-support machines) used in modern ICUs today. The first device was donated to Wellington Hospital by Lord Nuffield.

Although New Zealanders were less affected overall by polio than the US or Australia, ongoing epidemic waves meant many people continued to die. The outbreak of 1947 was one of the worst, with all North Island schools closed for over 4 months to limit the spread. Eleven patients were treated with respirators in Wellington Hospital, of whom seven died. During the 1956 outbreak, 925 people were paralysed and 73 died. In response, an additional 6 iron lungs were imported from Sydney to add to the 2 already in Wellington Hospital. Patients in such devices required 24-hour nursing care.

To treat the overwhelming numbers of patient paralysed by polio, the Danish anaesthetist Bjørn Ibsen opened what is now recognised as the world's first ICU in Kommunehospitalet in Copenhagen, Denmark.

An acute respiratory unit was established in Auckland Hospital, generally thought to be New Zealand's first ICU. It used the Both Portable Cabinet Respirator to provide support for patients suffering respiratory failure caused by illnesses such as polio or tetanus.

In August 1964, a 7-bedded Intensive Care Unit opened in Ward 10 in Wellington Hospital, located at the end of the neurosurgical ward. The first patient - a woman with head injuries - was admitted that day. The ICU was only possible due to the experience of two doctors returning from overseas - Dr Graeme Marshall (who had observed the development of an ICU in Adelaide), and Dr Cam Barrett (who had set up a 2-bedded ICU in London). Intensive Care nursing began as a specialty in Wellington Hospital.

Admissions to ICU were limited with the number of patients needing care frequently more than the space available. An ICU nurse at the time recalled "You could squeeze one more in if you had to, then you could kick the relatives out of the waiting room and squeeze another one in there”.

The inaugural six month Intensive Care Post-Basic Nursing Course began in May 1968. The Evening Post described this as "ground breaking‟ as this was the first course of its type to be offered in New Zealand. It was recommended that applicants should be staff nurses of at least six to twelve months standing. It was not necessary for them to have had previous experience in any ICU.

Senior medical staff gave lectures in their own specialties and ward sisters instructed students in the principles and nursing techniques within their specialist areas. An examination was held at the end of each course in May and November, with a diploma issued to successful candidates.

By the commencement of the 11th course in the middle of 1973, 83 nurses had achieved a diploma. Of these, 27 nurses were from Wellington ICU, 50 came from hospitals within New Zealand and three came from Australia. Of the first 83 nurses to undertake the course, 42 remained in Wellington Hospital on completion. The diploma both attracted nurses to ICU and also encouraged them to stay.

Some questions from the final ICU exam for the 1976 course are shown below:

A review of the facilities determined that the ICU was "significantly lacking in storage, office space and teaching amenities and… these factors seriously impair the functioning of the unit". As a result, an ICU Planning Committee was convened and made plans to improve storage, monitoring and computer equipment.

There was an agreement that "at least 14 (ICU) beds" were required, each occupying a minimum of 200 square feet (18.5 square metres).

Modern Australasian ICU standards recommend a minimum of 25 square metres per ICU bed space.

Eight years after planning began, the new ICU opened on Level 5 of the Clinical Services Block, below the operating theatres and recovery areas on levels 6 & 7 of the hospital. It contained 14 bed spaces consisting of 2 four-bedded bays, 4 single isolation rooms (for infectious patients), and a separate two-bedded bay for children.

There was an allocated drug preparation area with storage and a central desk for both nursing and medical staff. A raised console area was situated in the middle of the unit that allowed direct sight of most bed spaces. It also incorporated the latest in technology - a central monitoring system that allowed all ICU patients' vital signs to be seen from a single place (see photo above).

The two senior clinicians responsible for running the unit during the 1980s & 90s - Charge Nurse Myra Wilson & Clinical Director Dr. Peter Roberts - are shown below.

As both the local and regional population grew and healthcare technology rapidly improved, the old hospital became no longer fit for purpose. Formal proposals for a new Wellington Regional Hospital began in 1999, were submitted to government in 2001, and approved by Cabinet on 1st May 2002.

To create space on the Newtown site for the hospital, many of the older buildings began to be demolished, the first in 2004. The entrance stairway and arches were carefully preserved, removed from their usual location and re-erected in a courtyard in the centre of the hospital (see photo).

The new Wellington Regional Hospital opened in 2009. Within it was a new purpose-built ICU. It was situated on Level 3 of the main hospital building and contained 18 bed spaces, 4 of which were in self-contained isolation cubicles. The unit was divided into two administrative areas - 'North' & 'South' - of 9 bed spaces each. Prior to opening, the ICU held an open day for members of the public to walk through the new space.

The (then) Dominion Post newspaper spent a day in Wellington ICU. The article can be found here.

TVNZ aired the first series of 'Life Flight', a reality TV documentary series following the crew of Life Flight and medical and nursing staff from Wellington ICU. The series told the stories of patients retrieved by the ICU aeromedical service and followed them during and after their time in the unit. The series ran for 10 episodes. A second series aired in 2016.

A trailer is available here with some episodes also available on YouTube.

The fiftieth anniversary of Wellington ICU was celebrated with a cocktail party and the launch of a charitable trust, set up with the assistance of a former ICU patient. The Stuff report on this milestone event can be found here.

As demand for ICU capacity increased, office and meeting rooms were moved with the now empty area turned into a new 'South' pod. This created an additional 6 ICU bed spaces, increasing the total capacity of the unit from 18 to 24. The project won a Commercial Project award in 2019.

The South pod was subsequently renamed in memory of Clinical Leader Dr. Peter Hicks who helped guide the expansion, from planning to construction to opening.

With uncertainty around the impact of coronavirus upon New Zealand, plans were made to increase ICU capacity to provide life support for up to 56 patients. This required physically expanding the ICU into other areas of the hospital, with multiple patients under the care of non-ICU staff, overseen by an ICU team. The entire 6-bed South pod was converted into a negative pressure isolation area to allow patients with COVID to be treated together.

The world-leading public health response along with New Zealand's very high vaccination rate meant that these plans never needed to be enacted. Every ICU staff member received the COVID vaccine as soon as it became available.

As part of a review of national critical care capacity, significant new funding to increase the staffing of ICU and HDU beds was announced. For the Wellington region, funds were allocated to increase ICU capacity at Hutt Hospital and build a new 12-bed High Dependency Unit (HDU) in Wellington Regional Hospital. When opened in 2024, along with a further planned 4-bed ICU expansion, this will take the total available critical care capacity in Wellington to 40 beds.