Frances Gillam Holden (1843–1924)

by Lyn Collingwood, from Bulletin 6/2025 (August)

Frances Holden was the second matron ‒ her official title was Lady Superintendent ‒ of the Hospital for Sick Children which opened on the corner of Glebe Point and Wigram Roads in January 1880. A forthright personality, she became openly critical of the honorary doctors and the women’s house committee, censuring the former for their perfunctory attitude and the irregularity of their visits and the latter as worse than useless and knowing nothing of hospital management. In 1887 matters came to a head in what the Australasian Medical Gazette described as ‘a first class row’. The doctors threatened to resign, the Hospital Board took the doctors’ side and accused Holden of defective management. When she refused to step down, she was fired ‒ after seven years in the job. The bitter dispute was widely reported in a largely sympathetic press. Holden lost the battle with the medicos but won the public opinion war. 

The eldest daughter of seven girls and five boys, Frances was born Fanny Gillam Holden ‒ her middle name acknowledging a maternal grandmother ‒ on 9 February 1843 at Brisbane Water. Her parents were police magistrate Alfred Holden (1810–1902, born in Worcestershire) and Jane Osborne (1820–1895, born in Ireland) who had married at Dapto in 1838. Fanny’s maternal grandfather was Alick Osborne, a surgeon on convict and emigrant ships, who brought his family to the colony in 1835 and settled in the Illawarra where he bred dairy cattle. A paternal uncle was solicitor and politician George Kenyon Holden.  

Fanny’s father survived two episodes of insolvency and an attack by the ‘Jewboy Gang’ of bushrangers. At Brisbane Water, he was assigned convict labourers. In 1849 he moved his still growing family to Penshurst, a property near the township of Gresford on the Upper Paterson River, where he raised pigs and cattle, made cheese, and employed German immigrants as vine dressers.   All his 12 children were educated privately by tutors and were avid readers. Alfred Holden was opposed to education outside the home, a belief sustained by Fanny who maintained that children should enjoy fresh air and freedom before going to school at age seven at the earliest.

Fanny worked as a governess before changing career in 1874 when she and her sisters Laura, Isabella (always known as Rosamund) and Edith began training under Florence Nightingale’s protégé Lucy Osburn at the Sydney Infirmary. Fanny worked mainly in the men’s and accidents wards. She did not get along with Osburn who found her ‘dreadfully disagreeable’ and dismissed her, Laura and Rosamund on the grounds of incompetence. Fanny then nursed privately for a short period.

In 1876, the three sisters took up employment at Hobart General Hospital where the Lady Superintendent was attempting to reconstruct the hospital’s management only to have her authority undermined by the medical staff. As head nurse, Fanny gave evidence before a parliamentary commission investigating complaints against the Surgeon-Superintendent. The commission vindicated her concerns. Rosamund testified in an inquiry into an unauthorised postmortem, and against the House Surgeon who had given a storeroom key to a perpetually drunk wardsman who helped himself to vast amounts of the brandy kept onsite as a medical stimulant.  

In Hobart, Fanny devised strict cleanliness and safety rules for the care of typhoid patients, but she herself contracted the disease and was invalided to Melbourne in 1877. Laura was appointed matron of that city’s Homeopathic Hospital before assuming the same position at Newcastle Hospital. In 1880, Fanny and Rosamund (sisters in life and now by profession) moved to the newly established children’s hospital at Glebe, co-founded by their cousin John Brown Watt and administered by a Board comprised largely of titled men and their wives. The 40-bed infirmary catered for chronically ill children cared for by the Lady Superintendent, two sisters, four nurses, two honorary physicians and two honorary surgeons. Infectious cases were not initially admitted although there were periodic local outbreaks of measles, smallpox, typhoid and diphtheria.  

After Jane Hellicar, the first Lady Superintendent, married clergyman Frederick Smith in April 1880, Fanny was appointed her successor. Some months later, she was commended for Trained Nursing, her paper on nursing as an art based on science and was elected a member of the Victorian Social Science Congress. In November 1881 (by which time she had adopted the first name Frances) she lost a key supporter when Rosamund, who had been in charge of one of the wards, married and moved to Parramatta. Although there were more Board members than patients in the early years, the Evening News in 1882 noted that the Glebe infirmary had achieved ‘a high standard of character and efficiency’ under the supervision of ‘a lady thoroughly conversant with hospital life and its needs’. Nevertheless, Holden was already developing a reputation for making her views known, especially on the lack of a resident medical officer. There was accommodation onsite for nurses, but doctors had to get to the hospital by foot, horseback or hansom cab and be summoned by a personal messenger or telegram in cases of emergency.

In 1884 Anderson Stuart, newly appointed to the Chair of Anatomy and Physiology at Sydney University, and Robert Scot Skirving became honorary medical officers at the hospital. They had been fellow students at Edinburgh University and were close friends. Holden soon made an enemy of both, beginning with a dispute over an incinerator which Stuart installed to burn infected dressings. The furnace was dispensed with after she protested that it wasn’t working properly and the smell was intolerable.

In 1887, a year which saw an influx of typhoid patients, Holden complained to the house committee about the doctors’ unreliable attendance, their rudeness to her nurses, and her own discomfort when faced with anxious parents wanting to know when their child would receive medical attention. She cited an emergency case when she sent a messenger to the Union Club where one of the doctors was staying. He was out and the message was given to a porter. By the time the doctor received it two days later the patient had died. 

Holden’s claim that a child had died through negligence led to a government inquiry which was held on the hospital premises. Although suffering from a recurrence of typhoid, she prepared a detailed history of events. Among her supporters were judge William Hattam Wilkinson who lived locally at Hereford House, and the architect John Horbury Hunt who commented that the nursing staff should be ‘protected from the interference and annoyance of young doctors who make the hospitals the field of experimental practice’. There was a strong suspicion that the doctors treated their paying private patients differently from the hospital’s ‘paupers’  

When Holden was formally dismissed in October 1887, two sisters, six nurses and three servants resigned: Misses Piguenit, Nicholls, Brookes, Masters, Cuthbertson, Quinn, McKenzie, Tooher, Gunn, Campbell and Larkin. The Lady Superintendent’s successor was renamed ‘matron’ and paid 60% of her salary. This and other staff savings enabled the hospital to finally employ a resident medical officer. 

In 1888 Holden co-founded the Dawn Club with Louisa Lawson, the poet’s mother and a suffragist, and contributed to its journal The Dawn.  During the First World War, she worked for the Red Cross Society. Frances Gillam Holden died on 21 August 1924 at Omagh Burwood and was buried in the Church of England section at Rookwood. In 2015, she was mentioned in the American Association for the History of Nursing’s Annual Conference for her work and life in nursing.    

During the time she worked at the Hospital for Sick Children, Holden published a number of booklets and pamphlets: Trained Nursing; Woman’s Ignorance and the World’s Need: A Plea for Physiology; Plain Words to Mothers and Temperance Reformers on Food and Health; Plain Directions for Nursing Typhoid; The Travels of Red-jacket and White-cap; or, A History of the Circulation of the Blood; Scientific and Useful; Dying of Typhoid, or Dying of Ignorance – Which? and Her Father’s Darling, a collection of poems.  

Sources:  Australian Dictionary of Biography; Hipsley, P L The Early History of the Royal Alexandra Hospital for Children 1952; National Library of Australia Trove website; NSW Registry of Births, Deaths and Marriages; Sydney Hospital for Sick Children The new Sydney Hospital for Sick Children 1900.   

Footnote for family historians: The author has notes on Fanny’s siblings.