On 4th December 1881 the Board appointed Mrs Mary Meyler Matron.

There is presently little personal information available about the first Matron of the Coast Hospital. She had joined the quarantine Service in June 1 1881. Most nurses who were voluntarily seconded to the Quarantine Service during the epidemic came from Sydney Hospital.

It is certain Mrs Mary Meyler was a competent, experienced nurse with impeccable references which took the place of registration certificates at that time. She would more than justify the confidence shown in her ability by the distinguished Board members

Her task was challenging! The new, partly equipped hospital was situated in virgin bush on sandhills, four miles at least from the nearest public transport, the steam tram from the city which terminated at the bayside village of Botany. Her salary was £100 per annum with allowed quarters, rations, fuel and light.

When the smallpox epidemic finished at the end of February 1882, the Sydney Hospital committee applied to use the Coast to relieve its wards of long term convalescent patients on the understanding that the committee would meet all expenses and provide medical and nursing staff: a promise which was not kept. The Government met most of the costs. 

Mrs Mary Meyler remained as Matron and Dr Beattie was the only medical officer. The one condition the Government imposed was that the hospital had to be completely evacuated within 24 hours if it was required for quarantine purposes. 

It was, on two occasions, the first in August 1882 when the crew and passengers of S.S. “Gunga” were quarantined because of a case of smallpox and again in March 1883 when the S.S. “Munmuir” arrived with several cases of smallpox. 

The Sydney Hospital resumed its transfer of patients when the quarantine order was lifted. 

Mary Meyler was dismayed when the hospital was again emptied in September 1883 because of Dr Beattie’s resignation. She was relieved when informed by the Government that it would reopen again in December with a new Medical Superintendent, Dr T.M. Smith and that it would no longer be controlled by the Quarantine Service but would be under the jurisdiction of the Chief Medical Adviser to the Government. 

More surprising was the Government’s plan to admit convalescent patients from all metropolitan hospitals and to entirely manage and fund the hospital. This was a revolutionary concept; for the first time in N.S.W. the state would own and operate a general hospital. Previously all major hospitals and special category hospitals were controlled by private charity committees supported by large government subsidies.
The Government of the day was not satisfied with the disposal of public health funds as far as destitute and needy patients were concerned and had decided to provide its own care at the Coast at Little Bay. 

The Coast was admirably suited for its role as a convalescent hospital. 

The emergency site was a magnificent one. Many patients would require minimal medical care and being mobile, would not find the distances between wards and other essential facilities inconvenient. The proximity of Little Bay beach and the abundance of fresh air together with the bushland would add a therapeutic dimension not found in other hospitals.

It was a worthy concept, but within a month the urgent reality of a typhoid epidemic changed the hospital’s identity once again. Metropolitan hospitals were unable to meet the emergency demands for beds and it was the scattered nature of the Coast buildings that provided the solution. 

The Sanatorium on the northern side of the entrance gates was set aside for fever patients and the buildings near the sea for the general patients, mainly for destitute sick and convalescing patients. 

From that point the hospital “just grew”; a “lock” ward was added for male with venereal diseases; an outpatients clinic developed as the people from she village of Botany, where there was no resident doctor, crossed the sandhills seeking medical aid; the aboriginal community at La Perouse required medical assistance from time to time. 

To match the influx of patients with a variety of diseases the nursing and general staff had to expand. By the end of 1884 a Head Nurse, Marion Fairburn had been appointed to take charge of the Sanatorium, she also acted as Sub-Matron. Sixteen nurses were appointed, six senior and ten junior. There were three wardsman, two cooks, one sculleryman, one carpenter and one assistant, three general attendants, two laundresses, four general servants, two ambulance drivers and one stableman.
Recruiting medical officers was difficult. The isolation of the Coast was the reason why the medical staff was unstable for many years, which increased the work and responsibilities of medical superintendents, matrons and senior sisters. 

Mary Meyler resigned from the Matronship in November 1885 quite sure that the “start and stop” vicissitudes of the early years were over. The Coast would not close again.