The Foundation’s history began long before NHS Lothian, and long before the establishment of the NHS in 1948. During the 18th and 19th centuries, voluntary hospitals were established up and down the country on the benevolence of wealthy society, for the benefit of the poor. They were most often closely linked to notable medical schools (such as the University of Edinburgh), and had access to the latest in medical knowledge and technologies. It was the collected endowments of those early hospitals which created the Foundation we know today.

The original four-bedded Edinburgh Infirmary, established in 1729, is the oldest voluntary hospital in Scotland, founded on the success of a fundraising appeal run by the Royal College of Physicians of Edinburgh. A royal charter was granted in 1736, and a new larger hospital with 228 beds was funded and opened in 1741, the site expanding over the next hundred years. But increasing demand and medical advances led to another major fundraising appeal to create the new Royal Infirmary on Lauriston Place, where benefactors were remembered in the marble entrance hall.

The Western General Hospital, formerly St Cuthbert’s Poorhouse was opened in 1761, merging with Craigleith Hospital and Poorhouse in 1868, and was later renamed the Western General by Edinburgh Town Council in the 1930s.

The Royal Edinburgh Hospital was established after a fundraising appeal led by Dr Andrew Duncan in 1792, creating a hospital in Morningside to care for the mentally ill with dignity and respect.  Duncan was moved to create such a centre after the tragic death of his patient, poet Robert Fergusson, in the Edinburgh madhouse, after sustaining a head injury in a fall.

The Royal Hospital for Sick Children was opened in 1860, again following a successful fundraising appeal launched with an impassioned letter to the Scotsman by surgeon, Dr John Smith. The hospital opened on Lauriston Lane with just 12 beds, but within a year was reported to be full and turning sick children away. A second appeal was launched and a new hospital was built, receiving royal charter in 1863.  The third major appeal, in 1895, established the Royal Hospital for Sick Children at its present location at Sciennes.

The Edinburgh and Lothians Health Foundation was founded on two things: the benevolence of Edinburgh society, and the ongoing support of generations of patients and their carers, to the work of the hospitals.

Various reorganisations of the NHS in Scotland, including the separation from the NHS in England and Wales in 1978 and the most recent reorganisation and establishment of the fourteen regional Scottish Health Boards has effected the administration of the endowments, but their charitable object, “the advancement of health” has remained constant. The Foundation was registered as a charity in 1992.