The hospital we now know as St James's started life in a very different form as the Moral and Industrial Training School run by the Poor Law Guardians for the Township of Leeds, a building opened in October 1848 in what is now part of Lincoln Wing.

At this time it stood isolated on the brow of a hill surrounded by open countryside. Ten years later, the Poor Law Guardians resolved to bring all Workhouse relief in Leeds into one new Institution, the Leeds Union Workhouse. Now known as Ashley Wing, and noted for its splendid facade, the building today houses the Thackray Medical Museum.

The new Workhouse accommodated 784 paupers who existed under a spartan regime of work in return for food and accommodation, with discipline rigorously applied by the Master, who was responsible to the Guardians. Nearby was built the Chapel, in byzantine style, whilst the building which now houses Chemical Pathology at St James's was commissioned in 1862 to accommodate "lunatics from Wakefield".

Many of the inmates were sick and feeble, and in 1874 the Leeds Union Infirmary was built on the site of what is now Gledhow Wing. The staff consisted of one medical officer, a male nurse and a female nurse, with other duties undertaken by able-bodied paupers. By 1881, there were an average of 400 patients in the Infirmary every day, and nursing and medical care was beginning to improve, although staff shortages were common as many nurses, for example, preferred to work in voluntary hospitals.

Attitudes were changing by the end of the 19th century, when many pauper children were sent to start new lives in Canada. The Workhouse and Industrial school buildings were given over to caring for the sick poor of the city, and new buildings were erected along Beckett Street.

The outbreak of a ferocious war in Europe in 1914 meant that Leeds had to play its part in caring for the thousands of casualties pouring back from battles on the Western Front. In March 1915 the Guardians offered the War Office use of the Workhouse and Infirmary to care for sick and wounded servicemen, in what was to be renamed the East Leeds War Hospital. Remaining inmates were transferred to the Hunslet Workhouse.

After the war, the days of the Workhouse were numbered, and in 1925 the Poor Law Infirmary was finally renamed St James's Hospital. By this time, the once green fields surrounding the institution had been swallowed up by a vast complex of back-to-back houses, and an almost constant pall of smoke hung over the area.

By the outbreak of the Second World War, many new facilities at St James's were nearing completion. These included a new operating theatre suite, massage and electrotherapeutic department, nurses training school and pathology unit. In this war it was expected there would be large numbers of civilian casualties from air raids, and many wards were left empty for this purpose but were never needed.

When the National Health Service was formed in 1948, the role of St James's was again enhanced and the hospital began to develop many more specialisms. One of the first ever Consultant Geriatric Physicians in the UK was appointed at the hospital in December 1950, recognising changing attitudes towards the aged sick.

By 1963, the Regional Hospital Board produced an ambitious plan to redevelop the whole hospital. This move led to the construction during the late 1960s and mid 1970s of many of the parts we are familiar with today, including Chancellor Wing, Beckett Wing and the very large nine-storey Gledhow Wing.

The end of the 1960s also saw an important milestone for St James's, which for years had been in the shadow of the older institution across the city, the Leeds General Infirmary. An expansion of the Leeds Medical School led in October 1970 to St James's being officially named as a University.

Further building work in more recent times has seen the completion of the Clinical Sciences Building and the new Lincoln Wing. The sheer size of the St James's site today is impressive, and it is often described as "Europe's largest teaching hospital"