Downe Hospital (main block), 9a Pound Lane, Downpatrick, Co Down, BT30 6JA

Downe Hospital (main block), 9a Pound Lane, Downpatrick, is a two- and three-storey classical style infirmary building of 1834, designed by John B. Keane of Dublin, now much extended and partly rebuilt to the rear during the mid to later 20th century. It stands on a commanding rise to the south of Pound Lane, to the south of Downpatrick town centre, and has group value with the similar former fever hospital that shares the same site.

In its original form the building consisted of a long rectangular front wing with three rear returns, two of them apparently linked at their southern ends so as to enclose two courtyards. Today the plan has been greatly altered: the courtyards are now covered by a larger rebuilt south-west return and by various 20th century extensions. To the west the building is also connected, via a flat-roofed single-storey section, to a modern brick-built block.

The front elevation faces roughly north and is symmetrical. At its centre is a shallow full-height bay topped with a gabled pediment. On the ground floor of this bay is a large tripartite window with a modern frame, plain lintel, and cornice — originally the main entrance to the building. On the first floor of the bay is a smaller tripartite window with the same surround but with a pediment over the central light. To the left and right of this central bay are three windows to each floor, those at first-floor level having hoods on brackets. At each end of the front elevation is a tall projecting gabled bay that rises significantly above eaves level and effectively contains an attic storey. Each of these end bays has two windows on the ground and first floors, corresponding in treatment to the windows on the rest of the elevation outside the central bay. Above the first-floor windows the main eaves course continues across each end bay, and resting on that eaves course is a semicircular recess that was originally an attic-level eyebrow window opening. There is a thick moulded course between ground and first floor, with rusticated render below it and lined render above. The eaves course between the bays carries widely spaced dentils. In-and-out quoins finish the corners.

The east elevation is that of the three-storey east return, with various modern extensions to its left (south). The façade is symmetrical. At the centre of the ground floor is a doorway with a fanlight recess, small sidelights, and all contained within a large semicircular arched recess. Directly above on the first floor is a tripartite window, and on the second floor — the attic level — is an eyebrow window with a small gable over it. This window alone appears to have retained its original sash frame. To either side of these central openings are three windows to each floor. The façade is finished in lined render.

The west elevation has a complex appearance, dominated by the east façade of the three-storey south-west return, which was rebuilt on a larger scale in 1930–32. The two-storey west face of this return is plain, with seven windows to the first and second floors and four windows on the left side of the ground floor. Towards the centre-right of the ground floor the façade is abutted by a modern single-storey extension containing the main entrance, which links to a modern wing further to the west. To the right (south), the return connects to a two-storey gable section, which in turn connects to a two-and-a-half to two-storey gabled wing running east to west. It is unclear whether this wing was originally part of an outbuilding also dating from 1834 but formerly longer. The rear of the building is a conglomeration of mid to late 20th century extensions, mainly two storeys, flat-roofed, and built in concrete brick.

The roof of the original front section appears to be completely slated, with three rendered chimney stacks rising from the main front block. Rainwater goods are mainly metal. Window frames throughout the building are all modern with the single exception of the attic sash noted above.

The history of the institution dates to 1767, when the infirmary was first founded in two former dwellings in Saul Street. Those buildings were already old and in poor condition and were vacated in 1774, demolished, and replaced shortly afterwards by what are now Nos. 14–18 Saul Street. The governors then purchased the old 17th century cavalry barracks in Barrack Lane (now Fountain Street), which they converted at a cost of £150, and patients were treated there until the construction of the present building in 1834. The old barracks was subsequently subdivided into private dwellings and renamed Saul Terrace, but was demolished in the early 1970s.

The present building was constructed in 1834 to designs by John B. Keane of Dublin. A fever hospital was built to the south of the infirmary at the same time, and an entrance lodge to the north. John Lynn was engaged as builder, and the total cost for the whole complex came to £6,000, half raised by Grand Jury presentment and half by subscription. The building is shown on the Ordnance Survey map of 1834 with its three rear returns. The Ordnance Survey Memoirs of December 1836 describe it as "a fine and handsome building," but remark upon how little it cost to build, commenting — and undoubtedly implying cost cutting — that "some parts of the building (principally woodwork) are not so calculated to last as long as they should."

The infirmary was refurbished, and possibly had its internal layout altered, in 1897, but appears to have remained largely intact externally until 1930, when the south-west return was rebuilt on a much larger scale and the building was completely refurbished at a total cost of £13,000, of which £8,000 was raised solely through the efforts of Lady Clanwilliam. The building was renamed Downe Hospital in 1948 and was further extended throughout the 20th century, including the construction of a new outpatients block to the west of the original building in 1957.