The first contracts for the construction work were let in 1894, the major one going to the Sydney builder, John Baldwin, for an amount of £12,760-6-5. A second contract for about £923-9-0 was awarded to the local Goulburn builder, JC O’Brien. Baldwin’s contract involved the erection of a number of permanent buildings in brick: of the medical superintendent’s residence, a boiler house and chimney stack 85 feet high and three lodges at the entrance gates. Also included in Baldwin’s contract were some temporary wooden structures: a laundry, sewing building, workshops and stables. Initially, the stables were fitted out as offices, storerooms and a mess for the hospital’s male attendants, while the workshops were divided into four dormitories for male patients, five attendants’ rooms, a dining room and a workshop. The main purpose of these temporary arrangements was to provide accommodation as quickly as possible for a certain number of ‘quiet and industrious male patients, who could be transferred from other institutions to help with the development of Kenmore’.

The construction work involved in the first set of contracts was virtually completed by the end of 1894. On 5 January 1895, the first group of five patients, all males, was transferred to Kenmore from the mental institution at Newcastle. Further transferrals of male patients from Gladesville, Callan Park and Parramatta followed during the rest of the year. Meanwhile, the appointment of the new hospital’s first medical superintendent had been made in the person of Chisholm Ross.

Work on the second stage of construction proceeded throughout the period 1895-7. The Administration Block was completed in 1895, as was the northwestern or chapel half of the combined chapel and amusement hall. As early as March 1896, Ross was arranging concerts in the half-built hall for the benefit of the patients at the hospital.

The residence for the matron and medical officers and the kitchen and stores block with its distinctive clock-tower were completed around the end of 1896. Unfortunately, work on the first four permanent wards, which was supposed to have been finished at the same time, was delayed. Work on the new wards had progressed to such an extent by 22 March 1897 that the hospital was able to accept its first female patients, a group of fourteen from Gladesville. Another eleven arrived from Callan Park two days later. The first four permanent wards were eventually completed in June, by which time Kenmore was housing 196 male and 96 female patients, a total of 292.