Sydney Institute, and the South Western Sydney Institute. At the 2011 census, 2.4% of Sydney residents are enrolled in a TAFE course. Health The first hospital in the new colony was a collection of tents at The Rocks. Many of the convicts that survived the trip from England continued to suffer from dysentery, smallpox, scurvy, and typhoid. Healthcare facilities remained hopelessly inadequate despite the arrival of a prefabricated hospital with the Second Fleet and the construction of brand new hospitals at Parramatta, Windsor, and Liverpool in the 1790s. Governor Lachlan Macquarie arranged for the construction of Sydney Hospital and saw it completed in 1816. Parts of the facility have been repurposed for use as Parliament House but the hospital itself still operates to this day. The city's first emergency department was established at Sydney Hospital in 1870. Demand for emergency medical care increased from 1895 with the introduction of an ambulance service. The Sydney Hospital also housed Australia's first teaching facility for nurses, the Nightingale Wing, established with the input of Florence Nightingale in 1868. Healthcare gained recognition as a citizen's right in the early 1900s and Sydney's public hospitals came under the oversight of the Government of New South Wales. The administration of healthcare across Sydney is handled by eight local health districts: Central Coast, Illawarra Shoalhaven, Sydney, Nepean Blue Mountains, Northern Sydney, South Eastern Sydney, South Western Sydney, and Western Sydney. The Prince of Wales Hospital was established in 1852 and became the first of several major hospitals to be opened in the coming decades. St Vincent's Hospital was founded in 1857, followed by Royal Alexandra Hospital for Children in 1880, the Prince Henry Hospital in 1881, the Royal Prince Alfred Hospital in 1882, the Royal North Shore Hospital in 1885, the St George Hospital in 1894, and the Nepean Hospital in 1895. Westmead Hospital in 1978 was the last major facility to open. Transport Roads The motor vehicle, more than any other factor, has determined the pattern of Sydney's urban development since World War II. The growth of low density housing in the city's outer suburbs has made car ownership necessary for hundreds of thousands of households. The percentage of trips taken by car has increased from 13% in 1947 to 50% in 1960 and to 70% in 1971. The most important roads in Sydney were the nine Metroads, including the Sydney Orbital Network. Sydney's reliance on