In the 1950s the hospital was renamed after Major Herbert Peebles, DSO, and Commissioner.

In the year 1953 a Children’s Ward was constructed and was officially opened in May, 1955.

Peebles Hospital celebrated its Golden Jubilee in 1976

During the early 1990s the name was briefly changed to the H.R. Penn Hospital. The name was in homage to  Howard Reynold Penn OBE, a renowned BVI Leader who was a member of  the Territory’s  First Legislative Council. The change was not permanent as the hospital’s name was quickly reverted to Peebles Hospital.

Currently, the Peebles name is still carried by the facility. However, that name is used in reference to the old structure which now hosts the Road Town Clinic. That area is now referred to as the Major Peebles Wing. The portion between the old and new hospital is called the Annex. This area houses the laboratory, morgue and administrative offices.  The newly built hospital, which was opened in 2014 was renamed in 2019 after former Premier and BVI Health Care professional Dr. D. Orlando Smith.

The entire hospital falls under the British Virgin Islands Health Services Authority (BVIHSA) which is a semi-autonomous, statutory body that also manages the Territory’s community clinics. These clinics include: The Theresa Smith Blyden clinic (Cappoon’s Bay), Road Town Health Centre, Rosalind Penn clinic (Long Look), Iris Penn clinic (East End), Jost Van Dyke, Nurse Iris O’Neal Clinic (the Valley, Virgin Gorda), North Sound clinic, and Romalia Smith clinic (Anegada).

The BVI Health Services clinics and hospital offer the most affordable care in the Territory. This is because the BVIHSA is part of the Territory’s National Health Insurance scheme and accepts payment through the Social Security Board. As such, NHI is the preferred insurance payment provider at all BVIHSA facilities.

The BVIHSA was established to promote greater efficiency in administration and productivity of the public health care services of the BVI.