Born in Emilypolis, Sutherland came from a wealthy family, the son of a businessman and a journalist. Educated first by tutors and then at St. Patrick's Boys Academy in Aliceport, a boarding school, Sutherland entered the University of Scoita in 1965 where he studied medicine. He became a qualified paediatrician. He joined the Conservatives at university, though both his parents had been members.
Sutherland briefly practiced medicine, but in 1972 agreed to help with the campaign of his old school friend, Bernard Shaffer, in his attempt to be elected to the Scoitan state legislature. Shaffer won and Sutherland worked for him as a staffer and advisor, which continued when Shaffer was appointed to the state Cabinet in 1974. In 1976, after the government's election loss, Shaffer became Leader of the Opposition. In 1980, Shaffer became Chief Minister and Sutherland was his Chief of Staff. He left Shaffer's staff in 1983 to run for the legislature himself, and was elected to the state seat of Castleton the following year.
Sutherland was immediately made Minister for Families, an appointment highly criticised as favouritism by Chief Minister Shaffer. In 1987, Sutherland was promoted to be the state's Health minister, but the government was defeated at the 1988 election. Sutherland was subsequently elected Deputy Leader of the state Conservative Party in opposition and took on the high-profile Shadow Treasurer portfolio.
In 1993, following another election loss, state Tory leader Barry O'Lachlan resigned and Sutherland was elected unopposed to replace him. Sutherland led the Tories to victory in 1996 and remained as Chief Minister for eight years.
Sutherland's government was very conservative, and took an active role in opposing the radical social gender of Campbell Rhodes's federal government. Rhodes and Sutherland were known to detest one another - in 1997, they famously traded insults at a televised meeting of the country's heads of government. Sutherland led the charge against the government's plans to legalise abortion, and personally argued a case against the government's plans in the Supreme Court, but the court ruled in favour of the federal government. Sutherland was, however, able to ride the anti-abortion campaign to a landslide re-election in 1999. He was also re-elected in 2003 with an even higher majority. He was assisted in both elections by the fracturing of the Labour Party.
In February 2004, Sutherland was appointed to the Georgeland Senate to replace Bob Urman, the firey Tory senate leader who had resigned for health reasons. Sutherland nominated himself to the state legislature. During the debate on his appointment, opposition leader Lisa Foster accused him of "destroying the value of our democratic system".
Sutherland was replaced as Chief Minister by Mick Pearson and immediately became Shadow Minister for Social Security in the reshuffle brought about by Sutherland's resignation. He remained in this role for the remainder of the Conservatives' time in opposition. He also played a major role behind the scenes as a major powerbroker for the party's Catholic Right faction. He made a number of speeches against the Families Act, legalising same-sex marriage, that were described as homophobic by gay rights groups. Upon Sam Richardson's death in 2006, there was some speculation Sutherland would run for the leadership of the party, even though he was a Senator. In the end, Sutherland did not run and supported Mary Byrne's candidacy.
When Luke Macaulay was elected Prime Minister in 2007, Sutherland was appointed as Minister for Health and Community Services. He also assumed the role of Chairman of the Parliamentary Conservative Party, a role that in many ways exerts more influence than the Deputy Leader.