A
History of Pharmacy in Great Britain
by Dr Stuart Anderson
Pharmacy
in Britain before 1841
In most European countries, including England, apothecaries developed
from the Pepperers and Spicers. English traders in spicery, which
included crude drugs and prepared medicines, evolved into either Grocers
or Apothecaries and became a distinct occupational group in the
thirteenth century.
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They were under the jurisdiction of the Guild of Grocers until 1617 when the Society of Apothecaries was formed.
Apothecaries were both physicians and pharmacists, diagnosing and dispensing the medicines they themselves prescribed. There was, however, another group interested in dispensing medicines - the chemists and druggists who not only manufactured, packed and wholesaled drugs but also retailed and dispensed them. The Apothecaries Act of 1815 confirmed apothecaries as general practitioners - and most took this role leaving others to sell and supply medicines.
Pharmacy
in Britain 1841 to 1911
The modern history of British pharmacy begins with the foundation of the
Pharmaceutical Society of Great Britain in 1841. In that year William
Allen moved a resolution that 'an Association be now formed under the
title of The Pharmaceutical Society of Great Britain'. By the end of
1841 the new Society had around 800 members and by May 1842 nearly 2000.
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The rise of the multiple chemists stemmed from legal proceedings against the London and Provincial Supply Association. The Pharmacy and Poisons Act of 1868 stated 'from and after 31 December 1868 it shall be unlawful for any person to sell or keep open shop for retailing, dispensing or compounding medicines, or to assume or use the title chemist and druggist, or chemist, or druggist, or pharmacist, or dispensing chemist in any part of Great Britain unless such person shall be registered under this Act'.
The Society decided to determine the legal position. Two years later, in 1880 the House of Lords ruled that the word 'person' under the 1868 Act did not include corporate bodies. This meant that companies could not only use restricted titles but could sell poisons provided that they were sold by a qualified person.
Pharmacy
in Britain 1911 to 1948
A major influence on pharmacy practice has been the extent of the powers
of the Pharmaceutical Society. In 1920 Arthur Jenkin took out an
injunction to restrain the Council of the Society from undertaking a
range of activities, including the regulation of pay and conditions of
service, to function as an employers' association, and to provide legal
and insurance services to members.
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The injunction was granted. At a hearing on 19 October 1920 the Court decided that the Society did not have powers to regulate wages, hours of business, and the prices at which goods were sold, or to provide insurance or legal services.
The rise of the multiple chemists stemmed from legal proceedings against the London and Provincial Supply Association. The Pharmacy and Poisons Act of 1868 stated 'from and after 31 December 1868 it shall be unlawful for any person to sell or keep open shop for retailing, dispensing or compounding medicines, or to assume or use the title chemist and druggist, or chemist, or druggist, or pharmacist, or dispensing chemist in any part of Great Britain unless such person shall be registered under this Act'.
The Society decided to determine the legal position. Two years later, in 1880 the House of Lords ruled that the word 'person' under the 1868 Act did not include corporate bodies. This meant that companies could not only use restricted titles but could sell poisons provided that they were sold by a qualified person.
Pharmacy
in Britain 1948 to 1986
By 1946, 24 million workers were covered by National Insurance - about
half of the working population. The National Health Service, introduced
on 5 July 1948, made the service available to everyone.
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The impact on pharmacists was substantial. Prescription numbers leapt from 70 million in 1947 to 250 million in 1949. Private prescriptions and counter sales of medicine declined rapidly. Ready prepared preparations were few, dispensing assistants were recruited and dispensaries enlarged. At the beginning of the NHS most prescriptions were dispensed extemporaneously. Many pharmacists took the opportunity to enlarge their dispensaries and take on staff to deal with the counter sales but continued to undertake the dispensing themselves.
Through the 1950s and 60s the numbers of prescriptions continued to grow but, with new drugs constantly being marketed, tablets and capsules increased and extemporaneous dispensing decreased. Prescriptions now accounted for about half of the pharmacist’s income. New entrants into pharmacy believed their place to be in the dispensary. Overnight the pharmacist migrated to the back of the shop where he spent most of his time dispensing prescriptions. Public access to the pharmacist diminished.
The conflict between trade and profession has been a central issue throughout pharmacy’s history. In 1955 the Society set up a committee to examine the general practice of pharmacy, with particular reference to professional standards. Following publication of its report in 1963, the legality of the recommendations was tested in the courts in what became known as the Dickson Case. The High Court ruled that 'it is not within the powers of the Society to enforce the provisions of the motion on the ground that the provisions are in restraint of trade'.
Pharmacy
in Britain, 1986 to the present
In the early 1980s there was uncertainty about the future of pharmacy.
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The Minister for Health, Dr Gerard Vaughan, announced at the British Pharmaceutical Conference that 'one knew there was a future for hospital pharmacists, one knew there was a future for industrial pharmacists, but one was not sure that one knew the future for the general practice pharmacist'. Pharmacy began to reinvent itself. Important initiatives included the National Pharmaceutical Association's 'Ask Your Pharmacist' Campaign.
An independent and far-ranging inquiry into the profession was needed. The result was the Nuffield Report. Its terms of reference were 'to consider the present and future structure of the practice of pharmacy in its several branches and its potential contribution to health care and to review the education and training of pharmacists accordingly'. The tone of the report was positive: 'we believe that the pharmacy profession has a distinctive and indispensable contribution to make to health care that is capable of still further development'. Twenty-six of its 96 recommendations related to community pharmacy.
The years that followed its publication were dominated by the action necessary to implement the recommendations. Two aspects came to dominate the discussion; whether a pharmacist needed to be on the premises in order to supervise, and the extended role. In order to have time to carry out the extended role, pharmacists would need to be able to leave the pharmacy at times. But the profession rejected this suggestion and in 1989 the Council of the Society issued a statement that 'every prescription for a medicine must be seen by a pharmacist'.
The first decades of the twenty-first century have seen the further rapid transformation of pharmacy and pharmacists. The separation of the registration and representative functions with the creation of the General Pharmaceutical Council in 2010 heralded the start of the most significant period of change in the Pharmaceutical Society's 169-year history. The emergence of consultant and prescribing pharmacists mirrors the role of apothecaries in the eighteenth and nineteenth centuries; and the creation of two registers, for pharmacists and pharmacy technicians, reflects the dual registers for chemists and druggists and pharmaceutical chemists that existed between 1868 and 1954.
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