On Saturday, September 4, 1847, Edward Frankland, then a young man of 22 years, arrived at Queenwood college in Hampshire to teach chemistry. Queenwood, a newly founded, pioneering institution for science education, was housed in a magnificent building, constructed in the baronial style, and set in 533 acres of farmland.
This remarkable edifice was the creation of the utopian socialist Robert Owen, whose intention had been to set up a grand co-operative community called “Harmony Hall”. But by August, 1845, the colony had broken up and the palatial buildings remained deserted until transformed into Queenwood college in the summer of 1847. As Frankland made his way up the long drive to the college, he may well have noticed the inscription, “C. of M. 1841”, picked out in flint on one of the red brick chimneys. For this was the way Robert Owen had chosen to proclaim the “Commencement of the Millennium 1841”.
Owen believed that the construction of “Harmony Hall” would usher in a thousand years of peace and prosperity for all mankind. When Jacob Bell, in that same year, founded the Pharmaceutical Society of Great Britain, his aims were more modest. Owen wanted to rebuild the world; Bell was merely trying to reform an occupation. Yet a glimpse at Frankland’s career reveals how difficult Bell’s self-imposed task would be.
Edward Frankland (1825-1899), the illegitimate son of a distinguished lawyer, became one of the most eminent chemists in 19th century Britain. After gaining a PhD from Marburg, he became the first professor of chemistry at the University of Manchester and then spent the rest of his life working in prestigious scientific institutions in London. For nearly 40 years he acted as the government’s chief adviser on the purity of public water supplies. He discovered the chemical bond, founded the science of organometallic chemistry and was the first person to measure the calorific value of foodstuffs. He was knighted in 1897.
On January 18, 1840, Frankland celebrated his 15th birthday by being apprenticed for six years to Stephen Ross, a chemist and druggist in Lancaster. The first two years consisted of nothing but hard manual labour. In the summer he collected the keys of the shop in Cheapside at 5.45am, took down the shutters at 6am, and continued sweeping the floor and dusting the bottles until his master arrived at 8am. In winter, work began an hour later and included lighting the fire. He was allowed 30 minutes for breakfast and an hour for lunch. The shop remained open until 8pm. But on Saturdays there was no lunch break and the shop stayed open until 9pm. Frankland was fortunate to be apprenticed to a deeply religious man – the other three chemists in Lancaster opened on Sundays as well.
An apprentice’s work was often arduous. Frankland recalled wheeling a cask of treacle through the streets and carrying a two-hundredweight sack of barley “up a steep and narrow staircase”. Much of his time was spent working a 20lb pestle, rotated by a vertical rod extending through the ceiling. With this he spent hours reducing drugs to the finest powder, crushing and blending sugars and grinding and mixing paints. It took nearly a day of non-stop work to produce a pound of cocoa.
When “Spanish flies” (cantharides) were being powdered, he wore a tightly fitted linen sack over his head, but he took no safety precautions when mixing mercury and lard to produce mercurial ointment. Using 14lb of lard and 6lb of mercury it took about three months, with two full days each week, to produce ointment of the required standard. Yet the end product was, in Frankland’s opinion, “by no means equal to the machine-made article”. But Stephen Ross, his master, had good reason for not buying manufactured preparations: his apprentices worked long hours without pay or gratuities.
Not all Frankland’s duties were strenuous. Once during these first two years he painted the shop and, every Saturday evening, he sold tea, sugar, coffee and nutmegs across the counter. Later in his apprenticeship he acquired the responsibility of making up the full range of pharmaceutical preparations, which he did from the directions in the pharmacopoeia, without any additional instruction from his master. Sometimes dispensing errors occurred. On one occasion, his colleague John Hodgson inadvertently substituted “butter of antimony” for “antimonial wine”. Fortunately the mistake was spotted in time.
During the final period of his apprenticeship, Frankland often deputised for his master in dispensing physicians’ prescriptions and in the general management of the shop. “My chief delight, however,” he confessed, “consisted in drawing people’s teeth whenever I could get a chance, and prescribing for patients, who seemed to have more confidence in me than in any of the duly qualified practitioners in the town. I never heard that I did any harm, but many grateful people came to tell me of the cures I had effected.”
Towards the end of his life, Frankland described his apprenticeship as “six years’ continuous hard labour, from which I derived no advantage whatever, except the facility of tying up parcels neatly”. He condemned the whole experience as one of “mere mechanical and even menial work without the slightest intellectual training or incentive thereto”.
Viewed from today’s perspective, it might be said that Frankland had received an invaluable introduction to patient-focused pharmaceutical care in a busy walk-in health centre. The level of trust his patients had in his clinical practice was matched by his own concern for the therapeutic outcomes of his treatment.
Within a few days of completing his apprenticeship in October, 1845, Edward Frankland left Lancaster to seek his fortune in London. But instead of seeking employment in one of the fashionable metropolitan drug houses, Frankland secured the post of chemical assistant in Dr Lyon Playfair’s new laboratory in Duke Street, Westminster. His days as a chemist and druggist were over; his training as a chemical analyst was about to begin.
In spite of all its inherent deficiencies, apprenticeship to a chemist and druggist was usually the only way in Britain that young men from humble backgrounds could gain an introduction to scientific knowledge and a foothold on the ladder of opportunity. In Germany and France, disappearing apprenticeships were replaced by state-funded trade schools and technical institutes, the springboards for future scientific and technological superiority. Yet, from Stephen Ross’s shop there emerged four apprentices who went on to become major players in British chemistry. One of Frankland’s contemporaries, John Hodgson, gained employment as a chemist at an alkali works in South Lancashire. Frankland’s immediate senior was Robert Galloway, who taught at Queenwood and later held a chair of applied chemistry in Dublin. Following Frankland two years later was George Maule, whose pioneering work on aniline dyes gave him an international reputation. These exceptionally bright young men were, none the less, lost to pharmacy. Since the normal expectation of a druggist’s apprentice was to become a journeyman-assistant, with the often forlorn hope of getting together enough capital to acquire his own shop, their decision to leave pharmacy is hardly surprising.
Rise of the chemist and druggist
Chemists and druggists had emerged as a distinct branch of the medical profession during the 18th century. Their emergence was part of that century’s retail revolution, the birth of a consumer society, and the spread of fixed-premise trading. As the ancient fairs and markets declined and the itinerant pedlars, chapmen, and hawkers began to disappear, so the chemists’ shops were built to serve the new urban populace. The staple parts of their pharmaceutical trade were vending drugs, with and without prescriptions, supplying the ingredients of family recipes, restocking medicine chests, selling veterinary and patent medicines, and producing their own proprietaries. They made up mixtures, draughts, pills, powders, liniments, lotions, ointments, drops, electuaries, gargles and plasters. They took natural barks, herbs, leaves, flowers, roots and seeds, and crushed, boiled, infused and strained them. They habitually performed the basic chemical techniques of extraction, separation, crystallisation, sublimation and distillation. They dealt with all manner of aches and pains, bruises and strains. They let blood and applied leeches. They bandaged wounds, lanced boils and reduced inflammations. They sold and fitted surgical appliances. They drew teeth and sold spectacles. They were general medical practitioners, advising and prescribing over the counter, but rarely visiting patients except to deliver goods.
From the beginning the chemist’s business was never exclusively medical and pharmaceutical. Although specialising in herbs, drugs, and chemicals, they also sold general groceries, oils, colours, ironmongery and even books. The distinction between food and drugs was not as clear then as it is now. So, when chemists sold tobacco, snuff, tea, coffee, mineral and soda waters, ale, spirits and wines, their customers might be buying them, like their purchases of medicines, for health reasons. Moreover, the preparation of medicines from herbs, drugs and chemicals led easily to the production of mustards, vinegars, sauces, pickles, confectionery, cosmetics, perfumery, furniture cream and polishes. The needful equipment, manufacturing techniques and even the ingredients overlapped.
In order to survive and prosper each chemist and druggist had to respond to the business opportunities in his own area: the diversity of neighbourhoods accounts for the heterogeneity of chemists and druggists. The sovereignty of the consumer was the driving force behind the rise of the chemist and druggist; respect for the autonomy of the individual customer was the key to success. In the early 19th century sick people habitually played an active role in interpreting and managing illness. Self-diagnosis and therapy were standard practice at all levels of society and adults regularly dispensed medicine to family, friends and servants. Lay persons believed, with good reason, that they could understand illness and treat it just as effectively as the medical practitioner.
At the time of the foundation of the Pharmaceutical Society, persons without any form of qualification whatever could sell and advertise practically any medicine they liked, could put into it whatever they pleased, could call it by any name they fancied, and claim for it anything and everything they wished the public to believe. The public were likewise free to buy any drug or pharmaceutical preparation they wished, in any quantity, without restriction from the chemist or the necessity of a medical prescription. Even the physician’s prescription implied the minimum of medical control since it belonged to the patient and could be dispensed indefinitely. Since the majority of raw materials were so cheap, and the competition among vendors so keen, the most potent substances were obtainable by all bar the destitute.
The more consumer power fuelled the profits of the chemist and druggist, the more the general medical practitioner sought ways of containing it. The movement for the professionalisation of medicine, with its emphasis on the value of specialised training and knowledge, constituted an assault not only on the freedom of the chemist and druggist but also on the tradition of family self-medication.
The medical reformers intended to put the patient firmly under the doctor’s control. They regarded self-medication as the essence of quackery, that is, the practice of medicine beyond the control of the qualified. The free market was seen as a conspiracy between buyer and seller which produced profit-hungry drug sellers and obsequious doctors ingratiating themselves with their patients by giving them what they demanded.
Rise and fall of the apothecary
In the early part of the 19th century the apothecary began to imitate the style of the gentleman-physician: he went to London to obtain credentials from the College of Surgeons and the Apothecaries’ Society and he insisted on being paid for giving advice. He abandoned the shop and turned the front room of his house into a “surgery”. He claimed the authority of the expert to prescribe for his patients. But he did not abandon the sale of drugs. Even though he might want to become the “physician-in-ordinary” to the mass of the people, he could not survive without the profit made on dispensing drugs to his patients.
The introduction of parliamentary bills in 1840 and 1841 to reorganise the medical profession provoked the public meetings of chemists and druggists which led to the formation of the Pharmaceutical Society. From their point of view, the campaign for medical reform was directed not towards their elevation and protection as practitioners of pharmacy, but to their suppression as a business community. The London Society of Apothecaries, which already licensed general practitioners, now sought to bring the chemists and druggists under its control. But the idea that the regulation of the practice of pharmacy should be placed in the hands of dispensing doctors received a frigid reception, not only from chemists and druggists, but also from the Royal College of Physicians and the government.
Sir James Graham, the Home Secretary, had his own scheme of medical reform, which involved increased powers for the Royal Colleges of Physicians and Surgeons and the repeal of the 1815 Apothecaries Act. By incorporating the newly formed Pharmaceutical Society by Royal Charter in 1843, the Home Secretary was signalling not only the birth of a new force in medical politics, but also the corresponding decline of the Society of Apothecaries.
The fate of the apothecary is a reminder that occupations fall as well as rise and that attempts to get rid of rivals often backfire. But who, in the 1840s, could have predicted that the apothecary would survive today only as that curious anachronism, the dispensing doctor? Who could have foreseen the rise of the pharmaceutical chemist?
The Society’s foundation
The creation of the Pharmaceutical Society was an event full of irony. A meeting called to defend the chemist’s right to prescribe agreed a strategy to promote the ideal of a dispensing profession. A gathering intent on the defence of free trade ended by endorsing a programme of self-regulation. An appeal for the protection of business interests led to the promotion of scientific education.
This series of paradoxes reflected the tension between the Society’s founding fathers and the great majority of chemists and druggists. Chemists and druggists were flourishing and prosperous. The Society of Apothecaries rightly described them as “a powerful and wealthy body”. There were, of course, many levels of prosperity and many degrees of affluence within the ranks. A great gulf stretched between, on the one hand, the established, substantial manufacturer-cum-wholesaler-cum-retailer and, on the other, the corner shopkeeper scraping a living little better than that of his working-class neighbours. A series of gradations between these extremes reflected the character of the communities they served.
The great mass of chemists and druggists had no desire to become “professional men”. They were not eager to acquire commercially irrelevant educational qualifications, nor to pay an annual levy to a remote London Society. Above all, they did not welcome the prospect of having their work subjected to inspection and surveillance. They wanted to be left alone to carry on making money. That is why they flocked to the Crown & Anchor tavern on April 15, 1841 – not to form a professional association but to get the apothecaries off their backs.
It was Jacob Bell who seized the opportunity created by the furore against the 1841 Medical Reform Bill to establish the Pharmaceutical Society. It entailed transforming an occasional, informal committee of London druggists into a permanent professional association. It involved persuading the metropolitan elite to move from a defensive, laissez-faire position to one which sought actively to control and regulate the craft. It meant the adoption of a forward-looking educational strategy in place of the former protective trading policy.
Aims and objectives
A comparison of the successive statements of the aims and objectives of the Society shows how gradually the references to the protection of the present privileges of the trade gave way to an emphasis on science, education and the elevation of the profession. The historic resolution at the Crown & Anchor merely declared “that for the purpose of protecting the permanent interests, and increasing the respectability of chemists and druggists, an association be now formed under the title of the Pharmaceutical Society of Great Britain”. But, by February, 1843, the Royal Charter proclaimed that the Society had been formed “for the purpose of advancing Chemistry and Pharmacy and promoting a uniform system of education of those who should practise the same and also for the protection of those who carry on the business of chemists and druggists”.
For Jacob Bell there was no incongruity between the protection of the economic interests of the trade and the promotion of science and education. The constitution of the Pharmaceutical Society, he wrote, “provides, in the first instance, for the protection and welfare of its members; but the prominent means by which they are to secure these privileges consist in the promotion of the requisite education and scientific knowledge which will shield them from extraneous control and interference… . the two grand objects of our society, protection and improvement are mutually dependent on each other … the terms, improvement and protection are synonymous.”
The difficulty with this argument is that Bell’s conception of what was worth protecting was different from that of the majority of chemists and druggists. Bell had a progressive view; his followers were more conservative. “The Society was established for the purpose of … raising the character of those who practise pharmacy in Great Britain. It is proposed to attain this end, first, by uniting all the chemists and druggists into one body; secondly, by introducing a system of pharmaceutical education; thirdly, by claiming for the body thus organised and educated, such protection and privileges as the qualification of the members would entitle them to possess.” For Bell the privileges were to be earned by educational attainment; most members simply wanted to hang on to those they already held.
The Pharmaceutical Journal
For the first 18 years of its existence the Pharmaceutical Society was controlled by Jacob Bell. The key to his power was The Pharmaceutical Journal which he owned and edited, and to which he clung until his dying breath. The Journal was the crucial strategic instrument he used to establish his vision of the future of pharmacy in Britain. The circulation during his editorship was larger than that of any other scientific or medical periodical, except the Lancet.
The Journal was consequently in a unique position to give the science and profession of pharmacy its characteristic nature and form. It provided aspiring pharmacists with the intellectual framework to enable them to interpret and make sense of their new roles in society. It generated the structure of meanings by which they were able to construct a new understanding of their work, their practices and their values. From it they derived their sense of identity as members of a profession.
But its message was directed as much to politicians, scientists and leaders of the medical profession as to pharmaceutical chemists. A major objective was to disseminate information calculated to influence the opinions of those involved in public debate and decision-making.
In The Pharmaceutical Journal, Jacob Bell was free to conjure up his image of a future profession of pharmacy, but in the day-to-day activities of the Pharmaceutical Society a less idyllic reality emerged. Until the Pharmacy and Poisons Act of 1933 made membership of the Pharmaceutical Society synonymous with the legal right to practise pharmacy, the membership issue was a festering thorn in the Society’s side. Until 1933 the Pharmaceutical Society was a voluntary association which needed to attract members to survive.
The Society’s role
In the early days, three fundamentally different conceptions of the Society’s nature and purpose were espoused. A small group of scientific chemists wanted the project “confined to the advancement of philosophy and useful discoveries”. The majority of members believed that they had set up a national trade association. The third view, advocated by Jacob Bell, was that the Society was to be the engine by which the trade of chemist and druggist would be elevated to the profession of pharmaceutical chemist.
This third view incorporated a basic dilemma. Unless the Society endeavoured to protect its members and advance their interests, it risked having no members at all. It needed sufficient numbers to make it a financially viable, permanent and representative body. It wanted to speak to the government and to the medical profession on behalf of all chemists and druggists.
But regulations to enforce educational and ethical standards make feeble recruiting material.
Throughout the 19th century the Society was never able to attract more than a third of its potential membership. During the 1860s it had to ward off the rampant rivalry of the United Society of Chemists and Druggists, which offered its supporters freedom without responsibility.
From the outset, Jacob Bell realised that an Act of Parliament would be needed to achieve his objectives. Although he devoted his best efforts to persuading the nation’s chemists and druggists to join together to regulate and control the trade voluntarily, he knew that compulsion would be quicker and more effective.
In introducing his Pharmacy Bill in the House of Commons in 1851, he made clear the need for legal sanction: “According to the present arrangements, the examination of candidates by the Society was a voluntary matter; and, accordingly, if a person presented himself for examination, and he was found to be incompetent and unfit to receive a certificate, he might commence business without one, ignorant though he were, and could snap his fingers at the examiners.
… It was the object of the Pharmaceutical Society, in introducing the Bill, to make the examination obligatory.”
Jacob Bell’s professionalising project required the involvement of the state, the supreme legitimising and enforcing agency. The justification for state intervention, however, was public safety. The public had to be protected from ignorant, incompetent and disreputable practitioners. “It would be absurd to lay great stress on the importance of science and skill in writing the prescription, and at the same time to leave the preparation of it to chance,” Bell argued. “The safety of the public is as much concerned in the suppression of unqualified dispensers of medicine as it is in the suppression of unqualified medical practitioners.”
Many chemists and druggists inside the Pharmaceutical Society, and even more outside, must have found this line of reasoning disturbing. Jacob Bell seemed to have stolen the apothecary’s clothing. Instead of a union for the protection of independent privileges, the Pharmaceutical Society was taking on the function of providing the public with qualified practitioners. This inevitably entailed a system of education, examination, qualification, and registration. How would this affect existing practitioners? Who was going to foot the bill?
The Pharmaceutical Society was governed by a Council of 21, elected by and from the members. Two-thirds of the Council were elected, by ballot, each year at the annual general meeting. The President, Vice-President, and Treasurer were chosen from and by the Council, which also appointed the Secretary. In his comments on those who devised the original constitution, Jacob Bell explained that, “while they have vested in the Council sufficient powers to render their services effective, they have made them entirely responsible to, and to be elected by, the members at large.”
The primary qualification for membership, however, was not educational or scientific attainment, but ownership of property. Full membership was restricted to chemists and druggists who were established in business on their own account. Employed assistants could become associates, but were not entitled to vote, attend meetings or hold any office in the Society. They had a status no higher than that of the registered apprentices.
The power of property made itself felt in the Society’s decision-making process. The perennial problem facing those members of the Council who took the Society’s professionalising project seriously was to persuade proprietor chemists to finance it. Meeting the costs of educational and research facilities, which seemed to have no relevance for running a shop, had little attraction for most members. Nor was there much to be said for creating a future generation of better educated competitors.
Pharmacy Act 1852
The enactment of the Pharmacy Act 1852 had important repercussions for members of the Pharmaceutical Society. They all became, at the stroke of a pen, “pharmaceutical chemists”, and their names were duly listed in the Register of Pharmaceutical Chemists. Not one of them had ever passed an examination in either pharmacy or chemistry, yet, henceforth, only persons named in the Register had the legal right to describe themselves as “pharmaceutical chemists”. In future, however, they would be joined on the Register by those who had passed the Society’s major examination, even though such persons were neither members of the Society nor proprietors of shops. Indeed the newly registered might be employed as mere assistants.
Instead of accepting this development as an inevitable first step on the road towards an educated profession, the Council of the Pharmaceutical Society decided to flood the Register, by admitting to it, without examination, proprietor chemists in business before the Act, provided they joined the Society. Nearly 800 chemists availed themselves of the opportunity.
Another attempt to open the floodgates occurred during the Society’s financial crisis of 1861. The President, T. N. R. Morson, proposed that proprietors, whose age, respectability, and willingness to contribute generously to the Society’s coffers merited special consideration, should be allowed to register without examination. “The Pharmaceutical Society needs money, money cannot be got without members, and members do not come forward for examinations,” explained the infant trade journal Chemist & Druggist.
The members, however, decided against any further dilution of the Register. “No one can henceforth be placed on the Register of Pharmaceutical Chemists without previously passing the required examination,” declared The Pharmaceutical Journal in 1862. None the less, there were still ways in which property could make its influence felt. In June, 1864, a special examination was instituted for chemists who had been engaged in business on their own account for more than five years. More practical than theoretical in nature, this examination enabled proprietors to acquire the title of pharmaceutical chemist without further study and without being examined in the company of assistants and apprentices.
Pharmacy Act 1868
The Pharmacy Act 1868 provided the legal status of “chemist and druggist” to a wide range of practitioners: those in business prior to the Act’s passing, associates of the Pharmaceutical Society, assistants who passed the new “modified” examination, and everyone who passed the Society’s minor examination, which became the new test of qualification. The statutory registers (the new register of chemists and druggists was added to the existing register of pharmaceutical chemists) made no distinction between owners and employees: educational qualification alone was to become the criterion for admission to the registers.
Although the Pharmaceutical Society compiled the registers and conducted the qualifying examinations, the distinction between registration under the Pharmacy Acts and membership of the Society was maintained until 1933. And, until 1898, the basic requirement for membership of the Society remained ownership of property. Chemists who did not own shops, even if registered as pharmaceutical chemists, were treated as second-class citizens. To this general rule, there was one minor exception: the managers of the retail outlets of major wholesale and manufacturing firms could be elected to membership as “confidential superintendents” by the Council. Few were.
The Pharmacy Acts Amendment Act of 1898 gave all registered chemists and druggists, whether employers, self-employed or employed, the right to become full members of the Pharmaceutical Society and to be elected to its Council. The distinction between pharmaceutical chemist and chemist and druggist, retained in the registers, lost its significance in the Society’s constitution.
The Pharmaceutical Society until 1898 was a property-owning democracy. The characteristic form of that property was the independent shop. Pharmacy has often been referred to in the past as “the shopkeeping profession” and such a title hints at the underlying tension between commercial and professional activities. “The shop” has played a crucial role in the development of the pharmaceutical profession, a role quite distinct from that played by “the surgery” or “the practice” in the development of the general practice of medicine.
Before the advent of the National Health Service, general medical practitioners and pharmacists were independent professionals who had set up in business with small amounts of capital. They depended for survival on selling goods and services to whatever customers they could attract to their premises. The pharmacist spent his day in his shop and invested as much as he could in it. The doctor divided his time between seeing patients in his rudimentary surgery and visiting the members of his practice in their homes.
It was customary for both doctors and chemists to progress in their careers from assistant to partner to principal. The sale of practices and shops was used to finance retirement. The purchaser paid as much for the goodwill as for the physical plant.
But there was one difference between a shop and a practice which had profound consequences. Shops were enduring physical structures and there was a well-established tradition in retailing that the name of the shop survived changes in ownership. The business that Jacob Bell owned remained in the name of his father for more than 150 years. All the great metropolitan pharmaceutical firms, Allen & Hanburys, Dinnefords, Savory & Moore, and many others, held on to the names of their founders through successive generations. The implication of this is that the service being offered is a product of the establishment; the guarantee of quality is the traditional reputation of the firm.
The essence of professional practice, however, is to be found in the individual professional’s service to individual patients in a relationship of trust. The professional person, it is said, cannot spread his services, cannot go in for mass production, and cannot, except within narrow limits, distribute his skills through subordinates. Professional service depends on individual qualities and individual judgment, supported by an individual responsibility which cannot be shifted on to the shoulders of an organisation. This has been the traditional ideology of British general medical practice. It has been successfully used to resist lay ownership and control of the sites of professional practice.
The Pharmaceutical Society v The London and Provincial Supply Association was probably the most important legal case in the history of British pharmacy. The House of Lords decision, delivered in 1880, opened the door to the company chemists. It allowed limited liability companies to carry on the business of a chemist and druggist even though none of the shares was owned by a pharmacist and the business was not managed by a pharmacist. By 1883 Boots Cash Chemists had opened 10 branches; by 1906, 329.
The House of Lords judgment in 1880 revolved around the notorious “widow’s clause” in the Pharmacy Act 1868. The Act began by asserting the necessity, for the safety of the public, that every person who dispensed poisons should be qualified and registered, thus creating a form of statutory professional title, which was to be purely personal in its character. Unfortunately, the Council of the Pharmaceutical Society had tacked on to the Act a clause which said that, in the event of the death of a registered person, the qualification which was vested in his person should pass to executors, or to his widow and children, provided a registered assistant were employed. If widows or executors were able to keep open shop for the sale of poisons, what grounds were there for denying the right to company directors? The decision to insert the widow’s clause in the 1868 Act was made by a Council more interested in preserving the rights of property than in advancing the claims of education and qualification. Ironically, the insertion may have started the rot that brought thousands of independent chemists to ruin.
It is conceivable that if the Pharmaceutical Society had won the 1880 case, pharmacy in Britain would have developed along the lines followed in many European countries, ie, the pattern of individual professional ownership of the pharmacy would have been preserved. The identification of ownership and qualification would have been entrenched. The relationship of the pharmacist to his shop would have corresponded to that of the doctor and his practice, in which case, of course, the NHS contract would be a personal contract with the pharmacist for the performance of professional services.
All this is speculation. It could equally well be argued that it was the power and influence of the company chemists, in 1911, that secured National Health Insurance dispensing for the retail pharmacist. Without their economic muscle, the NHI dispensing would have been assigned to dispensaries run by friendly societies and local authorities. In 1911, and again in 1946, the existence of a nation-wide network of dispensing outlets, readily accessible to the general public, and privately owned and financed, persuaded the architects of the state-run health services to incorporate the chemist’s shop in their schemes. The precise form of the NHS contract may not accord with the canons of professionalism, but at least there is a contract!
Nor should the rise of the company chemists be interpreted as the triumph of commerce over professionalism. Once the multiple shop firms became established, they added dispensing and the sale of poisons to the retailing of patent and other medicines, and this created new employment opportunities for pharmacists. The company chemists injected a much needed element of competition in the pharmaceutical labour market and did much to transform the conditions of work for the growing number of qualified persons who had no prospect of ever owning a shop. The opportunity to become the manager or superintendent of a branch of Boots transformed the salary and status of the assistant chemist.
The Pharmacy Acts Amendment Act of 1898 was a turning point in the development of the Pharmaceutical Society. The Act signalled the demise of an association of and for proprietor chemists and inaugurated the movement towards a modern professional organisation of educationally qualified practitioners. After this point the particular needs of proprietor chemists were increasingly met by newly created bodies, independent of the Pharmaceutical Society, such as the Chemists Defence Association, the Proprietary Articles Trade Association, the Scottish Pharmaceutical Federation, and the Retail Pharmacists Union.
The professional project that Jacob Bell launched in 1841 had as one of its central objectives the securing, enhancement and maintenance of the social and economic status of practitioners of pharmacy. The pharmaceutical profession did not rise like the sun at some predetermined hour: it was present at its own making. It is still in the process of being constructed.
The transformation of the chemist and druggist into the pharmaceutical chemist is not the end of the process, but it is a significant part of the story so far. The Pharmaceutical Society is the principal actor in that narrative. The Society was instrumental in transferring the fundamental basis for social recognition and reward for pharmacists from the ownership of property to the possession of educational qualifications.
During the past 150 years, the increasing concentration and centralisation of capital in retailing and the development of multiple-store corporations has undermined the profitability and security of small independent traders. Pharmacies have been protected from the full effects of these developments by their involvement in the state-funded health system. This involvement is dependent upon the possession of both private property and educational credentials. Both are valuable assets, but the value of small-scale retail capital is declining, while the value of vocational qualifications is still rising. Educational credentials, like economic resources, provide opportunities for income. Cultural capital is mobile and flexible because it is stored in the mind of the individual; when deployed in the labour market, it produces material rewards.
From its foundation, the Pharmaceutical Society was committed to the task of raising the standard of pharmaceutical education. The Society’s School of Pharmacy was set up in 1842 to provide a complete course in the basic sciences and their application to pharmacy. It was regarded as a beacon pointing the way forward to a more scientific and prestigious future. The school set standards of education and research which were far in advance of the needs and aspirations of the vast majority of chemists and druggists. By producing the men who became the leaders in scientific, academic and industrial pharmacy, the school inspired in each generation a vision of pharmacy that transcended the everyday reality of the chemist’s shop.
Eminent scientists, physicians, surgeons, civil servants and politicians acknowledged the school’s merits. It was one of only a handful of institutions in Britain during the 19th century to provide instruction in practical chemistry and chemical analysis. Its mere existence lent credibility to the Society’s claims to be a professional association.
Without the moral and financial support of the Pharmaceutical Society there would have been no professional school of pharmacy in Great Britain. Yet, despite such virtues, the school had few friends among the membership. In the early days only a few proprietors were enlightened enough to give their apprentices time off to attend the courses. Later, a new line of argument was used to disparage the school. Its products, it was said, were over-educated. They adopted superior airs and spurned the mundane routines of the shop. On more than one occasion, prominent members of Council suggested that the school be closed and the resources devoted to the encouragement of provincial education.
The Pharmacy Act 1868 made passing the minor examination the legal qualification for admission to the register of chemists and druggists. Although at the outset the standard was not high (before 1868 the minor had been the qualification for assistants) candidates needed some formal education to pass. The result was both an influx of students to Bloomsbury Square and the successful launch of private schools in London and the chief provincial cities. But the fact that apprenticeship continued to be the principal form of pharmaceutical training was a major impediment to pharmacy’s claim to be a profession.
Apprenticeship was essentially a conservative institution, passing on to the new generation the obsolescent practices of the old. As a means of instruction, it was haphazard and unsystematic, so much depending upon the character and attainments of the master to whom the apprentice was attached. Only a minority of shops carried out enough dispensing to provide adequate experience for the tiro. Long opening hours meant that only the most dedicated apprentices found time for private study. Apprenticeship emphasised the purely practical and empirical at the expense of the theoretical and scientific. It is, however, not difficult to see why a Council dominated by proprietor chemists should be reluctant to abandon it: it was a source of cheap and well-motivated labour. Thus the future of the profession was sacrificed to the short-term needs of the chemist’s shop.
During the 20th century, the Pharmaceutical Society steadily raised the educational requirements for registration, at each stage increasing the scientific and academic content. Immediately after the 1914-18 war, the qualifying examination was divided into two parts: Part 1 dealt with the basic sciences (chemistry, physics, and botany) and Part 2 with materia medica, pharmacy, and poisons law. Attendance at approved courses of instruction was made compulsory for the first time. An apprenticeship, now restricted to 4,000 hours, was still required.
In 1924 the Council approved the new degree of bachelor of pharmacy established in the medical faculty of the University of London. Degrees in pharmacy already existed in Glasgow and Manchester but the London degree was the first to be recognised for registration purposes. The Manchester bachelor of science degree in pharmacy was recognised in 1933 and others followed.
After the 1939-45 war, the chemist and druggist examination was phased out and entry to the Register came by means of the two-year pharmaceutical chemist diploma course. This enabled the Society to create a single Register of Pharmaceutical Chemists. In 1957, the course for the pharmaceutical chemist diploma was extended to three years, and, from 1967, all those aspiring to practise pharmacy in Britain were required to read for a degree approved by the Pharmaceutical Society.
When a Supplemental Charter was granted to the Society in 1953, the object of protecting “those who carry on the business of chemist and druggist” was replaced by the commitment “to maintain the honour and safeguard and promote the interests of members in the exercise of the profession of pharmacy”. This change in wording neatly encapsulates the progress achieved by the Society since its foundation.
Few would doubt that the transformation of the business of chemist and druggist into the profession of pharmacy has been carried out by the Pharmaceutical Society in the economic and social interests of its members. The issue which remains to be discussed is whether this process was also in the public interest.
Many commentators today would dismiss this question as unworthy of consideration. Professionalism in general is under attack by sociologists, economists and, more importantly, by politicians. Radical sociologists assert that professions are preoccupied with occupational closure, the consolidation of their class position and the pursuit of collective upward mobility. Neoclassical economists view professions as monopolistic occupations, bristling with restrictive practices and hostile to consumer interests. They believe the professions should be stripped of their protective privileges and be subjected, like other occupations, to free competition in the market-place. The politicians select whichever piece of these ideologies suits their immediate purpose. At their most charitable, they consider professions to be part of the forces of conservatism that seek to resist the will of the people.
Paradoxically, the more governments denigrate the professions, the more they turn to them for help. Faced with the political consequences of bovine spongiform encephalopathy or a rail disaster, the politicians defer to “scientific experts” to guide or justify their policies. Governments can no more survive without professions than professions can survive without governments.
There has been a great transformation in the profession of pharmacy since 1841; there has also been a great transformation in British government. In their journey to the year 2000, both state and profession have been diablement chang? en route.
“No industrial economy,” wrote Dr H. C. G. Matthew in his authoritative biography of W. E. Gladstone, “can have existed in which the state played a smaller role than that of the United Kingdom in the 1860s.” The aim of governments in Victorian Britain was not to determine the structure and working of society but to provide a framework of rules and guidelines to enable society to run itself. There was widespread pride that the British constitution had so little in common with the more coercive, interfering and directive regimes of continental Europe. The British government had no significant corps of salaried officials but relied, instead, in both central and local administration, on the largely unpaid services of the aristocracy and gentry.
The state in Britain was regarded as an institution of secondary importance. It existed mainly to serve the convenience and protect the rights of families in private life. In contrast, civil society, comprising business, industry, religion, leisure, culture, and family life, was seen as the highest sphere of human activity.
When Jacob Bell was trying to get his pharmacy bill through the House of Commons in 1851, he adduced government regulation of pharmacy in Europe in its support. On the Continent, he claimed, pharmacists were all highly educated men. Governments provided schools of pharmacy where students “have the opportunity of obtaining all the information which the present age of discovery can afford; and they are compelled to undergo a strict examination before they can establish themselves in business.”
“Not only are unqualified persons prohibited from practising in any department of the medical profession,” he pointed out, “but the number of regular practitioners is limited by law; only so many being licensed as are considered to be required by the populations in their respective districts… . The course of education is definite and complete; and the examinations, through which each candidate must pass, are very severe… . the profession enjoys a monopoly which is rigidly maintained.”
The leaders of the Pharmaceutical Society were not seeking to replicate the centralised, bureaucratic control of pharmacy found in Europe. However much they admired the scientific education, professional status, and commercial protection of the French pharmacien and the German Apotheker, they realised that such state regulation was neither achievable nor desirable in Britain.
“If pharmacy is to advance and prosper in this country,” Jacob Bell argued, “it must be under the fostering care and management of the pharmaceutical body. If any science, art, or profession is to be well governed, it must be entrusted to its own members – those who by education, experience, and daily pursuits, are identified with its progress, and acquainted with its requirements.”
Control of poisons
The Pharmaceutical Society wanted the government to provide it with the political space to become the regulatory authority for pharmacy in Britain. This objective was not achieved until 1933. Before then, British governments were interested in fostering neither the science nor the practice of pharmacy. Their concern was restricted to the regulation of the sale of poisons.
The Pharmaceutical Society responded to this concern in two ways. First, it convinced the government that the control of poisons could best be achieved by professional rather than bureaucratic methods. Secondly, it used its involvement in the regulatory process to advance the education, examination, qualification and registration of pharmacists.
The government delegated poisons control to the Pharmaceutical Society. For more than 60 years, the Society, at considerable cost to itself, administered the poisons legislation more efficiently and more effectively than any government department could have done. No other body possessed the technical, scientific and administrative knowledge and experience necessary for the task.
The Society’s achievement is made all the more impressive when placed beside the performance of its successors. There can be little doubt that contemporary methods of regulating the supply of dangerous drugs, both nationally and internationally, represent one of the most striking failures of modern public administration. When methods of regulation cause greater social problems than the object of regulation, something very serious has gone wrong.
The Pharmaceutical Society was given, in 1868, the responsibility of determining which persons should be licensed to keep “open shop for the retailing, dispensing or compounding of poisons”. The certificate issued by the Society entitled the holder to conduct a chemist’s retail business, without supervision or assistance, but it had no legal reference to dispensing in hospitals or other public institutions. None the less, by focusing the examination on pharmacy rather than poisons, and by insisting on a steady increase in standards, the Pharmaceutical Society was able to establish the licence as the recognised qualification to compound and dispense all types of medicine.
Serving the nation
The Pharmaceutical Society, without any financial assistance from the state, constructed both the science and profession of pharmacy in Britain. In so doing, it furthered the economic and social interests of all pharmacists, members and non-members. But it also served the public interest.
It is improbable that any occupational association will perform public services without any consideration of the costs and rewards, but it is equally implausible to suggest that the only motivation which drives it is an unbridled quest for collective gain. Much of the time and effort of the Pharmaceutical Society has been spent, not on the search for monopoly and privilege, but on the task of providing an efficient and effective pharmaceutical service to the nation. Occupational closure and the defence of work domains are not ends in themselves but the means of securing the social conditions necessary for the ethical practice of pharmacy.
Professions are not actuated solely by self-interest. They do in fact provide the vital services they claim to be providing, services of crucial importance to their patients. For over 150 years the Royal Pharmaceutical Society, by serving the long-term needs of its members, has served the ever-changing needs of the British people.
Sydney Holloway is senior lecturer in the faculty of social sciences, University of Leicester. He is the author of ‘Royal Pharmaceutical Society of Great Britain 1941-1991’, which was published to celebrate the Society’s 150th anniversary
|Russell, Colin A. Lancastrian chemist: The early years of Sir Edward Frankland. Milton Keynes: Open University Press, 1986.|
|Russell, Colin A. Edward Frankland: Chemistry, controversy and conspiracy in Victorian England. Cambridge: Cambridge University Press, 1996.|