Pharmacies are a pivotal part of the local community in no small part because the NHS electronic prescription service allows people to access the medicines they need thanks to a dispensing chemist, but this is far from all a pharmacy does.
Alongside offering advice and being able to provide a range of medications over the counter as required, pharmacists can even prescribe certain medications through the Pharmacy First service.
Whilst this is a new and groundbreaking service that allows chemists to both prescribe and dispense treatments for a wider range of conditions than ever before, it is not entirely a new concept.
In fact, the Pharmacy First scheme’s origins could arguably be traced back as far as 1703, when a landmark case established the right for pharmacists to help treat patients.
The Rose Case
Rose v Royal College of Physicians [1703], often known simply as The Rose Case, was a landmark case that established the rights of pharmacists to treat patients long before pharmacist or chemist was even the widely used term.
In the 17th and 18th centuries, there were three types of medical professionals; there were physicians who were qualified general practitioners and are the doctors we know today.
There were also surgeons who performed the same role they do today albeit with far more rudimentary equipment than we have now, and finally, there were the apothecaries.
An apothecary dispenses medicine to patients, traditionally under the direction of a physician or surgeon. As all three roles were governed by different professional societies on a for-profit basis, there was an unwritten but strongly held view that physicians prescribe and apothecaries dispense.
This was most forthrightly argued by Dr Jonathan Goddard in 1670, but it was around this time that the practice of medicine was beginning to change, despite a law enacted by King Henry VIII over a century before that banned apothecaries from “practising” medicine.
The Great Plague of London in 1665 wiped out potentially a quarter of the population of London at the time, and the Great Fire of London a year later caused most of the rest of the population to flee, including many physicians.
This left apothecaries to treat the sick that had been left behind, but once the physicians came back, the patients largely stayed loyal to the apothecaries or could no longer afford to be treated by a physician. This was before the NHS and rigid controls on the price of prescriptions.
This led physicians to open dispensaries and become dispensing doctors, largely as an act of revenge, but the true flashpoint for the two groups came in 1701.
William Rose was an apothecary and was influential in London and as a member of the Society of Apothecaries. He treated a poor butcher named John Seale, who after becoming enraged with the high cost of treatments accused Mr Rose of practising “physick” illegally.
Initially, the Court of Queen’s Bench found Mr Rose guilty and fined him £5, a month of practice at the time and worth over £1000 adjusted for inflation.
He appealed with the help of the Society of Apothecaries, who argued that this verdict would make it impossible for pharmacists to, for example, advise on treatments for common conditions or undertake basic medical treatments for free.
Ultimately the House of Lords reversed the decision, which established a legal foundation for pharmacies and their ability to do more than dispense prescriptions, which is echoed in the role of the community pharmacist today.