Pharmacists and the National Health Service, 1942–48
By Susan Osbaldstone
My MSc dissertation focuses on the decision of UK pharmacists to enter the National Health Service (NHS) in 1948. To do this, my research will focus on the claims and concerns of pharmacists, from the initial consultations on a health service in 1942 until 5 July 1948, when the NHS Acts came into effect. Although there is an abundance of literature available on the origins of the NHS, most of it focuses on either the high politics and government policies involved or the well-publicised claims of the British Medical Association (BMA). Most literature, if it mentions pharmacists at all, characterises their entry into the NHS as trouble-free, usually only stating that pharmacists did enter the NHS, the rate received for prescriptions and the differences in the Scottish and English rates.
Pharmacists were generally in favour of the principles behind the NHS and, although their decision to enter the NHS was not as tumultuous as the doctors’, it was not entirely unproblematic. I aim to explore the problems and concerns that faced pharmacists during the period 1942–48 and analyse how these problems were resolved, allowing an overwhelming majority of pharmacists to agree to dispense in the NHS. My research is based on a variety of primary sources including contemporary pharmacy journals, newspapers and a variety of NHS administrative, service and staff files that provide information on negotiations with the Ministry of Health, details of the pharmacists’ working party and specific files relating to Scottish negotiations.
The research I have done thus far has highlighted pharmacists’ concerns about remuneration under the new regime. They were worried that joining the NHS would result in a loss of private dispensing and that they would be forced to subsidise dispensing in the NHS as they had under National Health Insurance (NHI). Their main aim, with regard to finances, appears to have been securing reasonable compensation, which would reflect the high standard of work they were expected to perform; Scottish pharmacists, in particular, were keen to ensure that the higher rate they received for NHI dispensing continued in the new service. However, this led to internal divisions between proprietor chemists and employee chemists on the one hand, and retail chemists and hospital pharmacists on the other: each felt that the other would secure a more advantageous position.
The implementation of the NHS also prompted attempts to improve the professional status of pharmacists. Some thought that they should take the opportunity to enhance standards of education and training as it would be beneficial in future negotiations, particularly in relation to pay. This study will also analyse the popular perception of pharmacists during this period, as many thought that they did not publicise their case as well as the BMA, and that this had an adverse effect on their claims in the eyes of the public. While this research will discuss pharmacists’ entry into the NHS nationwide, it will also highlight the differences and continuities between Scotland and England and attempt to provide a more coherent understanding of what drove Scottish pharmacists to work in the NHS. I hope to enhance specific understanding of pharmacists’ entry into the NHS in 1948 and also contribute to a more comprehensive understanding of the creation of the NHS, both in Scotland and in Britain as a whole.
Susan Osbaldstone is an MSc student, studying Health History at the University of Strathclyde.