The future of homoeopathic pharmacy in the United Kingdom T. M. COOK, MSe, PhD, CEng, MIProdE, CChem, FRSC

In 1977 it became clear that fundamental changes were necessary in the organization and structure of homoeopathic pharmacy in Britain. Hitherto, physicians and the general public relied on the services of a small number of traditional homeeopathic pharmacies situated in one or two large cities. Several factors, however, gave rise to the urgent need for a new approach, namely:

1 Traditionally, the role of the homeeopathic pharmacy and the manufacturer had always been recognized as one and the same. The implementation of the Medicines Act 1968 in relation to homeeopathic medicines, however, separated these functions in both legal and practical terms. Under the provisions of the Act, homeeopathic medicines could only be manufactured on separate, licensed premises, which conformed to exacting and expensive standards in relation to qualified and experienced staff, buildings, equipment, manufacturing procedures and records. In addition, stringent quality control procedures were also applied, which required well-equipped laboratories. Subsequently, A. Nelson & Co. Ltd. and Weleda (UK) Ltd. were granted manufacturing licences.

Manufacturing licences, together with product licences for each individual medicine, granted by the Department of Health, permitted Nelson and Weleda to advertise and supply their medicines on a wholesale basis to pharmacies throughout the UK. Whilst the individual pharmacies retained their traditional right to manufacture nostrums on their premises, for all practical purposes this was considerably restricted in terms of the facilities demanded by modern standards. Furthermore, these medicines could not be advertised directly or indirectly and their sale was restricted to the pharmacy's own premises. Occasional sales to other pharmacies were permitted, on request, provided such dealing constituted no more than an inconsiderable part of the pharmacy business. Consequently, only the two licensed manufacturers now produce all the mother tinctures.

2 The rapid growth in demand for homoeopathic treatment in recent years, to a level which probably exceeds that enjoyed at any time over the last fifty years, was placing an intolerable burden on the few homaeopathic pharmacies that existed. These pharmacies, based in London and a few major cities, were responding to prescription demands from homoeopathic physicians throughout the country and supplementing the supply of the medicines to the general public through direct mail orders. Many homeeopathic physicians expressed fears with regard to the future availability of homeeopathic medicines in Britain, both in

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legal and practical terms. Many physicians were seeking a professional service from a local pharmacy to enable their patients to obtain their medicines more quickly. Similarly, more and more of the general public, encouraged by the growing number of regional and local homoeopathic groups, were demanding local facilities, both for their medicines on prescription and for the treatment of their everyday ailments.

3 There was a chronic shortage of homceopathic pharmacists in the UK. Moreover, the average age of the handful of pharmacists in practice was in the late fifties. With no facilities for the formal training of pharmacists, either in the universities or within homoeopathy itself, apart from the attendance of a few pharmacists on Faculty courses for general practitioners, no provision had been made for the future availability of hom~eopathic pharmacists or for the maintenance of professional standards to fulfil their vital role.

The licensed manufacturers have responded by making their medicines available to pharmacies throughout the country. These include a small range of "speciality" medicines for specific, common ailments and conditions, which may be legally sold over the counter. Nelson speciality medicines are not new; indeed, they have been selling them to the public for more than twenty years. Many thousands of people have been introduced to the wider arena of homoeopathy by the unsophisticated, successful use of these medicines, obtained locally.

Since 1977, the number of pharmacies engaged in homaeopathy has increased dramatically from less than 40 to more than 800. These pharmacies are located in every major city and town and many of them now provide a prescription service for local homoeopathic physicians. Naturally, these new pharmacies are not wholly homoeopathic; allopathy is also practised on the premises. The concept of the "mixed" pharmacy is, of course, well recognized in most EEC countries, where they have existed since the late nineteenth century. In France and Germany more than half of all pharmacies practise hom~eopathy to some extent. Many of them have two doors--one marked "Homaeopathy" and the other "Al lopathy"-- a relic of the times when a total division existed in the ranks of the medical establishment in those countries, and the firm conviction that each medicine contaminated the other unless divided by a wall.

The new facilities set up by the licensed manufacturers in larger, modern premises (Weleda in Ilkeston and Nelson's in Wimbledon) at considerable cost, have underpinned the future availability of homoeopathic medicines of high quality and reliability. Fortunately, their joint capacity is now such that there is no likelihood whatsoever of the licensed manufacturers being unable to respond to substantial increases in the demand for homoeopathic medicines until at least the end of this century.

The postgraduate training of pharmacists in homoeopathy to meet increased public demand became a priority. The problem was seen to be complementary to the need to train more doctors by the Faculty of Homoeopathy. Accordingly, in 1978, the British Homceopathic Manufacturers' Association commenced discus- sions with the Pharmaceutical Society and the Department of Health and Social Security, who expressed their concern about the shortage of pharmacists trained

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in homoeopathy. The first one-day introductory postgraduate course in homoeopathy for pharmacists was held in London in 1980. A report in The Pharmaceutical Journal led to a considerable demand for further courses, and subsequently courses were held in Liverpool, Nottingham and Birmingham. Courses are held on Sundays, the only day when pharmacies are normally closed. The eighth of these courses was held in London in January 1982, bringing the total number trained at this level to date to over 400 pharmacists. The success of these courses is largely due to the unselfish and enthusiastic participation of many people, including Dr L. G. C. Martin, Dr C. O. Kennedy, Dr M. D. Jenkins, Dr D. H. Gemmell, Dr A. Ghosh, Dr V. Mainey and homoeopathic pharmacists Mr J. C. Pert, Miss H. Levi and Mr S. B. Kussman. These courses are now mounted by the Homoeopathic Development Foundation Ltd. in conjunction with the British Association of Hom0eopathic Pharmacists.

A further development has been the mounting of courses and seminars in hom~eopathy for pharmacists by Regional Health Authorities and Regional Groups of the Pharmaceutical Society. Recently, for example, the Mersey Regional Health Authority joined forces with the Mersey Region of The Pharmaceutical Society and the School of Pharmacy of Liverpool Polytechnic to mount a one-day seminar at Clatterbridge Hospital, Wirral. The seminar, which was arranged with the help and involvement of the British Hom0eopathic Manu- facturers' Association, attracted 70 pharmacists and proved a great success. A similar seminar is planned by the National Pharmaceutical Association in September.

In 1980, the British Association of Homoeopathic Pharmacists was formed. Its formation was largely due to the initiative of Mr J. C. Pert, who has 45 years experience of homoeopathic pharmacy, and he became its first Chairman. The Association is the recognized professional body in the United Kingdom and membership is open to qualified pharmacists who are members of the Pharmaceutical Society of Great Britain and who are engaged in homoeopathic practice. The purposes of the British Association of Homoeopathic Pharmacists are to advance the knowledge and practice of homoeopathic pharmacy, to maintain standards and to encourage research and development in this field. The Association encourages liaison with The Faculty of Homeeopathy and gives active support to the Homeeopathic Development Foundation in mounting their training courses. With nearly 100 members already, the Association is rapidly becoming the focal point for the organization, the development and the standards of homoeopathic pharmacy in support of homoeopathic physicians and the general public throughout the country.

Although more important progress needs to be made, the achievements over the last four years are such that the future of homoeopathic pharmacy is now secure.

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