Opposition

The Edinburgh dispensary faced considerable opposition from the city’s infirmary to its foundation. The infirmary regarded the establishment of another charitable medical institution and, moreover, one which aimed to teach as well as practice medicine as a direct threat to its position. Medical students in Edinburgh were a profitable source of income and the infirmary was heavily reliant on these funds. The resulting disagreement played out in the public press, with statements issued on behalf of the infirmary and rebuttals by Dr Andrew Duncan printed in the Weekly Magazine, or Edinburgh Amusement, Edinburgh Evening Courant, The Edinburgh Advertiser, and the Caledonian Mercury during the spring of 1777.

Management

Like most dispensaries, the Edinburgh dispensary held annual meetings which were open to all financial donors as well as dispensary medical staff. The purpose of these meetings was to review the regulations, patient admissions, and finances of the dispensary.

In its first year the Edinburgh dispensary had eight managers. Unusually, these managers were not appointed to particular roles such as secretary, treasurer or president. This unstructured approach to management allowed Duncan and his colleague, Dr Charles Webster, significant control over the formulation of the dispensary’s regulations and teaching programme. These two men comprised the entirety of the Edinburgh dispensary’s staff at its foundation, assisted in their work by the dispensary’s medical students.

Funding

In its early years, all the financial backers of the Edinburgh dispensary were individuals, mostly personal friends of Andrew Duncan. Over time though, organisations began to also donate, including the College of Surgeons, the Corporation of Shoemakers and the Incorporation of Taylors.

The dispensary also received funds from church collections and theatre benefit performances.

Accommodation

The Edinburgh dispensary experienced a number of relocations in its early years. In 1777 Duncan built a property at Surgeon’s Square, an area in Edinburgh’s Old Town renowned for its medical schools which provided private tuition outside the walls of the city’s university. These schools were affiliated with the College of Surgeons of Edinburgh and operated broadly under their supervision. While this supervision did not extend to closely monitoring the content of the curriculum of individual tutors, it does appear to have covered the maintenance of standards of decorum. Although lecturing to students was an accepted practice, it was deemed by the college that attendance by dispensary patients would prove a ‘nuisance to the neighbourhood’ and Duncan was therefore forbidden from using his premises for this purpose. As a result, the Edinburgh dispensary had a number of temporary homes in its early years, including the Great Hall of the Royal College of Physicians of Edinburgh and rented rooms in College Wynd before a purpose-built dispensary was erected in 1780 on Richmond Street.

Opening hours

The early regulations of the dispensary give the opening times as only two hours on Tuesdays and Fridays, but by the mid-1780s the dispensary was open six days a week and only closed on Sundays.

Home visits

Providing home visits to patients was a common feature of dispensaries in the 1700s. Unusually, in the early days of the Edinburgh dispensary it was decided that home visits would not be carried out. This was because the dispensary also operated as a clinical teaching institute and so the students needed access to patients.

Home visits were carried out on an ad hoc basis, particularly when a patient was simply too sick to attend in person, but this was not done in a systematic or regular way.

The end

When the National Health Service Act came into force in 1948 the Edinburgh dispensary was subsumed into the University of Edinburgh and became the centre of a new General Practice Teaching Unit.