Almost every day we can read about how expensive health care is and the need for cost controls. Even in the middle of the 18th century, the government of The Hague struggled with this problem. Due to poor economic conditions at that time, increasing numbers of residents looked to the municipality to pay for their medications. Seeking to meet these obligations more cheaply, the Vroedschap (City Council) unanimously decided on 21 March 1749 to set up a city pharmacy (later known as the municipal pharmacy).
Accommodation and staffing
The pharmacy was set up in a building on the Grote Markt, where it would remain until 1844. The initial staff consisted of a master pharmacist and an apprentice. The latter was in fact a trainee pharmacist who was employed as an assistant. He also had to administer enemas to men; for women, special enema “setters” were appointed.
Two years after the start, a third employee, known in Dutch as a “stamper” was brought on to do the heavy work. In 1781 the pharmacist received permission to employ a live-in maid to clean the building. This servant had to be over 40 years of age and unmarried, or a widow without children.
Medications that the pharmacy was allowed to dispense were set down on a list, which was amended regularly. Typically, the pharmacy provided medicines to the poor relief of the churches, orphanages and poorhouses, which administered them to those in need. The number of dispensations rose and fell, often in response to prevailing diseases and epidemics. (In the 18th century, for example, many people suffered from dysentery).
At the beginning of the 19th century, our country was occupied by France. In that period, the population became very impoverished and therefore more quickly ill. The number of prescriptions grew from over 35,000 in 1806 to over 54,000 in 1811.
In 1832, a cholera epidemic caused a sharp increase in the work of the pharmacy.
A new building for the municipal pharmacy
During the 1880s, the population of The Hague increased enormously. People came to the city from everywhere, but there were not enough jobs for everyone. Once again, poverty grew, health conditions deteriorated, and the municipal pharmacy’s work load increased.
However, in 1886 the pharmacy moved to a new, purpose-built building at Prinsestraat on the corner of the Molenstraat. The costs of the move amounted to about ƒ 2,900,=.
Working with the Municipal Hospital
The largest hospital in The Hague was the Municipal Hospital, which since 1865 had been located on the Zuidwal. The work of the municipal pharmacy for this institution was at first rather limited, because most of the poor served by the pharmacy were ill at home or in poorhouses and other institutions, rather than in hospital.
From 1880 onwards, however, the municipal pharmacy suppliedthe hospital with medication for all its patients, including private (paying) patients. From then on, the pharmacy supplied more and more medicines to hospitals and fewer directly to poor patients.
In 1939, the Municipal Pharmacy was relocated to the Zuidwal, in a wing of the Municipal Hospital.
An impression from 1949.
Scarcity caused by war
On 28 June 1914, Franz Ferdinand, the heir to the Austrian throne was assassinated. Thinking ahead, Mayor Karnebeek of The Hague promptly took the initiative, providing funds to the municipal pharmacy to lay in extra supplies of medicines and bandages. This proved to be very wise, because in August the war broke out and it became very difficult for the neutral Netherlands to obtain such supplies.
Mayor Monchy had the same foresight when, during the mobilisation in 1939, he ordered the director of the municipal pharmacy to stock as many medicines and bandages as possible in preparation for whatever was to come..
In 1942, an ancient practice was revived: A medicinal herb garden was set up in the Zuiderpark, a valuable source of raw material for medicines.
Not just medicines
The municipal pharmacy did more than supply medicines. For example, the organisation was jointly responsible for maintaining the quality of water in the public swimming pools. t also examined the seawater close to the coast to see whether it was polluted by sewage.
The dispensary also participated in investigations of suspicious deaths, such as poisoning and suffocation.
Central hospital pharmacy
After the Second World War, more and more social provisions were introduced in the Netherlands, such as the AOW and the Health Insurance Act. This made the ‘pharmaceutical care of the city poor’ (the task with which it all began) unnecessary. The Municipal Pharmacy became the central hospital pharmacy for The Hague and neighbouring municipalities. It also supplied other public health authorities, such as the GG and GD (Municipal Health Service) with vaccines.
A pharmacy that moves with the times must have the most modern facilities. The municipal pharmacy got these in 1971 when it found new quarters in the new municipal hospital complex in Leyenburg The staff enjoyed an ‘efficient pharmacy building with a particularly pleasant atmosphere, where it is a pleasure to work’. The well-equipped production department of the pharmacy soon became the envy of many other institutions in the country.
In 1992, the Municipality of The Hague decided that pharmaceutical care was no longer a task for the municipality. This decision was preceded by much research and discussion, but it fitted in with the prevailing view that management of care institutions should not be the responsibility of municipalities. So the pharmacy was privatised and became Apotheek Haagse Ziekenhuizen.
This pharmacy is still an important part of The Hague healthcare. Every day, its employees ensure that medicines are produced, analysed and delivered in a timely manner. More information: www.ahz.nl
I can tell you more about the history of health care in The Hague during a city tour.