Before legal regulation, there was ‘self-regulation’ as typified by the Hippocratic oath (460–370 BC): ‘I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free’. The oath also states: ‘I will impart precept, oral instruction, and all other instruction to my own sons, the sons of my teacher, and to indentured pupils who have taken the Healer’s oath, but to nobody else’—creating the medical ‘closed shop’, restricted to a selected group.1 It was to be over 2000 years before a law introduced modern medical regulation to Britain.

The ‘closed shop’ became formalised with the rise of the guilds,2 associations of specialist workers who oversaw the practice of their trade and determined who could join. Barber-surgeons’ guilds emerged in Paris and London in the 1300s, as both trades used sharp instruments. The incorporation of the Barber-Surgeons of Edinburgh followed in 1505. The apothecaries were originally allied with Grocers’ guilds because they both used and sold spices.

From the 13th century, female health workers faced intense opposition from the all-male guilds, which saw themselves as the exclusive practitioners of medicine. Women were barred from medical training. Women herbalists practising in secret without licences were often called witches and drowned.3

In the 1500s, many ‘physicians’ were working with no formal training or knowledge. The leading physicians of the early 16th century wanted the power to grant licences to …