14 The Changing Work Patterns of Pathology

The history of British pathology can be traced back to the 18th century when the best clinicians, such as the Hunter brothers, William and John, began to perform autopsies on their patients and to collect their autopsy and biopsy specimens into museums. The fi rst half of the 19th century saw the introduction of microscopy and the setting up of laboratories, staffed initially by part-time clinicians. Later in the century some full-time appointments were made and Chairs of Pathology were established in major cities; most were in morbid anatomy, with some in bacteriology. However, in comparison with Continental Europe, the recognition of clinical pathology (which included diagnostic histopathology) as an independent discipline in the UK was delayed until the second decade of the 20th century. Furthermore, although Pathology Departments were present in most Medical Schools, there were very few in non-teaching hospitals (Cunningham, 1992). Pathology tests were, therefore, available to only a very small number of privileged patients. Today, 100 years on, all clinicians and their patients have access to high-quality diagnostic histopatho logy services, including the latest molecular and genetic techniques. It is pertinent to this celebration of the centenary of The Pathological Society that this review gives an account of the profound changes that have taken place in the provision of these services and their impact on workload in diagnostic histopathology. For balance we have divided the century into two 50-year periods, 1906–1956 and 1957–2006.