I, AND I assume the rest of the
profession, await the results of the
Royal College’s consultation on the
provision of a 24-hour service with
great interest.
I have long had many misgivings
about this particular requirement in the
profession’s code of conduct, having
seen it as primarily a
means of preventing
competition within the
profession rather than as a
genuine safeguard of
animal welfare.
After all, my experiences of the
situation in most other countries was
that the UK was somewhat unique in
this requirement and the rest of the
world seemed at ease with itself both
in terms of client/owner acceptance
and no apparent reduction in animal
welfare.
The RCVS appears historically to
have taken the view that it is the only
one “marching in step” on this matter.
Without the requirement to
provide 24-hour cover the profession
would by now look very different
indeed. There would almost certainly
be a much larger number of smaller,
probably one man/woman practices
offering little more than simple first
opinion consulting, perhaps more
equivalent to the human GP practices
of old.
Bread and butter
Such premises could be opened very
cheaply, needing the minimum of
equipment, and would deal with much
of the routine “bread and butter”
work that makes up the majority of
veterinary cases.
I’m thinking here of things like
vaccinations; simple vomiting and
diarrhoea; the occasionally itchy dog;
minor injuries such as cuts, abrasions
and “sprains”; the clipping of claws:
you get the picture and can add your
own ideas to the list.
Without the requirement to
provide 24-hour cover, such a practice
could choose its own working hours to
fit in with those of the practitioner or
indeed with the requirements of the
clientele.
It might, for instance, only open
between 9.30am and 2.30pm when the
veterinary surgeon’s kids were working
hard at school. It might have a couple
of evening consulting opportunities
per week between, say, 7pm and 9pm.
Or perhaps a Saturday or Sunday
morning walk-in clinic for those clients
who could not attend during the week.
The success or otherwise of the business would be dependent solely on
providing a service desired by the
client at a cost that was of mutual
benefit to both parties. And when I
look back over my career I believe that
this was a pathway I might have taken
some years ago if it had been
permitted.
I think it could have provided a
good work/life balance that would
have enabled me to provide my family
with a reasonable standard of living at
the same time as having sufficient time
to spend with them in order to nurture
and help them to grow.
I also believe it would have
provided a very rewarding veterinary
career that would have enabled me to
do much good for animals and clients
alike, at a cost that would have been
far more reasonable and affordable for
the majority of the pet-owning public.
Clearly, in such a scenario it would
be necessary to refer all those cases
requiring an x-ray or ultrasound,
anaesthetic or hospital-style “work-up”
to a larger, more comprehensive
provider down the road.
But if there was no reason (i.e. no
requirement for me to provide 24-hour
cover) for that provider to object to
the sort of service I was offering,
there would be no reason for them to
object to (indeed there would be every
reason for them to welcome) the
constant stream of cases I would send
their way.
Relying on each other
The whole relationship between such
practices would have developed in a
much more co-operative and
supportive manner since both would
ultimately rely on each other to
provide both a means of making a
living and ensuring client satisfaction.
But this business model has, in the
UK at least, been blocked very
effectively by the requirement for each
and every practice to provide a 24-
hour service.
Competition has been stifled and
established practices (whose senior
partners it is who usually end up on
RCVS council and therefore decide on
the policy in this respect) have been
protected from the little guy who
might have dared to do something
different and encroach on the
monopoly that aforementioned veterinary practices have
enjoyed.
Who has benefited from
this? Certainly not the public,
who have seen the cost of
routine veterinary care soar in
recent years. Driven, of
course, by the need to justify
the expense of all those fancy
pieces of diagnostic equipment
possessed by nearly all practices these
days and which, for most of the time,
sit idle.
Not the animals either because I
dare suggest that many of them have
been submitted to unnecessary
procedures for the self-same reason as
just described. Sure, the manufacturers
of the equipment have sold far more
machines than they otherwise would
have (you have to keep up with the
practice next door after all). And, of
course, the principals of the
established practices, be they on the
private or corporate ownership model,
have been protected from having their
dominance challenged.
So I believe it was in
the interests of those in
positions of power to
maintain the status quo
and I suspect that there
will be little proposed
by way of change as a
result of the current
consultation.
Linked with the
provision of 24-hour
cover is the issue of
house visits, sharply
brought to the attention
of the veterinary
profession by the
outcome of the Chikosi
disciplinary hearing
which resulted in Mr
Chikosi’s name being removed from
the register.
The populist view amongst practising veterinary surgeons was that
this was a miscarriage of justice and
left any vet who refused in good faith
to carry out a house visit open to the
full force of disciplinary action.
It is true to say that the RCVS has
since back-tracked on its comment on
the case concerning the unsuitability of
the use of a blanket to transport an
injured animal to the surgery.
However, that begs the question
that if a committee sitting and
considering the issue in the cold light
of day can, with hindsight, come to
the wrong conclusion, what right do they have to remove
the livelihood of a
professional who has
had to, under not
inconsiderable
emotional and
professional pressure,
make a decision as to
what should or should
not have been done
when faced with a
difficult scenario?
It will be
interesting indeed to
see what the RCVS
has to say on the
future of 24-hour
cover. I suspect it will
be a case of “steady as she goes” and “yes, just one more
glass of wine to go with my smoked
salmon canapé please”.
