‘NHS for pets’: yes, no or maybe? - Veterinary Practice
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InFocus

‘NHS for pets’: yes, no or maybe?

Gareth Cross puts the arguments, as an objectively interested observer, for and against the plans of a national charity to expand its services into more areas of veterinary service provision.

“HOORAY! An NHS for pets,” is how the PDSA’s move into other areas of veterinary service provision has been described in some reports.

“A step too far!” cry neighbouring practices, especially those catering to the budget mass market. “Unfair competition from a charity against businesses” is another comment.

It is difficult to look objectively at the issues raised by this debate without seeming to come down on the side of evil profiteering capitalists or clumsy free market interference from cashed-up charities. Or offend both parties equally like in that last sentence: it’s important to be balanced in these things.

The following is my take on both sides of the argument. So what follows is not necessarily what I believe is the “right” argument, just what I think are the valid points raised by both sides.

I guess what I am trying to say is: “Don’t shoot the messenger” (as happened recently in these pages: when I surveyed the public on what they thought the RCVS was, I faced the ring squad in the next issue via a strongly-worded RCVS letter, something we all spend our lives trying to avoid). For those against PDSA expansion, the argument runs along these lines…

Budget clinic

One of the recently vociferous opponents of the PDSA’s expansion into other areas of pet healthcare provision has created a very successful business (or two) catering for the gap between normal private vets and the PDSA.

I worked at one of these budget clinics for several years in the Midlands. The clients paid £15 to see the vet and sometimes waited up to an hour for the privilege.

Customer service was pushed but clinical care was good. It catered for a group of pets that would never have seen a vet otherwise, plus a good number of people who could well afford better treatment but chose to put up with the queues to get the bargain. Neuterings were very cheap, as were vaccinations.

However, there was no charity fund to fall back on and no other fundraising activities: it stood on its feet as a business. Rates were paid, VAT and tax as normal. The business paid its staff well. It therefore made a good contribution back to the local (via wages) and national (via rates and taxes) economy.

It would be very difficult for such a business to survive against a charity operation competing for the same work and which paid lower taxes and had cross-subsidy from fundraising.

This could wipe out provision of reduced price veterinary care and leave the public with just an expanded PDSA and full-price practices. All other veterinary practices near to a PDSA would lose business to it for clients that qualified to use its services.

Feedback to the economy will be reduced as private veterinary practice revenues fall, the revenue being made up at the PDSA by charitable donations.

This brings me onto another issue: qualification for charity treatment. Most of us reading this will have either done EMS at a charity clinic, worked at one or know someone who does.

Open to fraud

We all know the stories, for example, of the pedigree Shar-pei brought in by a youth, but the dog belongs to Grandma who qualifies for the PDSA. Or the BMW parked around the corner whilst the dog is walked round to the practice door.

A charity system that relies on the benefit system to access its services is no more or less open to fraud than the benefit system. I know that charities do all they can to limit spurious claims and will limit the number of animals per client, but providing a greater range of services will mean that more money is spent on animals which don’t necessarily deserve it whilst their owners should be paying the full price at their normal practice.

If that practice loses revenue, it’s another hit on its income and this will feed back to wages and investment. Veterinary wages are under pressure currently from all sides: over-supply of graduates, global competition for UK jobs, stagnant practice incomes, etc. To take another tranche of work away from privately-run veterinary businesses (of any kind) is the last thing the profession needs.

Practices are used to competition from all sides, but at least corporates, budget vets, traditional private practices, etc., all have the same taxes and bills to pay, and generally have no back-up revenue stream from charitable donations.

These donations will have been made by people wishing to improve animal welfare and to channel this money into subsidised elective services may not be what many donors had in mind.

Would people really be so generous if they knew they were paying for a £1,000 pedigree Shar-pei to be spayed or vaccinated? Surely an owner who goes out and buys a dog or cat has some sort of common sense moral duty to fund a part of its routine care and maintenance?

People may be happy to donate to help animals who are ill and the owner cannot fund life-saving treatment, but would people, should people, give their money away so other people can maintain their discretionary purchases in good order? And, via gift aid, should the unwitting taxpayer be topping all this up?

A simple issue?

Well some of that was difficult to write, but it’s all valid argument. The other side is a lot nicer to write about.

Talk to anyone who works in a city practice that caters for low-income pet owners and before long you are onto the subject of ‘parvo. Lots of suffering, lots of money spent, lots of lives lost, all due to a preventable disease. Massive subsidised provision of vaccinations to all dogs would be of huge benefit to national canine welfare.

Cat flu vaccine for cats, similarly: less mortality with cat u but still a disease with very high prevalence.

Population control is another huge welfare issue and many dogs in the city are left to roam in the day as are nearly all cats. Provision of easy-to-access free or nearly-free neutering and vaccination for charity clients and as many others as possible can only be a good thing for animal welfare. Same goes for provision of as much subsidised care as possible to all pets.

All vets swore an oath to do our utmost for animal welfare and surely none of us could object to veterinary services being as freely and/or cheaply available as possible to as many animals as possible?

It’s a simple issue really: the cheaper and more widely available basic veterinary services become, the better. A large national charity is the ideal institution to take us forward as a nation in providing a better health service for pets.

People will need to contribute to these services, but at a price that makes them accessible for the client. It has worked to some degree with the introduction of cut-price neutering and vaccination clinics and this initiative will improve things even further. If this does eat into the profit of private practices, then it’s a small price to pay.

Strong points on both sides

Both sides of the argument have very strong and valid points which I think all of us will have sympathy with. From a personal view I would like to see the PDSA and RSPCA put funding into improving its current offering to rural pet owners before considering extending its offerings in the cities even further.

The access to treatment for qualifying clients living near a charity veterinary hospital is much easier and more comprehensive than is offered to those living elsewhere. I would like to see my current elderly and disabled clients who live in a remote rural area having access to the same level of charitable veterinary provision they would do if they lived in a city.

If we had a PDSA charity clinic within a hundred miles I might be more worried about what they were doing; as it is I can remain as an objectively interested observer, and sadly the local pets will be equally unaffected by their activities too.

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