THE draft “Health Protocol”,
according to the RCVS, “aims to
protect animals and the interests of
the public by helping veterinary
surgeons whose fitness to practise
may be impaired because of adverse
health” by dealing with the
“veterinary surgeons suffering from
adverse health without referring a
case to the Disciplinary Committee”.
Whereas the RCVS is
responsible for protecting animals and
the interests of the
public, it is mandatory
for the profession to
protect the interests of
the veterinary
surgeons. With this in
mind, Vets4BVU
conducted an internal
consultation. Based on
this a response has
been presented to the
RCVS, a gist of which
is presented for the
attention of the wider
profession.
The following sections of the
protocol attracted most criticism.
- “When considering whether a
veterinary surgeon’s fitness to practise
could be impaired because of adverse
health …, the veterinary surgeon’s
current physical or mental condition will
be taken into account.” - “Anyone coming into contact with
veterinary surgeons including … medical
practitioners, who have concerns about
a veterinary surgeon’s health are
encouraged to report those concerns to
the RCVS as soon as is reasonably
practicable.” - “Veterinary surgeons and veterinary
nurses who are concerned about the
health of a veterinary surgeon must also
take steps to ensure that animals are not
put at risk … This may mean that a
colleague must be reported to the
RCVS.” - “All investigations follow a similar
procedure and timeline as complaint
cases not involving adverse health.” - “The Preliminary Investigations
Committee (PIC) may… invite the
veterinary surgeon to: (a) undergo
medical examinations, assessments, or
tests at his/her expense; (b) agree to be
visited and interviewed by
representatives of the RCVS; (c)
provide medical reports to the PIC at
his/her expense; (d) embark on a course
of treatment recommended by a
medical practitioner at his/her expense;
and give undertakings to the PIC. - “If the PIC decides to invite the
veterinary surgeon to give undertakings .. the undertakings may include: (a) undergoing treatment from the
veterinary surgeon’s medical practitioner
at his/her expense; (b) supervision from
a medical supervisor appointed by the
RCVS … will not be the veterinary
surgeon’s own treating medical
practitioner; (c) supervision from a
workplace supervisor appointed by the
RCVS…; (d) specific undertakings to address concerns identified by the RCVS
or the medical
supervisor…; (e)
undertakings allowing
the sharing of
information between
relevant persons, for
example the veterinary
surgeon’s medical
practitioner, employer,
medical supervisor,
workplace supervisor
and the RCVS; and (f)
submitting to blood,
urine or other medical
tests.”
Observations
By allowing such a free range for
“anyone” to report regarding a vet’s
health could potentially open the gates
for malicious reporting and bolstering
of other complaints by adding a
suspicion or claim of a mental or
physical problem with the veterinary
surgeon.
There is a great concern that the
terms “physical and mental condition”
are too broad and could potentially be
abused when reporting, given the fact
that the problems of stress, anxiety and
depression appear to be quite
widespread in the profession.
Since the protocol does not lay the
requirements of hard evidence for
reporting, it is essentially unfair,
unethical and potentially illegal to put a
veterinary surgeon through an
investigative ordeal and then to have
him/her put up with the bills!
It would be breach of patient-
doctor confidentiality if a medical
practitioner reported a veterinary
surgeon to the RCVS without informing
the patient. It is not unlikely that the
medical profession may have serious
objections to this liability thrown at their
shoulders.
Importantly, vets in dire need of
medical help or advice may avoid seeing
their medical practitioner for the fear of
being reported, which is going to be
completely counterproductive.
The RCVS will hardly have any
options but to act on all reported
veterinary surgeons in order to avoid
potential future liability. Therefore, all
reported vets will have to submit
themselves to the procedures of the
health protocol. This would mean that reported vets will be considered guilty
unless they prove themselves to be
innocent, which flies in the face of
accepted standards of justice.
As it takes from several weeks to
months to go from initial complaint to
resolution with the RCVS, it will just
impose a greater amount of stress and
pressure to the affected vets, especially
those with real health problems.
The protocol involves too many
people – the vet, the RCVS case
manager, vet’s doctor, the RCVS
appointed medical practitioner, the
employer, the workplace supervisor, etc.
– which would clearly raise the
questions of confidentiality with such a
large number of people being involved.
It is hard to understand why the
RCVS thinks it necessary to stipulate
that a medical practitioner other than
the vet’s own medical practitioner
should be involved.
The veterinary surgeons required to
give undertakings will feel under
pressure to accept anything suggested
by the RCVS for fear of facing a charge
of professional misconduct should they
refuse. The protocol does not provide
any provisions to ensure that the
undertakings are suggested on a fair
basis.
It is unjustifiable to shift the
responsibility of welfare of the animals
under the care of a vet with suspected
“adverse health” to other fellow vets
and nurses.
In the absence of any independent
support, if a veterinary surgeon
suffering from mental or other health-
related issues is subjected to the
additional strain of a PIC investigation,
having to undergo dictated medical
assessments from assigned medical
practitioners, deal with a multitude of
people involved in the process, having
to pay for the costs of medical
assessments and treatments, having to
give undertakings to whatever the RCVS
suggests, and to feel forced to comply
with such undertakings, will only
exacerbate the problem and could push
vulnerable individuals over the limits
and may even provoke further tragedies
of suicides in the profession.
Recommendations
- The RCVS will need to be very
specific about the problems and
conditions that might attract necessary
attention. - Only vets and nurses, working
closely with a veterinary surgeon,
should be allowed to report on a
voluntary basis. - In the case of employed veterinary
surgeons, fellow professionals should
report the matter to the practice
principal, whereas practice principals
may be reported directly to RCVS. - If the practice principal is satisfied about the validity of the report, he/she
should speak to the vet concerned in
confidence and advise him/her to seek
necessary medical help and monitor the
progress and take care to support the
vet and organise for the necessary
work-related adjustments. - In a case where the practice principal
feels that progress is not being made or
does not want to deal with it directly,
the principal should report this to the
RCVS. - The practice principal should
produce specified evidence to support
the report; the same should apply to
the direct report which involves a
practice principal. - The RCVS should ensure that there
is no conflict of interest involved
between the reporter and the reported
vet, for example any pre-existing
internal disputes. - If the PIC is thoroughly convinced
that the reported veterinary surgeon
needs help, it should contact the
concerned vet, seek his/her consent to
approach the vet’s GP for a medical
examination, advise the vet about
work-related adjustments that may be
deemed necessary and inform and
advise the practice principal to
implement such adjustments. - The cases reported under the
health protocol should be dealt with
on an expedited basis. - The entire medical process should be
operated through the vet’s own GP
and if necessary the RCVS can request
the GP to seek further advice from a
medical consultant. - Should the GP confirm that the vet
needs medical help, arrangements for
such help should be made in
consultation with the GP. Any
programme of treatment should be a
matter exclusively between the RCVS,
the vet and the GP concerned. - Any monitoring required at the
workplace should exclusively be the
responsibility of the practice principal
on a very confidential basis. - Any undertakings required from the
vet should be in consultation with the
vet’s GP and that the GP should
certify all undertakings are strictly
indispensible.
Conclusion
In its current form the draft protocol is
going to serve as springboard to plunge
the affected vets deeper into their
problems.
However, with modifications in line
with the above submissions, the
protocol will on one hand meet its
objective to “protect animals and public
interest” and on the other it can truly
render the intended “help” to the
affected vets by proactively facilitating
their personal and confidential medical
care.
