Examination of Witnesses (Questions 220
- 230)
Wednesday 16 July 2003
PROFESSOR SIR
DAVID KING
AND PROFESSOR
JOE BROWNLIE
Q220 Mr Wiggin: You are saying almost
every disease should be notifiable?
Professor Brownlie: No, I am not
saying that, but I think data on diseases should be unified and
for the common good.
Q221 Paddy Tipping: You were telling
us about veterinary colleges and the need for role models. You
were saying there needed to be more large animal work and more
work with livestock. You went on to say this is not very profitable
and we need to do more research here. Could you expand that a
little and tell us how you would do that?
Professor Brownlie: There are
one or two layers there. One is for the livestock academic, to
encourage you to make progress personally yourself. Reward and
the elusive chairs that are given to people really come on the
back of teaching and research activity. It is extremely difficult
to get funding for endemic livestock disease and I think that
is a real fault in the system. Defra offers only directed programmes
so if you are not part of that directed programme it is not easy
to get funding. If you wanted to know how long foot and mouth
survived in cow pats, the Wellcome Trust are not going to fund
you. BBSRC are not going to fund you, but yet it might be an important,
relevant piece of work. If you want to know about the spike protein
on the new corona virus and what its three dimensional structure
is, you could go to a number of places to get funding. One hopes
that in the future we are going to support livestock research
and role models in veterinary schools. There should be opportunities
for funding for them. Whether it is profitable or not is another
matter. In the veterinary schools, we teach large animal veterinary
medicine and surgery. They have a lot of exposure to large animal
veterinary practices and a certain number go into large animal
practice, but it is often very hard work. It is not as attractive
as a small animal practice where they have more free time and
it is less demanding. We have to look very carefully at how we
support it more and make it more attractive. There are areas of
the country where it is difficult to have livestock skilled veterinarians
to provide a service.
Q222 Paddy Tipping: I wonder how
far we can intervene into this academic environment. We have had
a number of major outbreaks which in economic terms have cost
the public a great deal of money. On a second level, all of us
are saying we need to be more proactive. We need to build the
health of the national flock and yet we need to train the next
generation of vets. You mentioned funding streams into universities
from Defra. Do we need to be more directive about that? Is there
a place for saying if we want these public cuts delivered we,
the state, have to pay for them?
Professor Brownlie: Yes. There
is a big initiative at the moment for 25 million that is funded
by Defra. It is open to veterinary schools. I do not think Defra
initiated it. I am delighted they have done it but I think it
was initiated from the Wellcome Trust and the Selbourne Committee,
but it is there. If I get funded, I will think it is wonderful
but if I do not I shall feel very disappointed. The Royal Veterinary
College then will not be part of that funding stream. They have
asked for funding from the veterinary schools and they have put
it to open competition. That is very laudable and the best will
win. It is for five years. If you are going to make a real impact
into veterinary disease or any disease, it cannot just be for
three or five years. It has to be a longer term programme. To
some degree, one could consider that the funding is fragmented.
There does not appear to be a unified consideration of where the
country needs its funding. It is really where the best research
attracts the funding.
Q223 Paddy Tipping: How do we intervene
more positively to get the rewards that we want, a longer funding
stream and more funding but a clearer idea of the research we
need?
Professor Brownlie: If the country
needs research, it has to pay for it and direct it. Some of us
are free spirits in university. We do what we can where the funding
is available but what we are not indicating is that Defra should
be doing all the funding. There are other funding streams. Perhaps
one needs an overall view for the national good, particularly
for livestock.
Q224 Chairman: One of the things
I am still not quite clear about is this relationship. You said
first of all we need inspirational teachers to get people interested
in livestock, large animal work. On the other hand, during the
evidence that we have had so far, it is quite clear that small
animal work is the bit in the veterinary profession that is interesting.
It is the bit that pays well, where there is demand and where
people are moving from large animal work into, leaving the playing
field rather vacant of players in the very area where you are
saying if you have the right strategy manned by the right people
we have a chance to have good defences against any kind of major
disease outbreak. What I am not clear about is how, against the
background of pressure on livestock prices which is the generator
of wealth for the farmer, you make enough surplus appear in that
model to say to the farmer, "It is a good idea to have contingency
work done by the veterinary profession rather than call them in
when the fire has broken out." I do not quite see how we
intervene. Should we be paying for the good to be bought or do
you have to approach it in a different way. I am not quite clear
where you are at on that argument.
Professor Brownlie: I am not clear
on the answer. The partnership has to be both academic practice
and the funding agencies. There has to be funding into areas to
bring the work that we need to be supported. It has to be attractive.
The future of practice will not just be castration and TB tests.
The future of practice will alter. I am not sure who is going
to put the whole thing together.
Q225 Chairman: We are talking about
a strategy which involves the government, the scientific community
and the veterinary profession. Who do you think ought to put it
together?
Professor Brownlie: Defra.
Professor Sir David King: The
responsibility does lie with the government and therefore with
Defra but at the same time we are dealing with the market place.
Necessarily, people are looking at how to optimise incomes as
well as get job satisfaction. Professor Brownlie did point out
that career progression in the large animal side of the profession
is not really well developed and that is an area that I think
government could well look at.
Q226 Chairman: In the same analogy,
you mentioned you had upped the game to give yourself greater
protection, hopefully reducing the odds of a third visit of an
unwanted person to your house. Mr Tipping made a very salient
point about the cost of £4 billion-odd for us not having
had a good strategy in place with all the component elements.
It is a question of how much the nation seeks to invest to avoid
potential bills of £4.5 billion every so often, is it not?
Professor Sir David King: That
itself is a very complex question and that is what we are trying
to grapple with. Your question encompasses the whole thing. If
we then look at how we respond, yes, it was many billions of pounds
but it is 1967 since we had an outbreak of this kind. What is
the effective investment we should make in avoidance, looking
at it as a once in 25 year event? My own feeling is that we should
try and eliminate events of this kind if at all possible but the
response has to be proportionate and in relation to the question
we are now discussing we also need to decide to what extent it
is a shortage of large animal vets that makes us vulnerable to
an outbreak of that kind. This is where you come back to surveillance
and we can create a larger demand in this area if there is a bigger
demand on the surveillance set-up. In other words, if it is not
just random visits or visits called in by farmers on vets that
produce the surveillance but that there is some more directed
scheme of surveillance.
Q227 Chairman: Have we to approach
it from the point of view of a change in the way that vets are
trained in terms of the job they do, because for those of us who
are occasionally the purchasers of vets' services in the small
animal field it is when your cat is not well. You take it round
for some nice person to sort out. In the context of work on a
farm, I still think there seems to be an emphasis on, "Please
come in. I have a problem", as opposed to the veterinary
expertise adding value in terms of what goes on on the farm. Give
me a flavour, Professor Brownlie. Are vets taught to do both because
if you are going to make it more profitable for the farmer to
call the vet in, if the vet can come and look at the strategy
for animals, the nutritional side of it and this type of thing,
farmers might say, "It is worth having a vet in", but
you do not often hear that in terms of the work of vets.
Professor Brownlie: There are
two areas here. One is the undergraduate training, which is I
hope to encourage and fascinate the curiosity of veterinary undergraduates
in veterinary science and, on day one of the qualification, to
have a core competence in a range of skills to allow them to operate
in the veterinary sector. It is becoming clearer to the Royal
College of Veterinary Surgeons that there is a need for further
postgraduate qualification and training so that you can go into
one sector or the other. In livestock, this is being led to some
degree by the British Cattle Veterinary Association's health schemes.
They are requesting that people go on courses to train in how
to give health programmes. That is encompassed with individualising
health care for farmers but it includes nutrition, disease, breeding
programmes, for the postgraduate veterinarian. I think the veterinary
profession is aware that there are changes and is examining these.
You are right to say that there is a need for further training
and wider training and I think that is underway.
Professor Sir David King: Your
question is absolutely spot on. Training needs to include the
biosecurity arrangement. The single animal care that you refer
to is the emphasis on the training and it is also why many people
become vets. They want to do just that. Biosecurity is one aspect
of it. I would like to see the training including an understanding
of epidemiology. In other words, group animal behaviour and the
spread of disease through animals. I would like to see more understanding
developed in undergraduate courses, this core competence, to include
epidemiological modelling. To what extent does computer modelling
match with the real behaviour when disease spreads? I would also
like to see it include molecular biology, an understanding of
how improvements in antibiotics etc., can lead to better animal
welfare. There is a range of modernisation which I would focus
around group animal behaviour that, in my view, does need to be
substantially improved in that core competence area. I do not
think we disagree on that.
Q228 Paddy Tipping: Going back to
surveillance, I wondered whether those skills need to be cascaded
down because a team of vets, with the best will in the world,
cannot survey a whole flock. Going back to the Cambridge police
analysis, I wonder whether there is a need for some community
safety vets officers, a second tier. To pick up the licensing
of animals, if one were to look into the future, I do not think
it will be very far. I think the CAP reform, the way we want to
pay farmers, will eventually lead to some kind of annual, regular
visits to farms. One would need rights of entry and the rest of
it, but presumably one could pick up some of these issues through
an annual visitation, a registration scheme of this kind. Is that
your thinking? If it is, what are your colleagues in Defra saying
to you because I suspect, having listened to the discussion for
about an hour, that there is some tension between the views you
are putting across and colleagues in Defra.
Professor Sir David King: Surely
not.
Q229 Paddy Tipping: But it is about
handling tensions, is it not?
Professor Sir David King: Precisely.
My job is trans-departmental and coming in on issues of this kind.
You raise some very good issues and I really do match in quite
strongly with what you are saying. The vets' ability to pass on
the knowledge to farmers must be a key factor. Getting the farmer
to behave better on biosecurity, to understand animal disease
is going to give enormous added value. I feel like saying one
aspect of markets is that that is where farmers get together and
if we could imagine a society without the markets perhaps we could
replace them with get togethers where vets give upgrading courses
on surveillance and biosecurity measures. The other side of it
is the para-vet, the veterinary nurse and the role that they may
play. I do not think anything I would say would remove the value
of the vet.
Q230 Mr Drew: The issue that we have
all been lobbied on is prescription-only medicines. I know with
the best will in the world that this is not really something you
have had any influence over but, in the same way as we have been
heavily lobbied by community pharmacists over the potential damage
to their business by opening up medicines for human beings, the
parallel is there when you are talking about what could be happening
for vets for larger animals. There was a letter to the Chairman
and I was talking to Colin Breed and he said, "Make sure
you raise with David King the issue of the nice idea that we are
going to have a future for animal control but you will not have
much of a future if you do not have people prepared to go into
the veterinary practice for larger animals". Vets do see
this starkly at the moment. Their argument is the only reason
they stay in there is that they are able to subsidise aspects
of their business. I wonder what your reflection on their comments
is.
Professor Brownlie: I am aware
that there is some subsidy to veterinary fees that comes through
medicine. If you remove that, one has to increase the veterinary
fees per se. That could have a Catch 22 to it in that veterinary
fees might be considered high by some farmers, particularly the
farmers who one is trying to get to, and there would be some reduction
in that. I think the way forward is to make sure that, if veterinary
large animal practice is important to the nation, some way of
funding that should be evident. Otherwise you will lose veterinary
services from some areas of the community. In the high density
cattle areas, there are some extremely good practices and their
costs to their clients are quite high, but the profit of those
clients is even higher because good veterinary services will provide
good profit. It is in the other area that we are most concerned
about. We have a national strategy here. If that leaves some areas
poorer, then there is a problem.
Chairman: Gentlemen, may I thank you
most sincerely on behalf of the Committee for coming and giving
your views? They have been very stimulating indeed. There may
be one or two other questions that we might write to you about
and, if I may extend the same courtesy to you, after you have
digested the exchanges today, if there is anything else you want
to submit to our inquiry we would be very pleased to hear from
you. Thank you again for volunteering to come.
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