House of Commons - Environment, Food and Rural Affairs

Select Committee on Environment, Food and Rural Affairs Sixteenth Report

2 SUPPLY OF AND DEMAND FOR VETS AND VETERINARY SERVICES

3. The Foot and Mouth Disease 2001: Lessons to be Learned Inquiry raised concerns about recruitment to the State Veterinary Service and about the number of vets, in general: in its introduction and summary, the Inquiry said that vets were a scarce resource.[4] It reported that there were "difficulties in recruiting veterinary staff to the State Veterinary Service", and that "there were many occasions during the 2001 epidemic when vets in short supply were overburdened with animal health tasks that could have been done by someone with a lower level of expertise". It pointed out that "the shortage of vets varies across the country".[5] This view was echoed by the NFU[6] and the BVA.[7]

4. The assertion is that that there is an absolute shortage of vets, and a particular shortage of vets undertaking large animal work. The RCVS is required to maintain a register of veterinary surgeons who are legally able to practise in the United Kingdom. At present there are 21,000 vets on the Register of whom around 9,000 are in practice. The RCVS acknowledged that "over the last 15 years there has been an undersupply of UK veterinary graduates", which has largely been filled by graduates from the European Union and the Old Commonwealth.[8] However, it expected the number of veterinary students would be about 700 per year in five years' time, compared with 300-330 ten years ago, and suggested that "within 5-10 years there is going to be a surplus of veterinary graduates".[9]

5. The RCVS Register, perhaps surprisingly, does not formally record the work undertaken by vets. Neither is there a requirement for practices to be notified to the College. However, it is aware of 2,375 practices of which 964 "are listed as undertaking work related to cattle and/or sheep/goats and/or pigs".[10] In addition, the RCVS has conducted surveys of veterinary manpower in 1998, 2000 and 2002. In its evidence, the College highlighted a reduction of around 29 percent in full-time veterinary equivalents working with farm animals.[11] The most recent survey showed that 9.4 percent of time spent in general practice was devoted to farm animal work, down from 20 percent in 1998, although data appears to have been classified slightly differently then (see Table 1).[12] Table 1: Percentage of time spent in general practice on various activities (1998, 2000 and 2002)

	1998	2000	2002
Small animals	66	68	73.5
Horses	11	9	8.4
Cattle	14	9	7.5
Sheep	4	2	1.3
Pigs	2	1	0.4
Poultry	0	0	0.2
Other*	2	11	8.3

Source: RCVS (2002) A Survey of Employment in the UK Veterinary Profession in 2002, Table 11 (see www.rcvs.org.uk)

Note: Other includes exotics, meat hygiene, fish, LVI, practice management and other (some of these categories were not separated out in the 1998 survey).

6. Defra reported the results of a recent survey it had commissioned "to gauge the [Local Veterinary Inspector] input received at local level and identify potential problems currently being encountered". The survey, of the 19 Animal Health Divisional Offices in England and Wales, explicitly looked at "changes to the number of practices handling large farm animal work over the last five years". It concluded that "a majority of AHDOs in all 5 SVS regions report a decline in the number of practices able to carry out large animal work although the problems are by no means uniform".[13] We were also made aware of declining interest in large animal practice among students and the retirement of older large animal and mixed practitioners.[14] In oral evidence Defra acknowledged that the decline in the availability of large animal veterinary services was "a matter of concern", but stressed that "it is not a uniform decline".[15]

VETERINARY EDUCATION

7. Professor Brownlie of the Royal Veterinary College considered that undergraduate veterinary training should "encourage and fascinate the curiosity" of students and have provided "a core competence in a range of skills to allow them to operate in the veterinary sector".[16] He also told us that "all the vets' schools devote a considerable amount of time to teaching livestock medicine and surgery".[17] However, concern was expressed that the teaching of veterinary science did not encourage students to want to follow careers in large animal practice. We were made aware of a number of factors that individuals and organisations argued affected career choice after college:

heavier small animal caseloads in the veterinary schools "stimulate the interest of students" whereas "at least four of the schools do not have viable farm animal practices with large caseloads and have not been able to develop the level of expertise that now exists in a number of farm animal practices";[18]
"the lack of interest amongst veterinary students in farm animal medicine stems, in part, from the lack of investment in this area of teaching in veterinary schools when compared with teaching in companion animal medicine",[19] and because few teachers "are truly inspiring";[20]
"the 'Herriot factor' has almost gone and current television programmes mostly concentrate on small animals";[21] and
large animal practice was "poorly taught at University so new graduates feel ill-equipped to go into large animal work".[22]

8. During the course of its inquiry into infectious diseases in livestock following the foot and mouth disease outbreak, the Royal Society reiterated the concerns of the 1997 Selborne Report on veterinary research.[23] The Royal Society noted that no Government Department supported universities in the training of students in and provision of research facilities for veterinary education. It suggested bringing the veterinary expertise in Defra and the Veterinary Laboratories Agency and the veterinary schools together through joint funding or a joint standing committee in education and research. This, the Royal Society argued, "could do much to improve our national capability in the surveillance, diagnosis and control of infectious diseases in animals".[24]

9. Mr Scudamore, the Chief Veterinary Officer, acknowledged that Defra needed to work very closely with the veterinary schools and pointed out that a number of initiatives were already in train.. First, Defra was funding "two veterinary investigation type units at London and Liverpool which will be part of the surveillance network". Second, jointly with the Higher Education Funding Councils for England and Scotland, Defra was providing "£5 million a year to develop training and research at the universities".. Mr Scudamore also highlighted links between the Veterinary Laboratory Agency and the vet schools.[25] Mr Morley noted that whilst the Department of Health was funding the placement of doctors in the NHS, Defra did not have an NHS structure for livestock.[26] When questioned about the merits of a joint standing committee on education and research, Mr Morley told us that "there is some merit in that. It is something that could be considered".. Mr Scudamore added that the animal health and welfare strategy was "all about collaborating" and it would "identify the best partnerships with the universities, with stakeholders and with practice".[27]

10. Mr Morley pointed out that providing students with adequate experience of large animal work whilst at college was the responsibility of the vet schools themselves. Mr Scudamore added that it was an issue of training quality and that it fell to the RCVS "to ensure that the schools can produce vets who have the right training to the right standard".[28] Mr Scudamore also acknowledged that "equally we do have a part to play". He said that there had been a scheme for veterinary students to undertake placements in the State Veterinary Service and the Veterinary Laboratory Agency and that Defra needed to look at placements in animal health offices.[29]

11. Professor Brownlie highlighted the need to ensure that expertise, developed in research centres, was also fed out to practitioners who would be the first to see new diseases 'in the field'..[30] He also said that despite veterinary graduates having 'core competences', it was becoming apparent to the RCVS that further postgraduate qualification and training were needed to cope with large or small animal specialisation.[31] In its inquiry after foot and mouth disease, the Royal Society highlighted the importance of and acceptance of continuing professional development in the veterinary sector. It reported that "the RCVS is proposing that in future, legislation permitting, a period of professional training should take place after graduation but before registration".. But it also raised concerns about the continuing professional development that was available for vets in the SVS and for large-animal practitioners.[32]

CONCLUSION

12. Whilst, overall, there may be more than enough vets in the country and an expectation of an over-supply in years to come, some effort needs to be made to assess whether there is an adequate number of large animal vets to undertake all the current tasks that are currently expected of them. The results of Defra's survey, together with the evidence we received about the difficulties in obtaining veterinary services in some parts of the country, about the declining interest in large animal work among new recruits to the profession and about the exodus of experienced large animal practitioners, suggests that the number of large animal vets in practice may fall in the coming few years. We recommend that Defra, in conjunction with the RCVS, make projections of the number of practising large-animal veterinary surgeons, taking into account data on graduates' preferences and practitioners' retirement plans. If robust enough data is not available, such data should be collected. Defra should also conduct a risk analysis of the consequences of not having enough large animal vets in the country against the background of the costs to the taxpayer of not being able to deal adequately with either the threat or an outbreak of a serious animal disease.

Demand for veterinary services

13. It is difficult to quantify exactly the demand from farmers for veterinary services. The Director of the State Veterinary Service pointed out that private vets attend "as and when requested to do so by the farmer", and, as a result "we do not have really any information about how big the service that is needed might be".[33] However, Defra collects data on farm incomes and farm input costs, and surveys of work undertaken by vets give an indication of how demand for veterinary services is changing.

14. Defra reported that average veterinary expenses (i.e. veterinary fees and medicines purchased) paid by each livestock farm were "around £3,300", which was "broadly the same, on average, as expenditure in 1996". Within this overall average, expenditure had increased on dairy farms by ten percent, but had decreased on other types of farms.[34] Across livestock farming as a whole veterinary expenditure rose steadily in cash terms until the mid-1990s but since then has fallen back. However, it still accounts for a higher proportion of all inputs than it did in the 1970s (see Figure 1).

Figure 1: Veterinary expenses and veterinary expenses as a proportion of all expenditure

Source: Defra, Agriculture in the United Kingdom 2002, see www.defra.gov.uk.

THE IMPACT OF FARM INCOMES ON THE DEMAND FOR VETERINARY SERVICES

15. The Royal Association of British Dairy Farmers was of the view that "the majority of dairy farmers (perhaps 75 percent or more) call on veterinary services for 'fire brigade' work and little else". It also argued that "current levels of farm income are having a direct effect on the usage of veterinary services".[35] There was broad agreement among farming and veterinary organisations that the level of farm income affected the demand for veterinary services. For instance the BVA told us that "in simple economic terms there can be no doubt that the levels of farm income will affect the usage of veterinary services. If farm income falls farmers will inevitably look to cut their costs, one of which is the cost of the veterinarian".[36] A practising vet from Somerset told us that "there is no doubt at all, as farm incomes have dropped over the last 5 years, that there has been a significant reduction in general veterinary services on farm".[37] But the BVA and others also made it clear to us that a variety of other economic and non-economic factors influenced that demand. The BVA suggested the following list:

the value of the animals;
the number of animals;
the profitability of the farm;
legislative requirements;
increased farm size;
increased levels of hobby farming; and
the costs of employing a vet.[38]

16. The NFU did not believe that "the straitened circumstances in which livestock producers find themselves" led to specific animal welfare problems, but it accepted that farmers were carefully considering their use of veterinary services and veterinary medicines.[39] There is evidence of farmers joining co-operatives to benefit from a stronger collective ability to bear down on costs. However, the BVA argued that reduced demand or supply would "inevitably ... have an impact on animal health and welfare", as animals were left untended for longer periods because of either reluctance to call a vet or the time taken by the vet to attend a case.[40] One vet commented that "individual cow health is related to farm income and it is definitely at it worst ... [in] 15 years".[41] The RCVS also considered that livestock value and farm profitability had an effect on animal health and welfare. If an animal was not worth much it was not worth investing in, and "in economic terms it may also make more commercial sense to kill a sick animal than treat it".[42] The Family Farmers' Association questioned whether it would soon become the case in the United Kingdom that "the only remedy for a sick sheep is a bullet".[43] However, one vet pointed out that by contributing to a healthy herd vets could "improve the viability" of the livestock farmer.[44]

17. The RSPCA pointed out that "declining usage of veterinary services over a significant period naturally impacts on the veterinary practices concerned".[45] The BCVA told us that "an increasing number of veterinary practices all over the UK are making strategic business decisions to withdraw from farm services, with insufficient levels of farm work remaining to justify specific overheads".[46] Partly in response to our inquiry, the BCVA undertook a practice-based survey of its membership to find out what changes in workload and staffing had occurred in the last five years and were anticipated in the next three years. It also asked about "farm animal veterinary succession" and whether individual practices would still be undertaking farm work in five and ten years' time.[47] It found a considerable reduction in the amount of farm work undertaken by vets and an expectation that the decline would continue, but that the number of vets engaged in farm work had not and was not expected to decline as rapidly.[48]

18. The Royal Association of British Dairy Farmers referred to "a downward spiral of available expertise [as] a real possibility as a reducing pool of large animal vets will mean fewer specialists, lower demand for specialist teachers and if such expertise is not available, a reduction in farm demand".[49] The RCVS referred to a similar "vicious circle".[50] A number of vets pointed out that a reduction in the use of veterinary services also affects disease surveillance,[51] saying "if we don't get onto a farm we don't get an opportunity to see what is really going on",[52] and that "this means that outbreaks of novel or unusual diseases are much less likely to be noticed or recorded at an early stage".[53] A point echoed by the Royal Association of British Dairy Farmers who highlighted this in the context of "the farm not having close contact with a specialist vet for reasons of cost or access".[54]

New demands

19. These developments in the demand for and supply of veterinary services have implications for Defra as it seeks to "reduce the economic, social and environmental impact of animal diseases, and improve the welfare of animals kept by man",[55] and to enhance veterinary surveillance in the United Kingdom.[56] In the following section of our report, we examine the difficulties Defra is likely to face in achieving these objectives at a time when the large animal veterinary sector is under considerable pressure. We look at the animal health and welfare strategy and the veterinary surveillance strategy in turn, and note the implications of changing food safety rules.

ANIMAL HEALTH AND WELFARE STRATEGY

20. We were told that:

"Traditionally the veterinary surgeon has responded to demand and has galloped behind disease, 'fixing it' when it goes wrong. Indeed, the profession does have an excellent reputation for 'turning out & fixing it'.. It has less of a reputation for making sure it doesn't go wrong in the first place".[

Through the animal health and welfare strategy which Defra, the Scottish Executive and the Welsh Assembly are preparing, the Government is seeking "a more strategic approach" to managing health and welfare related issues in this country.[58] After an initial consultation on Preparing an animal health and welfare strategy for Great Britain which closed on 3 April 2003, the Outline of an animal health and welfare strategy for Great Britain was published on 15 July 2003,[59] after we took evidence from Defra during this inquiry. Views were sought on this document by 31 October 2003. Mr Scudamore then expected that the animal health and welfare strategy would be produced in March 2004.[60]

21. In the July document, the Government identified five "strategic outcomes" and a number of "milestones" for the strategy. The outcomes are listed below:

a new partnership approach;
a clearer understanding of roles and responsibilities;
promotion of animal health and welfare: prevention better than cure;
effective delivery and enforcement;
a clearer understanding of the costs and benefits of animal health and welfare.[61]

The Government devoted a whole section of the Outline of an animal health and welfare strategy for Great Britain to the roles and responsibilities of animal keepers and other stakeholders. The responsibilities of animal keepers identified by the Government are reported in the Box below.

Responsibilities of animal keepers[62]

All farmers, traders, dealers, pet, recreation, sport, and entertainment animal owners should understand and provide for the physical and welfare needs of the animals in their care. They should be able to recognise the signs of disease and should know which diseases are notifiable and have to be reported to Government. All animal keepers have a responsibility to be vigilant, report any suspicion of disease early on, and maintain good disease prevention and control (biosecurity) practices, including compliance with regulations such as livestock standstills and the safe disposal of animals when they are dead. These measures significantly reduce the spread of disease and help to maintain high standards of animal health, animal welfare and public health. In order to meet their responsibilities and legal obligations every animal keeper should employ private veterinarians as necessary. If they cannot fulfil their obligations in this way then people should not keep animals and sanctions need to be considered against those who abuse this position, possibly including permitting or licensing and withdrawal of permission to farm livestock.

Support for the Strategy

22. In order to enhance disease surveillance the Royal Society recommended that Defra should:

In evidence to us the Minister confirmed that "the health plan approach is desirable and will certainly feature in the consultation on animal and welfare strategy".[64] He also pointed out that such schemes were already in place in some assurance schemes.[65]

23. Farmers and vets appear to support the Government's approach. The BVA said that "the good farmer" is already producing herd health plans, and reported that schemes in the dairy sector "are extremely good and are already showing benefits" - although it also pointed out evidence revealed by the foot and mouth disease outbreak that many sheep had never been seen by a vet.[66] The RCVS also supported the Royal Society recommendation on herd health planning, arguing that the creation of a "market" for such plans for non-commercial keepers of livestock "would create a demand and keep veterinary services in those [more marginal] areas".[67]

24. The NFU has said that it "strongly supports the concept of an animal health and welfare strategy and will fully co-operate to ensure the vision set out in the outline strategy is realised". It was also "particularly pleased to see proposals for individual farm health plans, believing that the farmer/vet relationship is the main springboard for a pro-active strategy".[68] In evidence to us the chairman of the NFU's animal health and welfare committee highlighted the French Groupment system, and gave an example from Dijon, in which farmers and vets worked together to eradicate disease because of the benefits of selling locally-produced, disease-free products and because disease control was more effective on an area basis. However, he thought that "it would be ambitious for us to get to that stage very quickly".[69] We agree, but if the animal health and welfare strategy is not ambitious it will not be worth signing up to.

Promoting the Strategy

25. Promotion of the benefits to farmers and others of a comprehensive animal health and welfare policy is obviously important. The Government has said that "it is important that the benefits of farm health planning in improving the overall herd or flock health status are identified, and communicated as widely as possible in order to encourage uptake of this approach".[70] It has called on the farming industry to "champion this issue".[71] However, the NFU has said that it "believes it is up to vets to sell farm health plans to farmers on the basis of the money they can save by bringing about general improvements to flock or herd health".[72] It is important that all those involved - the Government, vets and farmers and farming organisations - take responsibility for 'championing' an animal health and welfare strategy. As well as wider economic, social and environmental benefits such a strategy will directly help the farming community. Defra should be willing to make the case to the livestock industry, assisted in this process by the evidence of farmers who already benefit from such schemes.

Paying for the Strategy

26. Although the precise costs of an animal health and welfare strategy have not been worked out, the Government has acknowledged that there will be costs associated with health planning, not least veterinary costs. It has said that "it is important that livestock keepers individually and collectively take responsibility for managing the disease risk and with that bear a share of the financial risks".[73] The past President of the RCVS told us that the College did not have a view on who should pay for such plans but it was his opinion that:

"if you keep livestock … you have a responsibility to ensure optimum welfare, and in terms of your other fellow keepers of livestock, your neighbours and so on, you have a responsibility to be aware of the dangers from infectious disease. So my personal belief is that the keeper of the livestock should pick up the tab".[74]

27. The Government is considering the introduction of a levy, or system of insurance payments, to meet the cost of the animal health and welfare strategy. It will shortly announce a consultation process on the matter.[75] Professor Sir David King, the Government Chief Scientific Adviser, told us that the levy system could be used to encourage certain behaviour by farmers:

28. Some of our witnesses sought to link implementation of the strategy to the payment of farming subsidy. The BVA asked us to "consider the possibility of linking farm support under the EU plans for decoupling and modulation to the appropriate use of on-farm veterinary visits and herd/flock health plans".[77] However, both the NFU and the Government pointed out that many livestock farmers either do not claim support,[78] or farm in unsupported sectors.[79] As the NFU noted, one element of the rationale of herd health plans is "the need to know who are animal keepers and where they [the animals] are kept".[80] That raises the issue of licensing, or registering, livestock keepers, a matter to which we return below.

VETERINARY SURVEILLANCE

29. On 10 December 2002, Defra launched a consultation on its veterinary surveillance strategy, accepting that the existing system of surveillance needed to change.. It identified five strategic goals to achieve necessary change:

strengthen collaborations with stakeholders;

develop a prioritisation process;

derive better value from surveillance information and activities;

share information more widely; and

enhance the quality assurance of outputs.[81]

Veterinary Surveillance: A Definition[82]

"the on-going systematic collection and collation of useful information about disease, infection, intoxication or welfare in a defined animal population, closely integrated with the timely dissemination of relevant outputs to stakeholders, including those responsible for control and preventative measures".

30. The BVA welcomed the proposals.[83] The BCVA argued that "due to local knowledge and high levels of farmer-trust, the practising veterinary surgeon is best placed to ensure animal health and welfare within a national disease surveillance programme".. It also stressed the importance of a national disease surveillance programme covering non-notifiable as well as notifiable diseases,[84] a point echoed by Professor Brownlie[85] and the Farm Animal Welfare Council.[86] The Farm Animal Welfare Council also recommended that any veterinary surveillance programme should record animal welfare problems.[87] Sir David King described the veterinary surveillance strategy consultation document as "a good report", but questioned the extent to which vets were "going to the places where they are most needed". He believed that it was necessary to have more than "a random surveillance operation", and raised the questions of licensing and of "random checks on farms".[88]

31. There are a number of surveillance projects either already operational or in planning. For example Defra is developing RADAR (Rapid Analysis and Detection of Animal Risks), "a new surveillance IT system" which, if funded, "is envisaged as a system to capture data from existing systems and data sources, collate the data, and to produce analyses and risk models by using spatial epidemiology or mathematical modelling techniques".[89]

32. We also received information about the National Animal Disease Information Service (NADIS), "a network of sentinel practices, set up to monitor diseases in cattle, sheep and pigs".[90] We were impressed with the concept of NADIS and sought opinions on it from vets, farmers and Defra. The scheme was welcomed by the BVA, who said that it "potentially provides one part of a very comprehensive surveillance system … [that is] information about what the individual veterinary surgeon is seeing on the farm".[91] The NFU considered it to be "a good model that could be developed further".[92] Mr Scudamore told us that it was of interest to Defra and that its advantage was the network of vets providing material.[93]

National Animal Disease Information Service
NADIS was formed in 1995 and now consists of 40 sentinel practices and the farm animal teaching units of all 6 UK Veterinary Colleges. The reporting vets record all the diseases they encounter on a daily basis. The information is loaded onto a central disease database every 2 weeks. Each disease is coded, with further subdivisions for species (cattle, sheep and pigs), type e.g. for cattle (dairy or beef) and age (adult, youngstock or calf). Data can be presented on either a national or regional basis for any period up to July 1995.

33. However, our witnesses expressed some concerns about NADIS. The BVA told us that "the one potential problem is that it is anecdotal and that creates data capture problems".[94] Similarly, the NFU commented that there was criticism that NADIS "is not strictly scientific and statistically relevant in all cases because there is an element of subjectivity in the reports".[95] Defra also raised concerns about the data quality, noting that "one of the difficulties with clinical observation is that unless you have a standard mechanism you can have misleading information. The case definition is an equally difficult problem to solve". Despite these concerns, Defra is going to set up a pilot project "to see how we can use that practice network to undertake targeted surveillance using clinical science".[96] We welcome Defra's assessment of the use it can make of targeted surveillance. We believe that there are considerable merits in the NADIS approach and, rather than 're-invent the wheel', there appears to be scope for Defra to work with NADIS to overcome concerns about consistency of reporting and to develop a useful dataset that would record farm-level occurrences of a whole range of livestock diseases and conditions. With appropriate development, the system could provide very valuable early warning of developing trends in both animal disease and welfare problems.

FOOD SAFETY: FROM "FARM TO FORK"

34. The Food Standards Agency (FSA) told us that the role of vets and veterinary services on farms "is likely to alter in the coming years through a new approach to farm hygiene and food safety".[97] At present European legislation requires slaughterhouses and cutting plants to be supervised by vets.[98] There is no such requirement placed on farms. However, "European legislation governing the production of food is being revised, simplified and consolidated": rules are being developed for the whole food chain, and will "include controls at farm-level on some zoonoses".[99] Although the FSA does not expect changes to apply until 2005 at the earliest, its says that:

100

35. The Government also highlighted these changes in the Outline of an animal health and welfare strategy for Great Britain.. It said that the rules "will require livestock producers to be registered as food businesses, to control hazards that can enter the food chain on the farm, to operate hygienically and keep records relevant to food safety". Defra announced that "a cross-industry working group will be set up to prepare industry for the necessary changes in the forthcoming food hygiene regulations.[101] Although the official veterinary surgeon may not have to be present at the slaughterhouse for as long, requirements for veterinary inspections of livestock for human consumption on-farm may well add to the workload of large animal vets.

CONCLUSIONS

36. The animal health and welfare strategy, increased surveillance, and a new approach to food safety will all require changes in the way farmers and vets operate. We set out in the following paragraphs what will be required. It is safe to conclude that the proposals, taken together, will place increased demands on the time and resources of large animal vets.

Delivering the strategies

37. The Outline of an animal health and welfare strategy for Great Britain and veterinary surveillance strategy provide a clear statement from Defra of what it expects to be delivered. This provides a starting point in evaluating the amount of private and public sector veterinary input they will require. But the first step in delivering either of these strategies, and implementing farm-level food safety rules, is knowledge of the location of every animal in the country. Further steps include the securing of livestock keepers' and vets' participation in the strategies, and a determination of what resources will be required to ensure that the strategies achieve their objectives. Each is considered in turn below.

Licensing or registering livestock keepers

38. One of the revelations of foot and mouth disease was that it is impossible to know where all livestock is at all times; it may not even be possible to know with complete accuracy the whereabouts of all livestock holdings. As a result support has been expressed for a system or licensing or at least registering all keepers of livestock. Indeed in its report following the outbreak the Royal Society recommended that all livestock keepers were licensed, with one of the conditions of the licence being an annual health plan.[102] The proposal has been endorsed by the Government's Chief Scientific Adviser.[103] When we commented on the opposition of some farmers to licensing, he argued that "those sections of the farming community that would like to avoid a 2001 type epidemic ever occurring again might welcome it".[104]

39. In his evidence to us Mr Morley told us that Defra was considering a licensing scheme.[105] But at the launch of the Outline of an animal health and welfare strategy for Great Britain, the new animal health and welfare Minister made clear that licensing was not on the agenda - for now. He said that "the theme of the strategy is that keeping animals is a privilege not a right, animal keepers must meet their responsibilities as set out in the strategy. If they can not fulfil their obligations, sanctions may have to be considered, including the possibility of licensing or permits for farm livestock".[106] We believe that equating the introduction of licensing for livestock farmers with putting 'sanctions' on them is not helpful. It is conceivable that a system of licensing might one day have to be introduced but for rather more positive reasons than as a way to 'punish' errant farmers.

40. That said, there are substantial obstacles to the introduction of a system of licensing for livestock keepers, as Mr Morley pointed out in his evidence.[107] The first, and most obvious, is cost. Although no assessment seems to have been made of the full cost, simply creating and maintaining a list of all livestock keepers will require some resources; if a licence is subject to conditions, and thus inspections of compliance are required, the scheme will be much more expensive. Second, the burden imposed on small or hobby farmers, with relatively few animals, would be disproportionate. The RCVS reminded us that the Royal Society inquiry had addressed this point, and had said that all types of "livestock keepers were equally at risk of [their animals] contracting an exotic disease".[108] Clearly, then, any form of licensing system must apply at the very least to all keepers of cattle, sheep and pigs; and the difficulties of smaller or hobby farmers will have to be dealt with..

41. Third, a number of witnesses sought to link the idea of licensing to the payment of subsidy under the Common Agricultural Policy, using cross-compliance. However, as Mr Morley pointed out, the pig and poultry sectors are unsupported, and therefore could not be subject to cross-compliance rules.[109] Therefore it seems apparent that, if it is to be introduced, livestock keepers will have to meet the cost of licensing themselves.

42. Notwithstanding these obstacles, pressure for licensing - or at least registration - may become irresistible. The Food Standards Agency told us about changes to European legislation governing the production of food. The new legislation will apply from 2005 at the earliest, and, inter alia, will place new requirements on farms as food businesses. Coupled with those new requirements will be a full range of official control activities including inspection, audit, monitoring, surveillance, and sampling and analysis.[110] Defra told us that the new rules, "which are nearing final agreement", would "require livestock producers to be registered as food businesses".[111]

The notion of registration of livestock keepers (without the conditions assumed to be associated with full licensing) met with approval from the RCVS in particular. It said that "all keepers of livestock - whether it is pet goats, pet sheep, pet cows, pet pigs, whatever - should be registered on a Defra database, and they should have registered the name of a veterinary surgeon, and they should submit some form of health plan at least once a year".[112] The introduction of some form of scheme of registration of livestock keepers is probably now inevitable. A database listing the location of all such keepers would of course be immensely valuable in combating animal disease. We recommend that Defra develop one without delay - and we note that we recommended such a database nearly two years ago in the aftermath of foot and mouth.[113] It may be that a registration scheme might in future evolve into a licensing scheme, but before that we recommend that Defra undertake an analysis of licensing, looking at the conditions which might be attached to a licence, the cost, particularly for smaller or hobby farmers, and the likely benefits..

Participation and implementation

43. In the Outline of an animal health and welfare strategy for Great Britain, Defra quoted a stakeholder who said that "animal health plans are the way forward". Defra then commented that farm health planning could help livestock keepers fulfil their responsibilities to prevent disease spread and maintain healthy animals. It described the process of farm health planning and identified a need to develop guidance and training in the preparation of farm health plans. It also committed itself to "facilitate the production of the required tools for encouraging farm health planning". However, Defra argued that stakeholder groups need to champion this issue themselves.[114] The NFU wanted vets to sell animal health plans to farmers but said that vets seemed to be more comfortable with 'fire brigade' work than with the "developing philosophy" of herd health planning.[115] Defra noted that it required "a cultural change in some farmer groups to adopt these beneficial practices".[116] If Defra wants herd health planning to succeed, it will have to take the lead in bringing about that cultural change. Changes to the CAP, especially the requirement for stricter cross-compliance, may provide Defra with both the 'carrot and stick' it needs to encourage universal adoption of animal health planning. But it will also have to provide guidance and support to the veterinary profession to ensure that any statutory requirements are consistently implemented and enforced. If Defra is determined to proceed without a licensing system, it should now detail how it envisages a herd health planning scheme could operate. It should also say whether it intends animal health plans to cover all livestock, including all pets, or restrict them to commercially-farmed livestock. Defra should undertake a cost benefit analysis of a compulsory herd health planning programme for all livestock keepers.

44. In terms of veterinary surveillance, protocols need to be developed to allow information to get to the central database, and then to be cascaded back down to vets and farmers. Professor Brownlie highlighted the huge amount of information that does not reach the SVS,[117] although the issue of confidentiality may be the cause in some cases.[118] Defra has outlined its ideas on partnerships: it needs to consider how it can ensure that these are developed between vets and all livestock farmers, especially those who, in the past, have not called the vet out. The Chief Scientific Adviser's suggestion of random checks may need to be considered. If it is not, Defra, farmers and vets will need to work together to determine how surveillance data is collected. They will need to address the following questions:

Can vets collect surveillance data when invited to a farm or should it be the subject of a specific pre-announced visit?
In both cases, how and who should the vet charge for this activity?
How should evolving international disease risks which have implications for British farmers be communicated to vets and farmers?

45. The animal health and welfare strategy, the veterinary surveillance strategy and the forthcoming food safety rules have much in common. They all require knowledge of where animals are (the registration requirements of the new European Union food safety rules could achieve this). They all require vets' presence on farms. They all require the support of the farming industry. They all have the potential to bring benefits to both farmers and wider society. Defra should examine with farmers and vets the extent to which the animal health and welfare strategy, the veterinary surveillance strategy, and the requirements of the food safety rules can be 'rolled-up' to bring the benefits to farmers and society without causing too much inconvenience to farmers or placing too heavy a burden on large animal vets.

Resources

46. We have listed above the new demands that will be placed on large animal vets in implementing the animal health and welfare strategy, the veterinary surveillance strategy, and forthcoming farm-level food safety rules. It is clear to us that more large animal vets will be needed if Defra is to deliver these strategies. We have already recommended that an assessment of the number of vets required to undertake current tasks is completed. But Mr Morley told us that "we clearly have to evaluate capacity as part of any animal health and welfare strategy - both in relation to ourselves and also within the private sector".[119] Using the results of the assessment we have proposed, Defra should determine how many additional large animal vets are needed to deliver its animal health and welfare and veterinary surveillance strategies. It should also assess the veterinary input that will be required to implement farm-level food safety rules and any consequent reduction on the requirement for vets in slaughterhouses.

47. One area in which the Government can usefully intervene to ensure that the supply of large animal vets is increased is in education and training. Efforts are needed to overcome current difficulties in attracting new graduates to large animal work. We urge the Government to invest in education to make large animal work more attractive to students. Some of the initiatives that Mr Scudamore mentioned are a start but more would be needed. It is imperative that the Government is proactive.

48. Professor Brownlie outlined the importance of research to the teaching of veterinary science. He argued that role models who would "impress upon the students that livestock farming is a worthwhile and very important career" had to be actively engaged in research work.[120] But he later expressed the concern that "it is extremely difficult to get funding for endemic livestock disease",[121] that short term funding programmes would not make "a real impact" on disease, and that funding was "fragmented".[122] We recommend that, in conjunction with the veterinary colleges and farming organisations, Defra and other sponsors of veterinary research should review veterinary research programmes, in the light of data gathered by the surveillance programme, to ensure they reflect the health and welfare problems faced by the industry. If a disease levy is introduced, one 'dividend' from it could be additional funding for research into the diseases it covers.

49. If indirect intervention does not encourage veterinary students to enter large animal practice, Defra and the veterinary colleges may need to consider more fundamental changes to the recruitment and training of students. One approach would be to allow undergraduate students to distinguish between veterinary science (farm livestock) or veterinary science (small animal) degrees on their enrolment. Course sizes could be determined on the basis of the need for practitioners and, if necessary, entry grade requirements could be differentiated to reflect demand for and availability of places on courses.

50. In the shorter term, Defra may still be able to stimulate interest in large animal practice. Offering extramural placements, an important element of veterinary training, to students would be a clear way of Defra demonstrating its commitment to partnership with the industry. We recommend that Defra explore with the veterinary schools and the RCVS not only how such placements might work but also the possibility of staff exchanges and secondments to provide opportunities for continuing professional development for both teachers and Government vets. Finally, given the additional responsibilities that the strategies will place on practising veterinary surgeons and the additional costs they will place on farmers, Defra may need to intervene directly in the market to ensure that veterinary practitioners are paid appropriately for the services they provide, and that all livestock keepers are within the ambit of the strategies.

Competition Commission report on prescription-only veterinary medicines

Background[123]

"On 9 October 2001 the Director General of Fair Trading announced that, following complaints from both farmers' groups and individual consumers and evidence that prices in the UK are substantially higher than in other European countries, he was referring to the Competition Commission for investigation and report under the Fair Trading Act (1973) the possible existence of a monopoly situation in relation to the supply within the UK of prescription-only medicines. The announcement noted that Office of Fair Trading's preliminary investigation gave rise to further concerns, in particular:
a lack of transparency in prices - as the medicines are dispensed in the course of treatment and may not be itemized separately; and
evidence of reluctance by manufacturers to supply veterinary pharmacies."

51. The Competition Commission's inquiry into the supply in the United Kingdom of prescription only medicines found one scale and three complex monopoly situations. One wholesaler supplied more than one quarter of all prescription-only medicines at the wholesale level (the scale monopoly). The first complex monopoly situation involved veterinary surgeons engaged in one more of the following:

failure to provide information about prescriptions;

failure to provide price information about prescription only medicines; and

pricing that did not reflect cost of supply.

The second complex monopoly situation involved eight manufacturers failing to enable pharmacies to obtain supplies of prescription-only medicines. The third complex monopoly situation arose from the failure of all veterinary wholesalers to take reasonable steps to market to pharmacies and supply them with prescription-only medicines. The Competition Commission's report recommended nine remedies be introduced under the Fair Trading Act (1973) and made a further eleven recommendations to change other regulatory requirements surrounding prescription-only medicines, including a number that would have to be implemented by Defra.[124]

52. Defra welcomed the report.[125] The NFU "endorsed the findings of the Competition Commission's report". It was pleased with the recommendations that more veterinary medicines should be available without prescription and that vets should disclose the cost of prescription medicines.[126] The NFU told us that "we need transparent supply chains on inputs and outputs", and that more competition in the provision of veterinary medicines was "an opportunity for the veterinary profession … [to] sell its excellent professional services".[127] However, the veterinary profession expressed a number of concerns. The BVA anticipated that the implementation of the Competition Commission's recommendations "could have a profound effect upon the veterinary profession", particularly in the large animal sector where 63 percent of practice income came from veterinary medicines, compared with 38 percent in small animal practice.[128] The RCVS accepted that medicine sales were used to cross-subsidise call-out charges but considered that in some areas this was necessary to ensure the viability of single-partner large animal practices.[129] However, the RCVS accepted the need for information to be available on prices and would change its guidance as the Competition Commission recommended.[130]

53. Individual vets also commented on the Competition Commission's inquiry. One accepted that farmers had subsidised 'fire brigade' work through their purchases of prescription-only medicines but, like the BVA, suggested that, if implemented, the Competition Commission's recommendations would "put a serious question mark over the future of the practice unless new means of funding are found".[131] Another vet told us that increasing fees for animal work or charging higher call out fees was "naïve". He argued that "the only viable option is that the owner of the well animal must contribute to the practice's provision of veterinary care". He suggested that if clients registered they would be entitled to a range of services, including a farm visit.[132]

54. We raised the concerns of the veterinary profession with Defra. Mr Morley accepted that "there is certainly an issue in relation to profitability of prescribing". He also told us that "it is a bit hard to judge what the impact will be".[133] We are concerned that neither Defra nor the Competition Commission appear to have obtained a clear picture of how veterinary practice income is derived, and what the economic impact of the proposals would be on the provision of large animal services, especially given that Mr Morley accepted that "how veterinary practices operate in relation to that element of cross-subsidy is a decision for them in relation to what is a competitive market with regard to veterinary treatment".[134] We are also concerned that the Competition Commission's recommendations could lead to a reduction in the number of practices providing large animal veterinary services which could, in turn, affect Defra's ability to achieve the objectives of its animal health and welfare strategy and its surveillance strategy.. Mr Scudamore told us that, after the Competition Commission published its preliminary findings, he sought an opportunity "to explain what the importance of practice was to us … the need for rural practice, what rural practice delivered on our behalf … and we pointed out to them that if we lost rural practices we would not be able to deliver our work in terms of surveillance and welfare". He added that the Competition Commission said that it had taken account of his representations but "their view was that cross-subsidisation was not correct and that they would rather see transparency and professional fees by veterinary surgeons go up to enable them to get their income from that source than marking up on drugs".[135]

55. On 9 July 2003, Gerry Sutcliffe, Parliamentary Under-Secretary of State at the Department of Trade and Industry, published the Government's response to the Competition Commission's report, in a written statement.[136] Of the eleven recommendations made by the Competition Commission, Mr Sutcliffe said that the Government accepted nine; one was not within the Government's power because of European Union legislation on the licensing assessment process, which requires judgements to be made on the basis of safety, quality and efficacy, not cost; and one was directed at the RCVS. The remedies proposed under the Fair Trading Act 1973 were being taken forward separately.

56. The President of the BVA wrote to us following a BVA Council meeting after this announcement. He raised a number of questions about the process of the Competition Commission Inquiry and the implications of the implementation of its recommendations for both veterinary profession and for the delivery of the Government's strategies to improve animal health and welfare and disease surveillance.[137]

57. Before the Government announced that it had accepted the recommendations addressed to it, Mr Scudamore confirmed that "we do not actually know, if the recommendations of the Competition Commission come into effect, what impact it will have on veterinary practice".[138] When we asked about the wisdom of the Competition Commission making recommendations without a clear idea of their implications, Mr Morley pointed out that its "prime responsibility is to look at consumer protection",[139] which we accept. However, given the crucial importance to Defra of a vibrant network of rural veterinary practices, we recommend that Defra urgently assess the likely implications of the Competition Commission's remedies on its ability to deliver the animal health and welfare strategy, the surveillance strategy and potential future food safety obligations. It should report the results of its analysis in time for them to be taken into account in the animal health and welfare strategy due to be published in March 2004.

4 Foot and Mouth Disease 2001: Lessons to be Learned, HC [2001-02] 888, p. 9. Back

5 HC [2001-02] 888, pp. 160-161. Back

6 Ev 36, para 7. However, in oral evidence, the NFU's Deputy President said "my suspicion is that there are probably plenty of vets about and probably enough good large animal vets about" (Q 68). Back

7 Ev 4, para 18. Back

8 Ev 23, para 7, and Q 37. Back

9 Ev 23, para 7, and Q 37. Back

10 Ev 23, para 2. Back

11 Ev 23, paras 3-4 and Ev 27, Figure 2. Back

12 RCVS (2002) A Survey of Employment in the UK Veterinary Profession in 2002, Table 11 (see www.rcvs.org.uk). Back

13 Ev 46-Ev 48, para 23, and Annex A, paras 9, 10 & 17. Back

14 Ev 2, para 4(b), Ev 98. Back

15 Q 81. Back