Memorandum submitted by Mrs J R Gidlow
BVSc, MRCVS, Ewing &Gidlow (W12)
I am a Large Animal Veterinary Surgeon, Principal
of a four/five vet practice situated in rural North Northumberland.
I have enclosed a map taken from the Competition Commission Report
to indicate site of practice and area covered [not printed]. I
would like to point out that there appears to be an error in the
database since there are no surgeries shown in North Northumberland!
I qualified in 1985 from Liverpool and went
to work on the Isle of Bute, moving to Wooler in 1987. I took
a career break from 1992-94 then returned to the practice as a
Partner (one of three). Within 18 months one partner aged 40 left
practice to run a Dairy farm. In 1999 the then Senior partner
retired early at age 56. The economy of the local area is based
on Agriculture. The livestock is mostly beef, and sheep kept on
large Farms. Many clients farm more than one holding and employ
stockmen and shepherds. The farms are run as Agribusinesses. Whilst
I have been in practice we have endeavoured to provide a service
which encourages preventative medicine, although this by it's
very nature decreases the need for "fire brigade" work.
Since becoming a partner in 1996 there have
been several dramatic events affecting farming and the Practice.
In March 1997 that the BSE announcement was
made in the Commons The number of farm visits dropped by half
overnight. This was a direct result of the dramatic fall in the
value of stock which meant that individual animals were no longer
worth getting a vet out to. The Agricultural recession followed.
Farm labour was further reduced. The practice made fewer visits
but the financial effect was initially limited because of our
preventative medicine policy. But we had to work a lot harder
to demonstrate the benefits of continued use. Farmers have became
increasingly more demanding when visits are made,the diagnosis
has to be right first time. More farmers began treating animals
themselves, phoning for advice and POM being handed out as result.
Visits were declined. Farmers viewed this as a cost cutting exercise.
Then Spring 2001, FMD came into the Practice
area but few farms were slaughtered out. A large number were placed
under D notices so they could not be visited. In latter stages
farms were inspected by us for stock movement purposes. This was
the first time in many months we had been on some of the farms.
Never had we had the opportunity to inspect all the animals on
some farms, this was a real eye opener. Most of my vets remarked
on how many lame sheep they were seeing which, hitherto not recognised
as major problem. In addition the numbers of farmers with stock
in several different places were far more extensive than we realised—another
effect of the agricultural recession.
In March 2002 the practice undertook some market
research and Farmers were questioned on their attitude to provision
of services and costs. The general agreement was they had all
reduced the number of callouts to cut costs and this had had a
direct impact on animal welfare. Some unpleasant things were happening
on their farms which they would not have thought possible to allow
10 years ago. They were now forced to accept this as a "sign
of the times". The overriding feeling was that animal welfare
was suffering but there was nothing farmers could do about it
given their economic circumstances. These farmers comments were
in keeping with our own observations.
This has now had marked financial impact. In
order to keep some presence on the farms we have kept our visit
charges down, this is counterbalanced to some extent by our selling
of medicines which contributes significantly to our turnover.
We do not charge for our telephone advice to try and keep some
contact with the farmers.
Although we have tried to diversify our interests
there are only a very limited number of SA and Equine clients.
I have developed my interest in game bird work which is useful
in the summer when LA practice is quiet. Due to the nature of
beef and sheep husbandry, busy times for LA practice are the Spring
and Autumn calving, Spring lambing and Autumn/Winter housing for
cattle. We also sell PML wormers, vaccines etc. for use in livestock.
This is a very price competitive area because there are four "trade"
outlets within the locality. It is necessary to compete in the
marketplace. Margins are tight on these products but we regard
this part of the practice as essential to ensure farmers have
available the best possible advice.
I have always been a committed LA vet and accept
that being on duty is part of the job. All my vets describe the
worst part of their job as "being on duty". It is not
possible to have a separate "out of hours" clinic as
do SA practices in cities, or spread the out of hours amongst
other practices for reasons described below. I have just read
the CC report in its entirety. I am therefore disgusted to read
the Chapter 2, para 159 which says that the RCVS & BVA do
not regard 24 hour cover as an onerous burden!! Although Fire
Brigade work is less, cows with calving difficulties do and will
still occur at 1.00 am. The cost of provision of this overall
service is enormous. LA farmers have subsidised this through their
purchases of POM medicines from Vets. If these CC proposals are
implemented in full it will put a serious question mark over the
future of the Practice unless new means of funding are found.
All the financial details quoted indicate that already large animal
practices are the least profitable of all types of practice. The
CC report gives figures for income of LA partners which are not
high especially when interest on capital invested in the business
is taken into account. There is a real danger overall vet costs
will increase if medicines are purchased elsewhere. Although other
practices within Northumberland (see map) have a much larger SA
client base the same economics apply to the LA side of their businesses.
The danger is that many mixed practices will cease any LA work
if it becomes more uneconomic, and other LA practices will cease
to exist. Farmers may only become aware of this situation when
it is too late. There are other ways of financing LA service but
these will take time to introduce to farmers.
We have one vet on duty at night and weekends,
a one in four rota. If the practice was reduced in manpower, the
hours on call would increase significantly. We work 42 hours plus
32 "on call" hours per week. To amalgamate out of hours
with other practices would increase the workload and distances
travelled per night since there would be fewer vets on call to
cover the same area. Farmers would have to wait longer. Ultimately
it is the animals for whom treatment is delayed who suffer. Would
any vet be willing to work night and day ?
It is already extremely difficult to find competent
experienced large animal vets. This has been an increasing problem
for a number of years. I believe this is due to:
(a) LA poorly taught at University so new
graduates feel ill equipped to go into LA work. Many then have
unpleasant experiences and retreat into Small Animal work.
(b) The increasing number of women entering
the profession—an excellent paper by Ms C Sheild demonstrates
that the working life of woman vet is only 2/3
that of male counterpart. She also demonstrated that women are
much less inclined to take on the responsibilities of partnership
or ownership of a practice, which is also true of the younger
members of the profession in general.
(c) There is a large drop out rate from our
profession of both sexes, due to the job not living up to expectations.
Are the wrong students being taken into University ?
(d) Students at University are told that
there is "no future in LA work" (we had an excellent
local student who was persistently told this at University for
three years, he then decided to go and be an equine vet).
(e) Extreme difficulty of introducing a new
graduate into large animal practice due to increased farmer expectation.
Few basic jobs are done by vets eg Dehorning, castration. Farmworkers
are more knowledgeable (which is good) so when vets are called
in for eg calving, they are always difficult. Often the newly
qualified vet is not as good at calving cows as stockmen. It is
vital that support is given so that neither clients or New graduates
lose confidence. They need to trust their vet otherwise they will
not call them out.
(f) The responsibilities placed on us now
are quite enormous, giving advice relating to thousands of pounds
worth of stock. Bigger farms with more stock increases this. As
compared with small animal work where there is usually only one
client and one animal to be dealt with at any one time.
(g) This shortage is particularly acute in
very rural areas like ours. So few people are used to living in
the country. Our nearest Marks and Spencer is 60 miles away!!
We and another local practice advertised last year—the one
suitable applicant with the relevant experience chose to work
for another practice down South. We re-advertised four months
later. Of the six replies the best on offer was a new graduate
from a crofting family. As Principal, I work an average of 55
hours a week, plus "on call" 32 hours in support of
the New graduate, plus other demands on my time (I am writing
this on Easter Sunday). With only three experienced vets it would
be not be feasible for me to work the above plus another 32 hours
on call to support a new grad, and nor could anyone else be expected
to do so. It is vital to bring on younger members of the profession
which is why we have students for their extra mural studies and
employ a New grad. The continuation of this is in doubt unless
we can be supported in some way.
(h) In recent times a significant number
of senior partners have retired early from LA practice. Many citing
the level of aggravation in LA practice due to the previously
outlined reasons. Within the locality, five have retired early
from four practices all saying they have "had enough."
The combined effect of all the above will have
serious consequences for the farming community if allowed to continue
unchecked.
Vets are being constantly urged to assess overall
levels of disease and effects on health welfare and production
for the whole of a farming enterprise. The breadth and depth of
knowledge required to do this takes several years to achieve.
Considerable effort is needed to keep up to date by attending
conferences, seminars etc. This is more difficult and time consuming
for a rural area practice. Nearly all CPD is at least three hours
each way and usually requires an overnight stay. CPD and all associated
costs is an additional expense borne by the practice.
Surveillance is a very important issue, if we
don't get onto a farm we don't get an opportunity to see what
is really going on. As a result many diseases are not diagnosed,
in addition fewer samples are taken for lab tests. Talking to
farmers and prescribing over the phone is just not the same. Too
many POM' s are handed out without seeing the animal concerned.
We and another local practice have urged for a review of the definition
of `animals under our care' as set out in RCVS Guide to Professional
Conduct. We would like it more defined but have been told by both
BVA and RCVS that this would be `difficult to do'. So nothing
is going to happen. The definition is so woolly only one farmer
in our survey recognised that there was any restriction in the
prescribing of POMs at all. We really need to get back on farm
to see more animals to stand a chance of providing any meaningful
surveillance. In addition to a tightening of the `animals under
our care definition', I believe quarterly or bi-annual visits
for whole farm assessment would bring enormous benefits in terms
of animal welfare and surveillance.
AHWS has drawn attention to Farm Assurance and
Herd/Flock Health Plans. We estimate that more than 70% of our
farmers are members of a Farm Assured Scheme. Not once have we
ever had to confirm to any FAS that a member of their scheme is
our client, although for all the schemes every farm must nominate
a vet.
FAS could be useful if set up in the right way.
A huge amount of effort has been put in by BCVA and NDFAS to introduce
their scheme. BCVA approved vet sets up a plan and signs to say
it conforms to what is required BUT no assessment takes place
as to whether plan is being adhered to. The Vet does not sign
to say plan is being complied with.
Similar problems exist when other HP's are created.
Although many schemes advise the use of vet there is no absolute
requirement for their involvement when an HP is constructed. eg
FABBL. Although for FABBL a written HP is now required I have
yet to hear of any farmer being asked to produce theirs.
Creation of a HP so that it is workable, meaningful
and addresses all the relevant issues of prevalent diseases, production
problems, uses of wormers, vaccines and other medicines is a hugely
time consuming, difficult and intricate task. In depth knowledge
of the individual farm and farmer as well as historical, current
disease status etc. is required before commencing. In my professional
capacity the construction of HP's is one of the most challenging
areas. Whilst others in the industry can help create HP's, if
POMS are incorporated I would regard veterinary involvement as
a must BUT all the effort is a waste of time unless an HP is used
and its impact on the Farming enterprise is monitored and updates
made. At present no FAS or HP incorporates a requirement for this.
I believe that this is the way forward to assess
the amount of disease present in our farms in the UK. Concerted
efforts need to be made by all parties. At present our farmers
just see HP as writing down what they already do. An enormous
amount of education needs to be done with farmers reference the
real benefits of HP's. Who will monitor them for assessment of
improvement/deterioration. Should standards be set? Some vets
argue that if it was to be `own vet' enforcing standards there
could be a conflict of interest however, if we have created the
plan we should oversee its' implementation. Periodically there
could always be external verification as was used for a similar
scheme in the pig industry.
SVS
All of the vets in the practice now have LVI
status to be able to carry out work for DEFRA. Most is routine
testing for TB (every four years) and Brucellosis (every two years).
It was demonstrated in the FMD outbreak of 2001 how vital the
resource of vets in practice can be. Three vets from my practice
went on rotation to DEFRA as TVI's. In addition, within the practice
huge amounts of work both paid and unpaid was generated by DEFRA.
Many vets feel that they were `left out of the loop' on numerous
occasions such as when press announcements were made, we were
bombarded by our farmers for information which DEFRA did not make
available to us. In essence it would seem that DEFRA want us when
they need us but not for the rest of the time. We perform many
other LVI duties some of which are paid for by DEFRA some of which
are paid for by the client. We advise on many other issues unpaid.
TYPES OF
LA PRACTICE
I recognise our Beef and Sheep practice is at
the sharp end of the problem compared to Dairy large animal practice,
for a number of reasons :
(1) Dairy practices have many clients within
a short distance due to the intense stocking of dairy cows. Beef
farms are more extensive, more travelling, fewer visits.
(2) Routine veterinary visits are common
for dairy farms—many animals seen on one visit occurring
on weekly/fortnightly/monthly basis, compared to extensive beef
farming where individual animals are often required to be seen.
(3) Dairy cows are much quieter and used
to being handled. Increasingly beef cows are becoming dangerous
to work with—far removed from the quiet temperament of Hereford
X cows that used to be present on farms.
(4) Much more research is done into dairy
cows, mastitis, nutrition. Easier for vets to investigate a problem
and provide solutions due to the amount of information available.
(5) Many practices say they never see sheep—this
has real consequences for animal welfare and the sheep industry.
(6) In essence, Beef and Sheep vet work
is physically hard, dirty, dangerous and mentally taxing with
large responsibilities.
We are part of the local community employing
seven other people from the locality. We hold farmer meetings,
provide vet cover for local shows, attend at Kelso races and many
other events. I am also participating in a local farmer initiative
to control sheep scab in the Cheviot Hills. All of these will
be lost if the number of LA vets is allowed to decline still further.
Whilst I fully appreciate the economics of competition and the
view that a free market economy is best—what price animal
welfare ? If farmers are allowed to continue to ignore it because
of economics, then they will. I remain a committed LA vet but
I wonder for how long?
25 April 2003
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